Treatment choices for urethral cancer vary for each diagnosis and depend on the size and location of the tumor in the urethra, as well as the stage or extent of the disease. Your doctor will also consider your age and general health when making recommendations about a treatment.
Types of Treatment
Treatment for urethral cancer is either local or systemic. Local treatments remove, destroy or control the cancer cells in one certain area and include surgery and radiation. Systemic treatments destroy or control cancer cells throughout the entire body and include chemotherapy. You may have just one treatment or a combination of treatments.
Watchful Waiting: In cases where your cancer is very slow growing or when treatment risks outweigh the benefits, your doctor may talk to you about choosing watchful waiting.
Surgery: The most common treatment for urethral cancer,the goal of surgery is to remove the tumor from the urethra, while leaving as much of the urethra intact as possible.
Radiation therapy: The goal of radiation is to kill cancer cells by using high energy X-rays. This treatment is sometimes used to shrink a tumor before surgery or to treat remaining cancer cells after surgery. If surgery is not possible, radiation may be used alone to treat the symptoms of urethral cancer.
Chemotherapy: The goal of chemotherapy is to shrink the cancer when it has spread to other parts of the body. Occasionally, it may be used to reduce the size of a urethral cancer before surgery.
Doctors are always looking for new ways to treat urethral cancer through clinical trials. Before beginning treatment, ask your doctor if there are any ongoing clinical trials that might be right for you.
Urethral Cancer Surgery
Surgery is the most common treatment for urethral cancer and is often used in conjunction with radiation therapy. Small, superficial tumors may be removed completely using one of many techniques, including:
Laser resection: Removal or destruction of tumor using a laser.
Transurethral resection: Removal of the tumor with surgical instruments passed into the urethra.
Fulguration: Use of electrocautery to burn away cancerous tumors.
Mohs surgery: Removal of infected tissue in very thin layers in order to spare normal tissue.
Large tumors or those that invade other structures or tissues require more extensive surgery, and in some cases, the urethra, bladder, vagina and lymph nodes may need to be removed. Plastic surgery may be also be required to rebuild the vagina following extensive surgery.
Potential side effects of surgery
Pain near the incision following surgery is common and short-lived. Scarring of the urethra after surgery may cause narrowing of the urethra or urinary strictures, which can be corrected with a urethral dilation procedure.
If your bladder or your urethra is removed, your surgeon will make or build a small opening in the abdomen called a urostomy, to provide you a new way of eliminating urine. This will require you to wear a small pouch under your clothes to collect the urine or use a catheter to remove the urine from the urostomy site.
Urethral Cancer Radiation Therapy
Radiation therapy uses high-energy radiation to kill cancer cells. Two types of radiation can be used to treat urethral cancer:
External beam radiation: X-rays are deliverer from a machine outside the body.
Brachytherapy: Radioactive material is placed directly in or around the tumor. This allows for a higher dose of radiation in a specific part of the body.
Radiation may be an option for some early stage cancers, but is usually used in conjunction with chemotherapy. Radiation therapy may also be used along with surgery to shrink tumors in more advanced cancers.
Potential side effects of radiation therapy
Side effects usually go away after treatment and many can be managed with certain drugs. Some side effects may be long-lasting, such as urethral or vaginal strictures. Common side effects of radiation therapy can include:
skin irritation, including redness and soreness
burning during urination
Urethral Cancer Chemotherapy
Chemotherapy uses anticancer drugs to kill cancer cells, attacking and killing cells that divide quickly, but affecting both cancer cells and some normal cells. Chemotherapy is not commonly used to treat urethral cancer. It has been used in certain cases to:
shrink the cancer before surgery in order to make it easier to completely remove
treat the cancer with a combination of chemotherapy and radiation when surgery is either not feasible or the patient has chosen not to have surgery
treat cancer that has spread to distant organs
The amount of chemotherapy performed will depend on whether the cancer is a transitional cell carcinoma or a squamous cell carcinoma.
Potential side effects of chemotherapy
The side effects of chemotherapy vary, depending on collateral damage to healthy cells.
If your white blood cell levels are affected by chemotherapy, the risk of infection becomes much higher. Any symptoms of infection, particularly fever, should be reported to the doctor or nurse as soon as possible.
If your platelet count is low, there may be a higher risk of bruising and bleeding. Fatigue is also possible because of the lack of red blood cells. In addition, nausea, vomiting, loss of appetite, loss of hair, mouth sores and diarrhea are other possible side effects. Most of these side effects go away a few days or weeks after treatment is stopped. Medication can be prescribed to reduce side effects and help people recover from chemotherapy more quickly.