Urethral cancer is a disease in which malignant (cancer) cells form in the tissues of the urethra. The urethra is the tube that carries urine from the bladder to outside the body. In men, the urethra also carries semen. Urethral cancer is a rare cancer that occurs more often in men than in women.

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 (cancer):

  • Squamous cell carcinoma is the most common type of urethral cancer. It forms in cells in the part of the urethra near the bladder in women, and in the lining of the urethra in the penis in men.
  • Transitional cell carcinoma forms in the area near the urethral opening in women, and in the part of the urethra that goes through the prostate gland in men.
  • Adenocarcinoma forms in the glands that are around the urethra in both men and women.

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.

Signs & Symptoms

These and other signs and symptoms may be caused by urethral cancer or by other conditions. There may be no signs or symptoms in the early stages. Check with your doctor if you have any of the following:

  • 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

Treatment

There are four types of standard treatment. Your OHC doctor will help you determine the best care plan for you.

  • Surgery to remove the cancer is the most common treatment for cancer of the urethra. One of the following types of surgery may be done:
    • Open excision: Removal of the cancer by surgery
    • Transurethral resection (TUR): Surgery to remove the cancer using a special tool inserted into the urethra
    • Electroresection 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.

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 lower the risk that the cancer will come back, is called adjuvant therapy.

  • Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
  • 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. The way the chemotherapy is given depends on the type and stage of the cancer being treated.
  • Active surveillance is following a patient’s condition without giving any treatment unless there are changes in test results. It is used to find early signs that the condition is getting worse. In active surveillance, patients are given certain exams and tests, including biopsies, on a regular schedule.