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Chemotherapy (chemo) is the use of drugs to treat cancer. Chemo is sometimes used to treat penile cancer.

Two types of chemotherapy can be used in treating penile cancer:

• Topical chemo
• Systemic chemo

Topical chemotherapy is the use of drugs applied directly to the skin. This is described in Local Treatments (Other Than Surgery) for Penile Cancer.

Systemic chemotherapy

Systemic chemo uses cancer-killing drugs that are injected into a vein or given by mouth. These drugs go through the bloodstream and reach cancer cells throughout the body.

When is systemic chemotherapy used?

Chemotherapy might be used in different situations:

• Chemo might be used to shrink tumors before surgery to make them easier to remove. This is known as neoadjuvant therapy.
• Chemo might be given after surgery (called adjuvant therapy), possibly along with radiation therapy, to help keep the cancer from coming back, especially if it wasn’t given before surgery.
• Chemo is often the main treatment for penile cancers that have spread to distant parts of the body.

Doctors give chemo in cycles, with each cycle of treatment followed by a rest period to give the body time to recover. Chemo cycles generally last about 3 to 4 weeks.

Which chemo drugs are used to treat penile cancer?

Some of the drugs used to treat penile cancer include:

• Cisplatin
• Fluorouracil (5-FU)
• Paclitaxel
• Ifosfamide
• Mitomycin C
• Capecitabine

Often, 2 or more of these drugs are used together. Some common combinations include:

• Cisplatin plus 5-FU
• TIP: paclitaxel (Taxol), ifosfamide, and cisplatin ("platinum")

Possible side effects of chemotherapy

Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body divide quickly, too, such as those in the bone marrow (where new blood cells are made), the lining of the mouth and intestines, and the hair follicles. These cells can also be affected by chemo, which can lead to some side effects.

The side effects of chemo depend on the type and dose of the drugs and how long they are used. Common side effects can include:

• Hair loss
• Mouth sores
• Loss of appetite
• Nausea and vomiting
• Diarrhea or constipation
• Increased chance of infections (from low white blood cell counts)
• Easy bruising or bleeding (from low blood platelet counts)
• Fatigue (from low red blood cell counts)

These side effects usually go away over time after treatment ends. There are often ways to lessen chemo side effects. For instance, you can get medicine to help prevent or reduce nausea and vomiting.

Side effects of certain chemo drugs

Some of the drugs used to treat penile cancer can have other side effects.

• Cisplatin and paclitaxel can cause nerve damage (neuropathy), which can lead to numbness and tingling in the hands and feet.
• Cisplatin can also cause kidney damage (nephropathy). Doctors give a lot of intravenous (IV) fluid with cisplatin to help prevent this.
• 5-FU and capecitabine can cause sores in the mouth (mucositis) that can make it hard to eat. These drugs can also cause diarrhea.
• Ifosfamide can damage the lining of the bladder (hemorrhagic cystitis). A drug called mesna is often given with ifosfamide to help keep this from happening.

Be sure to ask your doctor or nurse about ways to help reduce side effects. Let them know when you do have side effects so they can be managed.