Staging is a term used to describe how far cancer cells may have spread within the body and helps determine the best type of treatment. The most common way of describing this is called the TNM system and is based on the results of surgery, scans, and blood tests.

T stands for Tumour Size
This describes how big the cancer is within the penis. The size is given a number from 1 to 4:

T0: No cancer.
Tis: Cancer is only in the very top layer of the skin.
Ta: A type of cancer that looks like a wart and doesn’t grow deeper into the skin.
T1: Cancer has grown into the deeper layers of the skin or the tissue just under the skin.
T2: Cancer has spread into the area of the penis that includes the head (corpus spongiosum).
T3: Cancer has spread into the chambers that help with erections.
T4: Cancer has spread to other areas beyond the penis, such as the scrotum.

N stands for Lymph Nodes

Lymph nodes are small, oval-shaped structures found throughout the body that help filter out harmful substances. Cancer cells can spread and get trapped in these nodes.

N0: No cancer is found in the lymph nodes.
N1: One or two lymph nodes in the groin contain cancer.
N2: More than one lymph node contains cancer, either in one or both groins.
N3: Cancer has spread from the lymph node into nearby tissues, or cancer is found in pelvic lymph nodes.

M stands for Metastases
This refers to cancer that has spread to other parts of the body.

M0: The cancer has not spread to other organs or tissues.
M1: The cancer has spread to other organs or tissues, such as the lungs or bones.

Grading
Penile cancer can also be graded based on how different the cancer cells look under a microscope compared to normal tissue.

G1: Cancer cells look somewhat like normal tissue (low grade).
G2: Cancer cells look less like normal tissue (intermediate grade).
G3: Cancer cells look very different from normal tissue (high grade).

Stages
Penile cancer can be divided into four stages based on how far it has spread:

Stage 0: Cancer is only in the top layers of the skin.
Stage 1: Cancer has grown deeper into the skin, is low grade, and hasn’t spread to lymph nodes or other parts of the body.
Stage 2: Cancer has grown deeper into the skin or other parts of the penis, is high grade, but hasn’t spread to lymph nodes or other parts of the body.
Stage 3: Cancer has grown deeper into the penis and has spread to lymph nodes, but not to other parts of the body.
Stage 4: Cancer has spread deeper into the penis, affected nearby organs, and spread to lymph nodes and other parts of the body.

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