Chemotherapy for penile cancer

Chemotherapy uses drugs to destroy cancer cells. These drugs target rapidly dividing cells throughout the whole body. This means that chemotherapy kills cancer cells but it can also damage healthy cells.

If you have chemotherapy, it may be the only treatment you have or it may be used along with other cancer treatments. Your healthcare team will use what they know about the cancer and about your health to plan the drugs, doses and schedules.

Chemotherapy for penile cancer can be given in 2 ways.

When given regionally as a lotion, cream or ointment, the drug only affects the skin area where it is applied. This is called topical chemotherapy. It’s often used for stage 0 penile cancer.

With most types of chemotherapy, the drugs travel through the blood to reach and destroy cancer cells all over the body, including cells that may have broken away from the primary tumour. This is described as systemic chemotherapy. It is sometimes used for advanced penile cancer that has spread to the lymph nodes or other parts of the body.

You may have systemic chemotherapy to:

• shrink a tumour before other treatments (called neoadjuvant chemotherapy) such as surgery or radiation therapy
• destroy cancer cells left behind after surgery and reduce the risk that the cancer will come back (recur) (called adjuvant chemotherapy)
• relieve pain or control the symptoms of advanced penile cancer (called palliative chemotherapy)

Chemotherapy and radiation therapy may be given during the same time period to treat penile cancer. This is called chemoradiation. Some chemotherapy drugs can help make radiation work better by making cancer cells more sensitive to radiation. Combining chemotherapy and radiation therapy can be more effective than either treatment on its own.

Topical chemotherapy for penile cancer is usually given as a cream. It is applied directly to the abnormal area repeatedly for several weeks. It’s mostly given for stage 0 penile cancer, including penile intraepithelial neoplasia (PeIN).

The most common topical chemotherapy drug for penile cancer is fluorouracil (also called 5-fluorouracil or 5-FU).

Your healthcare team will show you how to apply the cream. They will also let you know if there is anything you should know after applying it, such as how long you should wait before touching the area or having sex.

Most systematic chemotherapy for advanced penile cancer is given by a needle into a vein (intravenously, or by IV) or directly into the abdomen (called intraperitoneal or IP chemotherapy).

The most common systemic chemotherapy drugs used to treat advanced penile cancer are:

• cisplatin
• carboplatin
• fluorouracil
• paclitaxel
• ifosfamide

The most common systemic chemotherapy drug combinations used to treat advanced penile cancer are:

• paclitaxel, ifosfamide and cisplatin (TIP)
• cisplatin and fluorouracil
• carboplatin and fluorouracil

Side effects of chemotherapy will depend mainly on the drug, the dose, how it’s given and your overall health. Tell your healthcare team if you have side effects that you think are from chemotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

The side effects of topical chemotherapy are very different from those of systemic chemotherapy.

Common side effects of topical fluorouracil for penile cancer include:

• red, itchy skin in the treated area
• burning and pain in the treated area
• swelling (edema)
• discharge from the wound

Common side effects of systemic chemotherapy drugs for penile cancer include:

• low blood cell counts
• weakened immune system
• infection
• low platelet count
• hair loss
• fatigue
• nausea and vomiting
• sore mouth and throat
• loss of appetite
• diarrhea
• nerve damage (neuropathy)
• skin problems
• kidney problems
• bladder problems

Find out more about chemotherapy and side effects of chemotherapy. To make the decisions that are right for you, ask your healthcare team questions about chemotherapy.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.