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Penile, Prostate & Testicular Cancer Diagnosis & Treatment

There’s no better place for penile, prostate and testicular cancer care than Virginia Mason Franciscan Health. Our top outcomes are rooted in our team approach in which oncologists, nurses, dietitians, physical therapists and other care specialists work together to make a custom care plan for each person, giving them the best chance of a healthier tomorrow.

Penile, prostate and testicular cancer diagnosis

Penile cancer diagnosis

Diagnosis begins with a physical exam. It’s usually necessary to obtain a tissue sample, or biopsy, which can be performed using a needle to collect sample cells. Sometimes removal of the entire abnormal area, called a wide local excision, is selected. Once cancer is diagnosed, you may undergo a cystoscopy, a procedure in which a tiny camera is inserted through the opening of the penis and into the urethra and bladder. An MRI of the penis may also be performed to determine if the tumor has spread to the deeper structures of the penis.

Prostate cancer screening and diagnosis

The best way to diagnose prostate cancer is through screening during annual physical examinations. Screening involves:

  • A digital rectal exam, where doctors examine the prostate for signs of cancer
  • Prostate-specific antigen (PSA) blood test, where doctors test your blood for elevated levels of the PSA antigen, a sign of prostate cancer
  • Percent-free PSA ratio, another blood test to detect prostate cancer

If your doctor detects signs of prostate cancer during these screenings, he or she may request additional tests such as a transrectal ultrasonography (TRUS), which uses a probe to direct sounds waves onto the prostate, or a biopsy to remove tissue to test for cancerous cells.

Testicular cancer diagnosis

Testicular cancer diagnosis is confirmed by physical exam and ultrasound and supplemented by blood tests that indicate tumor markers, though not all types of testicular cancer tumors produce blood markers. Unusual lumps in the testicle itself are generally cancerous.

Penile, prostate and testicular cancer treatment

Penile cancer treatment

Men with early-stage penile cancer that has not spread to the glands or lymph nodes have a good chance of long-term survival (80 percent survival at five years from diagnosis). Survival decreases when the cancer has spread to the lymph nodes in the groin or pelvic region. Treatment options for penile cancer include:

  • Surgery

    Surgery is the most common treatment for penile cancer. Virginia Mason Franciscan Health offers the latest surgical techniques for treating cancer while sparing normal tissues, including: 

    • Mohs surgery: A procedure in which the area of cancerous skin cells is removed layer by ultra-thin layer, until no more cancer cells are seen in the removed tissue under a microscope. The treatment is ideal for early-stage, skin-based cancers, leaving as much normal tissue intact as possible.

    • Surgeries using lasers or freezing: Lasers use a beam of intense light to destroy a surface lesion or other cancerous tissue. Abnormal tissue can also be destroyed by freezing, known as cryotherapy.

    • Circumcision: Removal of the foreskin of the penis.

    • Wide local excision: Cancerous tissue plus a margin of normal tissue around it are removed.

    • Lymph node removal: The latest techniques to selectively "map" cancerous lymph nodes help ensure the least invasive surgical option is chosen. 

  • Radiation therapy

    Radiation can be used in combination with surgery, or alone. External beam radiation therapy delivers high-energy X-rays by machine outside the body. Internal radiation therapy is placed inside the body in the form of radioactive seeds, wires or catheters to destroy cancer cells. A new class of drugs called radiosensitizers is now being used and studied, which work to make cancer cells more sensitive to radiation.

  • Chemotherapy

    Chemotherapy uses special cancer-killing drugs delivered intravenously or directly to the area being treated. The type and stage of cancer will determine how chemotherapy is administered.

Prostate cancer treatment

Treatment options generally depend on whether cancer is local (early) or distant (metastatic). 

  • Local prostate cancer

    For local prostate cancer, doctors may use many different treatment methods, including:

    • Brachytherapy, in which radioactive “seeds” are implanted into the prostate to deliver a high dose of radiation to the tumor while sparing the surrounding tissues. 

    • Cryosurgery (also called cryotherapy or cryoablation) is the process of eliminating prostate cancer by freezing cancer cells with a metal probe.

    • Expectant therapy, also called active surveillance, means doctors monitor tumors closely, and will eventually begin treatment if tumors grow.

    • Radiation therapy uses high-energy X-rays from a linear accelerator directed at the prostate or emitted from radioactive seeds implanted in the prostate to kill cancer cells.

    • Radical prostatectomy removes the prostate and seminal vesicles. When cancer is confined within the tissues, surgery alone can cure localized prostate cancer.

  • Distant (metastatic) disease

    Treatment options include:

    • Hormone therapy helps block testosterone, significantly slowing prostate cancer cells’  ability to grow. Doctors may also use intermittent hormonal therapy, in which doctors closely monitor your PSA levels, only administering hormone therapy when they start to rise.

    • Antiandrogen pills inhibit prostate cancer by blocking the body’s ability to use androgens.

    • Chemotherapy destroys cancer cells. Traditionally, chemotherapy is used for patients who have prostate cancer cells that have spread and after hormonal therapy has failed. However, chemotherapy is being evaluated in research settings for earlier-stage disease to see if it can be effective for patients at high risk for spread outside the prostate.

Testicular cancer treatment

Virtually all testicular cancer patients at Virginia Mason Franciscan Health will be cured. 

Testicular cancer is rare, so most medical facilities see just one or two cases per year. Men with testicular cancer are best served by multidisciplinary centers like ours that see 30 to 50 testicular cancer cases each year and have teams of highly skilled specialists with the experience to customize treatment for each person. Many of the national and international guidelines for treating testicular cancer come from the work of our experts, who also lead and participate in testicular cancer research studies.

Surgery, radiation and chemotherapy are all options in the treatment of testicular cancer. The surgical expertise at Virginia Mason Franciscan Health is unequaled in the Pacific Northwest. Christopher Porter, MD,  is one of the few urological surgeons in the country specializing in testicular cancer. Nerve sparing and resectioning of tissue are routinely done to minimize the effect of surgery on patients.

Penile, prostate and testicular cancer second opinions

If you’ve been diagnosed with penile, prostate or testicular cancer, learn more about second opinions and how they may help you find all your available treatment options.

Penile, prostate and testicular cancer research and clinical trials

Virginia Mason Franciscan Health is a leader in cancer research. Learn more about research and clinical trial options.

Penile, prostate and testicular cancer wellness and support

Cancer treatment includes more than just treating physical symptoms. Learn more about our comprehensive wellness and support services.

Penile, prostate and testicular cancer specialists

To learn more about penile, prostate and testicular cancer or to make an appointment, find a specialist near you.