Penile cancer: current challenges.

Penile cancer remains a formidable challenge in many developing countries because of its high incidence and the advanced disease stage at diagnosis. For early penile cancer, surgery alone offers a high cure rate. Penile sparing therapies are proposed as alternative treatment options for select patients with the added advantages of preservation of body image and improved quality of life. The optimal management of lymph node disease remains controversial. The role of the sentinel lymph node biopsy, lymphatic mapping, prophylactic lymphadenectomy and the template for lymph node dissection are discussed. For advanced, metastatic penile cancer, more effective and less toxic chemotherapy is needed. This may be coupled with palliative surgery or radiotherapy for the primary tumor and inguinal disease.