Cases of penile cancer have risen by 20% in the last three decades and there are huge concerns that men’s symptoms are being misdiagnosed as a sexually transmitted infection. The fears come as 58-year-old Nigel Smith, from Wolverhampton, almost lost his life from a misdiagnosis. Mr Smith was told he merely had a genital wart that would eventually go away. He managed to hide the symptoms from his wife for a whole year by sleeping in another room and blaming his snoring. In 2011 Mr Smith was eventually told he had penile cancer and last year underwent a partial penectomy (a removal of part of the penis), now left with the daunting possibility of having to go through reconstructive surgery. He said: “If my GP had sent me to a urologist rather than a sex clinic, the cancer could have been diagnosed at stage 1 and treated. By the time I saw a urologist, the cancer was stage 3 – one stage away from terminal. I’m now in temporary remission but there’s a 50/50 chance that the disease will return as a secondary cancer – maybe in my lungs or liver.” Mr Smith is clearly distressed he was not diagnosed early enough, and speaks of the impact it has had on his marriage, adding: “Every time I go to the toilet I have a painful reminder of what’s happened, so it’s hard to put things behind me. The sexual side of my marriage has ended. I’m 60 but I’m a young 60! It shouldn’t be the end yet. The psychological impact of it all is massive. It’s more traumatic than anyone who hasn’t been through this can know. I didn’t talk about my symptoms for so long and hid them from my wife. It’s a man thing; we ignore things and hope they’ll go away. If you find something, you need to get it looked at.” Despite the number of cases going up in the last 30 years, penile cancer is usually incredibly rare, with only around 550 new cases diagnosed each year in the UK – most commonly in men over the age of 50. The new research, supported by the male cancer charity Orchid, has been published in the journal Cancer Causes Control and provides an interesting insight into a rare disease that is still not well known amongst men. Orchid chief executive, Rebecca Porta says: “The research shows that the incidence of this devastating cancer, which currently receives little recognition, is on the increase. Unlike other more common cancers, penile cancer is rare and many men feel embarrassed and unable to talk openly about it. This can lead to feelings of isolation at a time when support is vital. It is very important that men are aware of the warning signs and symptoms of the disease and that those with worrying symptoms seek medical advice as soon as possible.” Symptoms of the cancer include: .  A painless lump or ulcer on the penis that doesn't heal. . A red rash underneath the foreskin. . Bleeding. . Change in colour of the skin. . Difficulty in drawing back the foreskin (phimosis). . Discharge from under the foreskin with an odour. . Flat growths that are brown in colour. . Swollen lymph nodes in your groin area. The causes of penile cancer have not yet been fully established, but certain factors are believed to increase your risk of developing the disease. For instance, men who smoke are at a heightened risk of cancer of the penis, whilst men with Human Papilloma Virus (HPV) infection could be as much as a six-fold risk of penile cancer. In addition, conditions like phimosis, where the foreskin sometimes cannot retract, can mean there is a chance of infections developing such as balanitis. For more information about the often misunderstood penile cancer, visit http://www.orchid-cancer.org.uk/Penile-Cancer