Urethral cancer is a disease in which malignant (cancer) cells form in the tissues of the urethra and it is a rare cancer that occurs more often in men than in women. A history of bladder cancer can affect the risk of urethral cancer.

What is the Urethra?

The urethra is a hollow tube that lets urine pass from the bladder, the organ that stores urine until ready for release, to the outside of the body. In men the urethra is about 8 inches long and passes through the prostate to the end of the penis. In women the urethra is about 1.5 inches long and opens to the outside just above the vaginal opening.

Types of Urethral Cancer

Squamous cell carcinoma: The most common type of urethral cancer forms in the cells near the urethral opening.

Transitional cell carcinoma: This type of urethral cancer forms in the area near the bladder in women, and in the part of the urethra that goes through the penis and prostate gland in men.

Adenocarcinoma: This type of urethral cancer forms in glands near the urethra in both men and women.

Urethral Cancer Risk Factors

Age: Urethral cancer occurs more frequently in people over the age of 50.

History of bladder cancer: Urethral cancer is more common in individuals with a previous diagnosis of bladder cancer.

Caucasian

History of any condition that causes chronic inflammation in the urethra including frequent urinary tract infections and Sexually transmitted diseases (STDs), including human papillomavirus (HPV), especially HPV type 16.

Signs and Symptoms 

  • Trouble starting the flow of urine.
  • Weak or interrupted (“stop-and-go”) flow of urine.
  • Frequent urination, especially at night.
  • Incontinence.
  • Discharge from the urethra.
  • Bleeding from the urethra or blood in the urine.
  • A lump or thickness in the perineum or penis.
  • A painless lump or swelling in the groin.

Diagnosis

Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits, past illnesses and treatments will also be taken.

Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. A speculum is inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease

Digital rectal exam: An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual.

Urine cytology: A laboratory test in which a sample of urine is checked under a microscope for abnormal cells

Urinalysis: A test to check the color of urine and its contents, such as sugar, protein, blood, and white blood cells. If white blood cells (a sign of infection) are found, a urine culture is usually done to find out what type of infection it is.

Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body.

Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for number of red blood cells, white blood cells, and platelets, The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.

CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the pelvis and abdomen, taken from different angles.

Ureteroscopy: A procedure to look inside the ureter and renal pelvis to check for abnormal areas

Biopsy: The removal of cell or tissue samples from the urethra, bladder, and, sometimes, the prostate gland. The samples are viewed under a microscope by a pathologist to check for signs of cancer.

Chest x-ray: An x-ray of the organs and bones inside the chest.

MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of the urethra, nearby lymph nodes, and other soft tissue and bones in the pelvis

Urethrography: A series of x-rays of the urethra.

Treatment

Surgery

Open excision: Removal of the cancer by surgery.

Transurethral resection (TUR): Surgery to remove the cancer using a special tool inserted into the urethra.

Electro resection with fulguration: Surgery to remove the cancer by electric current. A lighted tool with a small wire loop on the end is used to remove the cancer or to burn the tumor away with high-energy electricity.

Laser surgery: A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove or destroy tissue.

Lymph node dissection: Lymph nodes in the pelvis and groin may be removed.

Cystourethrectomy: Surgery to remove the bladder and the urethra.

Cystoprostatectomy: Surgery to remove the bladder and the prostate.

Anterior exenteration: Surgery to remove the urethra, the bladder, and the vagina. Plastic surgery may be done to rebuild the vagina.

Partial penectomy: Surgery to remove the part of the penis surrounding the urethra where cancer has spread. Plastic surgery may be done to rebuild the penis.

Radical penectomy: Surgery to remove the entire penis. Plastic surgery may be done to rebuild the penis.

Radiation therapy

Radiation therapy uses high-energy, painless, and invisible X-rays to kill cancer cells. Radiation may be considered for patients whose tumors are too large to be completely removed effectively with surgery. 

Chemotherapy

Chemotherapy uses drugs to attack cancer cells, slowing or stopping their ability to grow and multiply. Chemotherapy may also be given:

  • Orally: taking pills or capsules by mouth
  • Intravenously (IV): injecting medication into a vein
  • Intramuscularly (IM): injecting medication into a muscle
  • Subcutaneously: injecting medication under the skin

Targeted Therapy

Targeted molecular therapy  is a type of personalized medical therapy designed to treat cancer by interrupting unique molecular abnormalities that drive cancer growth.

Active surveillance

Active surveillance is following a patient’s condition without giving any treatment unless there are changes in test results

After Treatment

Even after aggressive therapy with chemotherapy, radiation therapy and surgery, urethral cancer may come back. It is important to have lifelong follow-up visits with  health care team. It is important to catch recurrence early, so once or twice per year visits are recommended for:

If you still have your urethra you will need more frequent follow up visits. You are recommended to visit your doctor every 3 months after the procedure for:

Disclaimer: All contents on this site are for general information and in no circumstances, information be substituted for professional advice from the relevant healthcare professional, Writer does not take responsibility for any damage done by the misuse or use of the information.

References:

https://www.urologyhealth.org/ (UROLOGY CARE FOUNDATION)

https://www.pennmedicine.org/  (Penn Medicine’s Abramson Cancer)

https://www.cancer.gov/  (NIH)