Last Modified : 2006-03-31
The urethra is the tube that carries urine from the bladder to outside the body. In women, the urethra is about 1½ inches long and is just above the vagina. In men, the urethra is about 8 inches long, and goes through the prostate gland and the penis to the outside of the body. In men, the urethra also carries semen.
Urethral cancer is a rare cancer that occurs more often in women than in men. There are different types of urethral cancer that begin in cells that line the urethra. These cancers are named for the types of cells that become malignant (cancerous):
Urethral cancer can metastasize (spread) quickly to tissues around the urethra and is often found in nearby lymph nodes by the time it is diagnosed.
Age and a history of bladder cancer can affect the risk of developing urethral cancer.Risk factors include the following:
These and other symptoms may be caused by urethral cancer. Other conditions may cause the same symptoms. Sometimes early cancer of the urethra does not cause any symptoms at all. A doctor should be consulted if any of the following problems occur:
The following tests and procedures may be used:
The prognosis (chance of recovery) depends on the following:
Treatment options depend on the following:
The process used to find out if cancer has spread within the urethra or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following procedures may be used in the staging process:
Urethral cancer is staged and treated based on the part of the urethra that is affected and how deeply the tumor has spread into tissue around the urethra. Urethral cancer can be described as anterior or posterior.
Anterior urethral cancerIn anterior urethral cancer, the tumors are not deep and they affect the part of the urethra that is closest to the outside of the body.
Posterior urethral cancerIn posterior urethral cancer, the tumors are deep and affect the part of the urethra closest to the bladder. In women, the entire urethra may be affected. In men, the prostate gland may be affected.
The following stages are also used to describe urethral cancer:In stage 0, cancer is found only in the inside lining of the urethra. Stage 0 is also called carcinoma in situ.
Stage AIn stage A, cancer has spread into the layer of tissue beneath the lining of the urethra.
Stage BIn stage B, cancer is found in the muscle around the urethra. In men, the penile tissue surrounding the urethra may be affected.
Stage CIn stage C, cancer has spread beyond the tissue surrounding the urethra, and:
Stage D is divided into stage D1 and stage D2, based on where the cancer has spread.
A small number of patients who have bladder cancer are also diagnosed with cancer of the urethra, or will develop it in the future.
Recurrent urethral cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the urethra or in other parts of the body.
Different types of treatments are available for patients with urethral cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.
Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.
Three types of standard treatment are used:Surgery is the most common treatment for cancer of the urethra. One of the following types of surgery may be done:
If the urethra is removed, the surgeon will make a new way for the urine to pass from the body. This is called urinary diversion. If the bladder is removed, the surgeon will make a new way for urine to be stored and passed from the body. The surgeon may use part of the small intestine to make a tube that passes urine through an opening (stoma). This is called an ostomy or urostomy. If a patient has an ostomy, a disposable bag to collect urine is worn under clothing. The surgeon may also use part of the small intestine to make a new storage pouch (continent reservoir) inside the body where the urine can collect. A tube (catheter) is then used to drain the urine through a stoma.
Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to increase the chances of a cure, is called adjuvant therapy.
Radiation therapyRadiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
Watchful waitingWatchful waiting is closely monitoring a patient’s condition without giving any treatment until symptoms appear or change.
New types of treatment are being tested in clinical trials. These include the following:Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.
Treatment of anterior urethral cancer is different for men and women.
For women, treatment may include the following:
For men, treatment may include the following:
Treatment of posterior urethral cancer is different for men and women.
For women, treatment may include the following:
For men, treatment may be radiation therapy followed by surgery (cystoprostatectomy, penectomy, lymph node dissection, and urinary diversion).
Treatment of urethral cancer that develops with invasive bladder cancer may include the following:
Treatment of recurrent urethral cancer that comes back near the urethra depends on the type of treatment the patient received before, as follows:
Treatment of recurrent urethral cancer that comes back in distant parts of the body is usually a clinical trial of chemotherapy.
This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.