Radiation therapy for penile cancer

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It’s sometimes used to treat penile cancer. Your healthcare team will use what they know about the cancer and about your health to plan the type and amount of radiation, and when and how it’s given.

You may be offered radiation therapy instead of surgery to keep the penis or if surgery can’t be done for medical reasons.

You may have radiation therapy to:

• treat early-stage penile cancer
• treat lymph nodes in the groin (inguinal lymph nodes) when surgery can’t be done
• treat lymph nodes in the pelvis
• shrink a tumour before surgery (called neoadjuvant therapy)
• relieve pain or control the symptoms of advanced penile cancer (called palliative therapy)

The doctor will usually remove your foreskin (called circumcision) before any radiation therapy for penile cancer unless you are already circumcised. Removing the foreskin helps the radiation reach the tumour more effectively and also reduces treatment-related side effects, such as swelling and inflammation of the head of the penis (glans).

Radiation therapy and chemotherapy 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.

During external radiation therapy, a machine directs radiation through the skin to the tumour and some of the tissue around it. External radiation therapy is also called external beam radiation therapy.

A mould or special device is often used to keep the penis in place during external beam radiation therapy.

A shield may be used to minimize radiation exposure to the testicles. This helps protect your fertility.

Brachytherapy is a type of internal radiation therapy. A sealed container of a radioactive substance, called an implant, is placed into the tumour or next to it. The radiation kills the cancer cells over time.

Brachytherapy is usually used to treat low-grade penile tumours that are smaller than 4 cm when surgery can’t be done.

There are different ways that brachytherapy can place an implant. Interstitial brachytherapy is most often given for penile cancer. It uses thin, hollow needles to place the implant directly into the tumour.

An interstitial brachytherapy may be given along with external radiation therapy.

Find out more about internal radiation therapy.

During radiation therapy, your healthcare team protects healthy cells in the treatment area as much as possible. Side effects of radiation therapy will depend mainly on the size of the area being treated, the specific area or organs being treated, the total dose of radiation and the treatment schedule. Tell your healthcare team if you have side effects that you think are from radiation therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

These are common side effects of radiation therapy for penile cancer:

• skin problems
• fatigue
• nausea and vomiting
• diarrhea
• difficulty passing urine
• reduced blood flow to the penis
• swollen penis
• blood clots
• narrowing of the urethra
• lymphedema
• sexual problems, such as erectile dysfunction
• fertility problems

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