In order to find out whether or not you have penile cancer, your doctor will do a physical exam and ask about your personal history. The physical exam includes checking your penis, testicles, groin, and abdomen.
Your doctor will need to take a biopsy, which is a small sample of tissue. The type of biopsy the doctor does depends on what he or she sees on your genitals. A local anesthetic is usually given for a biopsy. The doctor may do an excisional biopsy, which removes a whole lesion. Or, if the abnormal area is larger than about 1 centimeter (about 3/8 inch), the doctor may do an incisional biopsy, which removes only part of a lesion.
Fine needle aspiration (FNA) is another type of biopsy that can be done in a doctor's office or clinic. Doctors often use it to see if enlarged lymph nodes in the groin contain cancer. FNA is not used to take a biopsy from the penis itself. During FNA, you may need local anesthesia injected into your skin of your groin, but you may not need it in some cases. To take the biopsy, your doctor will place a thin needle directly into the lymph node for about 10 seconds and withdraw cells and a few drops of liquid.
After the biopsy, your doctor will send the removed tissue to a pathologist. A pathologist is a specialist who will use a microscope to check the tissue for cancer cells.
If the pathologist finds cancer, your doctor will probably order more tests to help decide which treatment plan would be best for you. These tests can also help stage the cancer to see if it has spread.