What Is Urethral Cancer?

Urethral cancer is a disease in which abnormal cells reproduce rapidly and begin interfering with the organ’s normal operation. The latter is a hollow tube that drains urine from the bladder, through the male penis or the female vulvar vestibule. There are three kinds of urethral cancer, as defined by cell types and where they develop: squamous cell carcinoma, transitional cell carcinoma, and adenocarcinoma. A number of factors predispose individuals for urethral cancer, including having a sexually transmitted infection (STI) or bladder cancer. Men are at greater risk for this condition than women.

Urethral cancer is relatively rare, representing only one to two percent of all urologic cancers. It nevertheless poses a serious risk to health, with possible medical complications, including urinary dysfunction, and the threat of spreading to other parts of the body (metastasis). If you or a loved one is exhibiting urethral-cancer symptoms, the oncologists and other caring professionals at Baptist Health can help.

What Are the Symptoms of Urethral Cancer?

The following symptoms are used to identify urethral cancer:

• Bloody urine
• Urethral discharge
• Difficulties urinating
• Urinary pain or incontinence
• Tumorous growths on the genitals or between the genitals and anus (the perineum)
• Swollen lymph nodes in the groin.

Urethral cancer manifests in three forms. These are:

• Squamous cell carcinoma: This is the innermost version of the cancer, typically found in the urethra itself, including the male organs or close to the bladder in women. It is the most frequent form of the disease.
• Transitional cell carcinoma: The transitional-cell version of urethral cancer forms nearer the urinary exit. In women, this means the urethral opening in the vulvar vestibule and, in men, the prostate and its vicinity.
• Adenocarcinoma: This form of the cancer develops in the glands adjacent to the urethra in both men and women.

What Causes Urethral Cancer?

Medical science has yet to determine the cause or causes of urethral cancer. There is evidence that certain infections might play a triggering role in the disease.

The following factors appear linked to this condition:

• Urinary tract infections (UTIs) and other chronic sources of inflammation
• Sexually transmitted infections (STIs), including human papillomavirus (HPV)
• Medical conditions such as urethral strictures in men and urethral caruncles in women
• Being age 60 years or older
• Having bladder cancer.

African American males are especially susceptible to developing urethral cancer.

How Is Urethral Cancer Diagnosed?

Urethral cancer is diagnosed in the following manner:

• Physical exam: Your doctor will look you over for evidence of a cancerous growth. He or she will also ask questions about your medical history and possible risk factors.
• Digital rectal exam: This is a physical examination of the rectum and anal canal. Your nurse or physician will insert a gloved and lubricated finger, looking for out-of-place lumps and misshapen organs.
• Pelvic exam: A pelvic exam has the same purpose as the digital rectal exam. A doctor or nurse visually inspects a women’s vaginal canal and adjacent organs for signs of cancer. This can be done by finger insertion or with the use of a speculum.
• Ureteroscopy: Ureteroscopes are long, slender tubes with optical elements and cameras that physicians use for close inspection of possible tumor sites, including the urethra, bladder, ureters, and kidneys.
• Blood test: The blood test will measure a variety of factors present in the blood, including red cells, white cells, platelets, hemoglobin, and other compositional elements. Amounts that are outside of normal parameters are often signals of an underlying medical issue.  
• Urine test: This test provides evidence of urethral cancer by identifying the presence of white blood cells in urine, which is a sign of infection.
• Medical imaging: X-rays, CT scans, and magnetic resonance imaging (MRI) scans can aid in the diagnosis of urethral cancer, and whether it has metastasized – spread to other parts of the body.
• Biopsy: To confirm the presence of cancer, your physician will collect a tiny sample of any lesion he or she finds, called a biopsy. The biopsy will be sent to a medical lab for analysis. You will receive test results in a few days to a couple of weeks.

If you’ve developed urethral cancer, your physician or oncologist will assess its stage of development. He or she will determine the size and disposition of your primary tumor, whether it’s reached the nearby lymph nodes, and how extensively it has traveled to other parts of the body, if at all. Cancer stages are generally rated from 0 to 4, with stage 4 being the most advanced and therefore serious version of the disease.

How Is Urethral Cancer Treated?

The treatment of urethral cancer depends on a number of factors, including:

• The type of cancer and its location in the urethra
• Test results
• Your sex (male or female)
• The cancer’s stage of development
• Other concurrent medical conditions.

Also important is whether treatment is localized or systemic. A local treatment focuses on eliminating cancer from the urethra. A more systemic or generalized approach is reserved for situations in which the cancer has metastasized.

There are four primary methods for treating urethral cancer:

• Chemotherapy: Chemotherapy is the use of drugs to treat urethral and other cancers. Anticancer medications are sometimes deployed before surgery to shrink a tumor and after surgery to kill any remaining cancer cells in the breast. Chemotherapy is also used to attack cancers that have moved into other areas of the body.
• Radiation therapy: Radiation therapy utilizes high-energy X-rays or proton beams to destroy cancer cells. It is often used in conjunction with surgery and chemotherapy in the treatment of urethral cancer.
• Surgery: Excising a tumor by surgery is the most common form of treatment for urethral cancer. A wide range of surgeries are utilized, including the urethra’s removal from the body. In the latter case, the surgeon will create an alternative path for bladder evacuation, called a urinary diversion. Surgery is sometimes combined with other forms of cancer treatment, including radiation and chemotherapy.
• Active surveillance: Active surveillance is taking a wait-and-see approach to the treatment of urethral cancer. Your condition is monitored but untreated, unless or until a change in symptoms or test results makes clear the best means of addressing your cancer.

Treatment success depends on a number of factors, including how early or how late the cancer was diagnosed. In general, the earlier the detection, the greater the chance of beating the disease. Individuals who are treated for urethral cancer require monitoring for a possible recurrence.

How Is Urethral Cancer Prevented?

There is no certain means of preventing urethral cancer but you can protect yourself from sexually transmitted infections. STIs increase the likelihood of urethral cancer.

Learn More About Urethral Cancer from Baptist Health

Although rare, urethral cancer is potentially fatal, especially if diagnosed in a later stage of development. The oncologists and other medical experts at Baptist Health are part of your frontline defense against urethral cancer.