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Grading and staging of penile cancer

If cancer cells are found during any of your tests, your doctor will need to know the tumour grade and stage so your team of health professionals can develop the best treatment plan for you. The grade of the cancer lets your doctor know how quickly the cancer might grow and spread while the stage of the cancer describes its size and whether it has spread.


Penile cancer is graded from 1 to 3 with 1 being the lowest grade and 3 being the highest grade. Low-grade means that the cancer cells are slow growing and less likely to spread. High-grade means that the cancer cells grow more quickly and are more likely to spread.


Staging describes where the cancer is and how far the cancer has spread. Knowing the stage helps doctors plan the best treatment for you. There are several staging systems for penile cancer, but the one most commonly used is the TNM staging system.

T (tumour)describes the size and extent of the main tumour. Refers to if the cancer is in situ or penile intraepithelial neoplasia (Tis) and in only the top layer of skin; is like a wart (Ta) but only in the top layer of skin; has grown into tissue just below the top layer of skin but not any further (T1a); has grown into blood vessels, lymph vessels or nerves in the layers of the penis (T1b); has spread into the spongy tissue of the penis and/or the urethra (T2); has grown more deeply into the penis and/or urethra (T3); has spread further into the penis, urethra or scrotum (T4)
N (nodes)describes if cancer has spread to nearby lymph nodes. No spread (N0) or spread to one or more lymph nodes (N1, N2, N3)
M (metastasis)describes if cancer has spread to other parts of the body. No spread (M0) or spread to other organs or bones (M1)

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This information is reviewed by

This information was last reviewed February 2021 by the following expert content reviewers: Gregory Bock, Urology Cancer Nurse Coordinator, WA Cancer and Palliative Care Network, North Metropolitan Health Service, WA; Dr Mikhail Lozinskiy, Consultant Urologist, Royal Perth Hospital, WA; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; Prof Manish Patel, Urological cancer surgeon, University of Sydney, Westmead and Macquarie University Hospitals, Sydney, NSW; Walter Wood, Consumer; Dr Carlo Yuen, Urologist, St Vincent’s Hospital, Sydney, Conjoint Senior Lecturer UNSW.