Urethral cancer is a rare form of cancer that occurs more often in women. It begins in the cells that line the urethra but can spread throughout the urinary or reproductive system and to other parts of the body. Urethral cancers are named for the types of cells that become malignant (cancerous):
- Squamous cell carcinoma: The most common type of urethral cancer, it forms in cells in the part of the urethra near the bladder.
- Transitional cell carcinoma: Forms in the area near the urethral opening.
- Adenocarcinoma: Forms in the glands near the urethra.
Urethral cancer can spread quickly to tissues around the urethra and is often found in nearby lymph nodes by the time it is diagnosed. People with urethral cancer have more treatment choices and hope for survival than ever before as doctors continue to find new treatments options.
Who's at Risk of Urethral Cancer
Certain risk factors can make one person more likely to get urethral cancer than another. However, just because someone has one or more risk factors does not mean they will get urethral cancer. Risk factors for developing urethral cancer include:
- chronic irritation or inflammation of the urinary tract due to repeated urinary tract infections (UTIs) and/or sexually transmitted diseases (STDs)
- other cancers of the urinary tract (such as bladder cancer)
- human papillomavirus (HPV) infection or history of other STDs
- being a woman
- being age 60 or older
- being African American
Preventing Urethral Cancer
Urethral cancer is rare, so doctors are still determining how to prevent it. Reducing known risk factors such as repeated UTIs and STDs is the first step towards preventing urethral cancer, along with regular exercise, eating a balanced diet, drinking adequate fluids, practicing good hygiene and avoiding unprotected sex.
There are no standard screening methods used to find urethral cancer. If you have risk factors for urethral cancer, such as a history of bladder cancer, repeated UTIs or STDs, talk to your doctor to find out how to prevent the disease or schedule an exam.
Symptoms of Urethral Cancer
Urethral cancer can be a silent disease, with no symptoms during the early stages. People with urethral cancer may eventually develop any of the following symptoms:
- lumps or growths on the urethra
- blood in the urine
- urinating often or feeling a frequent urge to urinate without passing much urine
- pain, low flow or dribbling while urinating
- enlarged lymph nodes in the groin area
- discharge from the urethra
It's important to remember that all of these symptoms can be caused by many other medical problems. If you have any of these symptoms, see your doctor immediately.
Diagnosing Urethral Cancer
If you are at high risk for urethral cancer, you should undergo a complete medical evaluation. The most important steps to make a diagnosis of urethral cancer are:
- Clinical history and physical exam: Your doctor will ask for detailed information about symptoms and personal and family history. During the physical exam, your doctor will look for signs of cancer spread near the urethra or at distant sites. This may include a rectal exam and gynecological exam to help determine if the cancer has spread to the vulva, vagina, uterus or ovaries.
- Laboratory tests: Blood tests may also be done to check the blood cell counts, as well as to evaluate the function of organs such as liver and kidneys.
- Urine cytology: A urine sample is collected and examined for abnormal cells.
- Cystoscopy: A thin, lighted tube is used to view inside of the urethra and the urinary bladder. With this instrument, your doctor can determine the exact location and size of the tumor. This procedure is also helpful to guide the doctor during the biopsy to remove a tissue sample.
- Biopsy: If your doctor suspects cancer, a small tissue sample may be taken called a biopsy. The tissue sample is examined under a microscope by a pathologist specializing in looking for cancer.
More tests may be needed to determine how far the disease has spread (cancer stage):
- Computed tomography (CT) scan: A CT scan uses X-rays to take a series of pictures of the body from many angles. These images are then combined by computer to provide a detailed cross section of your body. This test can help to show whether the tumor has spread to organs such as lungs, liver or lymph nodes in the pelvis or in the abdomen.
- Magnetic resonance imaging (MRI): An MRI is a test that uses magnets and radio waves to take pictures of the inside of the body and is often a better test to evaluate the spread of cancer.
- Ultrasound: An ultrasound uses sound waves to look for abnormalities in the abdominal organs (liver, spleen, kidneys). A transvaginal ultrasound may also be used to see if cancer has spread to the uterus, vagina or other nearby organs.
Urethral Cancer Types and Staging
The stage of cancer indicates how much and how far the disease has spread. By using imaging exams and blood and urine tests, a doctor can determine what stage your urethral cancer is in. A cancer's stage is one of the most important factors in deciding what treatment will be most effective.
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 anterior or posterior.