Any combination of phimosis and balanitis in adult men is suspect of cancer. The phimosis should be corrected surgically to facilitat washing and inspection of the glans.
The earliest symptoms in men with a normally movable prepuce are ulcers, warts, redness, itching, burning, scab formation, or discomfort.
Later, ulceration of the glans or prepuce starts. During the tumor growth, the surface will become necrotic. This will then be infected with anaerobic bacteria causing a foul smell, especially in the presence of phimosis.
Pain is not dominating with penile cancer, but in younger men, very intense pain from touch may be prominent.
It is not uncommon for a primary tumor to go unnoticed due to phimosis, or that the tumor is not visible (cis). The patient usually seeks medical help after a metastatic tumor in the groin can be seen or felt.