Urethral Cancer

Urethral cancer at a glance

  • Urethral cancer is the growth of malignant cells in tissues of the urethra, the tube that carries urine from the bladder and out of the body.
  • Urethral cancer is an extremely rare tumor, and makes up only 1­–2 percent of urologic cancers.
  • It occurs most frequently in older women and people who have had bladder cancer.
  • Doctors most often treat urethral cancer by removing it surgically.

What is urethral cancer?

Senior Woman Diagnosed with Urethral CancerThe urethra is part of the urinary tract. Urine passes through the urethra from the bladder to leave the body. The female urethra is about 1.5 inches long and opens just above the vagina. The male urethra is about 8 inches long and passes through the prostate and penis. The male urethra also carries semen.

Urethral cancer is a disease that occurs when malignant cells grow in the urethra’s tissues. It is a rare cancer, making up just 1 to 2 percent of all urologic cancers. Men or women can have urethral cancer, but it affects women most often. Urethral cancer is most common in Caucasian females age 60 or older.

Urethral cancer can also spread (metastasize) to other tissues around the urethra and often can be found in lymph nodes near the urethra.

There are three types of urethral carcinomas (a cancer that begins in the tissues lining the body’s surfaces). These carcinomas are identified according to the types of cells in which they begin to grow.

  • Squamous cell carcinoma forms in cells lining the urethra, inside men’s penises and near the bladder in women; it is the most common urethral cancer.
  • Transitional cell carcinoma also forms in cells in the urethra, near its opening in women and in the area of the urethra surrounded by the prostate in men.
  • Adenocarcinoma forms in both men and women in the glands that are around the urethra.

Risk factors for urethral cancer

Doctors and researchers don’t know what causes urethral cancer. Risk factors may include:

  • Having had bladder cancer previously
  • Suffering from chronic inflammation due to sexually transmitted infections (STIs) or chronic urinary tract infections (UTIs)
  • Having HPV (human papilloma virus)
  • For men, being treated for urethral stricture disease
  • For women, having had urethral caruncle or urethral diverticulum.

Symptoms of urethral cancer

At first, urethral cancer might not cause symptoms. Later, people may notice painful urination or blood in the urine. If a tumor (a lump or growth) becomes large enough, it might narrow the urethra, making it difficult to urinate.

Men or women should see a doctor if they experience:

  • Blood in urine
  • Bleeding or other discharge from the urethra
  • Frequent urination
  • “Stop-and-go” urine flow or especially weak flow
  • Any unusual thickness or lump in the groin, penis or perineum.

Other conditions besides urethral cancer could cause these symptoms. People should check with their doctor to find the cause of these symptoms.

Treatment of urethral cancer

Doctors begin with a physical examination to help diagnose urethral cancer. The urologist will send a urine sample to a laboratory to look for unusual cells.To confirm a diagnosis, the urologist will commonly use a lighted instrument called a cystoscope to view the inside of the urethra. The doctor also might biopsy the tissue (collect a sample) and send it to a laboratory for examination.

To confirm a diagnosis, the urologist will commonly use a lighted instrument called a cystoscope to view the inside of the urethra. The doctor also might biopsy the tissue (collect a sample) and send it to a laboratory for examination.If urethral cancer is present, more tests can identify the size of the cancer and whether it has spread to other areas of the body. These tests might include a CT scan, an MRI, a chest x-ray and perhaps a bone scan. The urologist also may order imaging of the kidney and the rest of the urinary tract.

If urethral cancer is present, more tests can identify the size of the cancer and whether it has spread to other areas of the body. These tests might include a CT scan, an MRI, a chest x-ray and perhaps a bone scan. The urologist also may order imaging of the kidney and the rest of the urinary tract.

Treatment options

Doctors treat urethral cancer via surgery, radiation and/or chemotherapy.

  • Surgery is the most common way to remove urethral cancer. Surgeons can remove some tumors without an incision, using electric current or laser tools. Others require conventional surgery. To remove larger tumors, the surgeon may need to remove additional parts of the urinary tract. In this case, the surgeon will create a new way for the body to store and pass urine.
  • Radiation therapy uses high-energy radiation (like x-rays) to kill cancer cells. Radiation may come from a machine outside the patient’s body. Some radiation treatments are implanted or injected.
  • Chemotherapy kills cancer cells with powerful drugs. Doctors often prescribe chemotherapy to treat a cancer that has spread (called a metastatic tumor). Sometimes, doctors use chemotherapy to shrink a tumor before surgery.

After surgery, doctors might use radiation or chemotherapy (or both) to complete the process of eliminating the tumor.