Cancer of the penis can occur anywhere along the penile shaft, but most are on the foreskin or head (glans). It is usually a slow-growing cancer and is curable if discovered early. Nearly all penile malignancies are cancers of the skin, the most common being squamous cell carcinoma, similar to squamous cell carcinomas on other parts of the skin such as the face or hands. Some penile cancers are melanomas, which appear as blue-brown flat growths and tend to spread more rapidly and more widely. Occasionally, the deep tissues of the penis develop cancer, typically sarcomas. The tumor spreads gradually becoming larger in the area of the skin where it first develops. Ultimately, it spreads to deep tissues inside the body of the penis and to lymph nodes in the groin (inguinal area) or pelvis. Cancer of the penis is, in a sense, a disease of poor hygiene. It is believed that the decaying cells of the undersurface of the foreskin (smegma) produce irritation leading to cancer. Penile cancer typically begins as a raised lump or lesion on the penis. It can begin more as an area of unexplained change in the color of the skin. Like most cancers, this is diagnosed by means of a biopsy. Treatment is determined by the tumor size and staging. If the tumor is small and local, it can be treated surgically, chemically, or with radiation or laser without major damage to the appearance or function of the penis. If it has penetrated the deeper penile tissues or is large, surgery is the preferred treatment for most men. Radiation is an option but results are less certain. If the tumor has spread to lymph nodes, surgery or radiation is used. Chemotherapy is of little value in ex.