Urethral cancer is a rare type of cancer. It can be difficult to detect until it’s more advanced. This makes treatment harder, and it can complicate the outlook.
Learn more about urethral cancer, what its symptoms are, how it’s diagnosed, and what a prognosis looks like if you’re diagnosed with it.
Urethral cancer is a type of cancer that develops in the urethra. The urethra is a hollow tube that passes urine from the bladder to the outside of your body.
In males, the urethra is about 8 inches long and runs from the bladder, through the prostate, to the end of the penis.
In females, the urethra is much shorter, at just 1.5 inches. It runs from the bladder to an opening just above the vaginal opening.
Urethral cancer is the rarest of all urological cancers.
Urethral cancer can be difficult to detect in its earliest stages. That’s because some people will experience no symptoms until the cancer is more advanced.
Primary symptoms
As the cancer grows, both males and females may begin to notice these symptoms of urethral cancer:
- a growth or lump near or on the urethra
- pain or bleeding when urinating
- difficulty emptying the bladder
Additional symptoms
Additional symptoms include:
- frequently urinating or feeling the need to urinate without passing urine
- low flow or dribbling when trying to urinate
- discharge or bleeding from the urethra
- trouble passing urine
- urinary incontinence (or an inability to control urine)
- enlarged lymph nodes in the groin, near the tumor
As with many cancers, it’s unclear what causes urethral cancer. The cancer develops when healthy cells begin to grow uncontrollably. These cells clump together and form a tumor. But why cells begin to grow wildly isn’t known.
However, researchers and doctors do know of some risk factors that increase a person’s chance of developing urethral cancer.
Risk factors
Risk factors for urethral cancer include:
- Illness. People with chronic inflammation or swelling from infections are more likely to develop urethral cancer.
- Sexually transmitted diseases (STD). People who have contracted STDs are more at risk.
- Human papillomavirus (HPV). A specific strain of HPV, a type of STD, has been linked to urethral cancer.
- Urethral stricture. In males, this condition can cause chronic swelling and inflammation.
- Urethral mass. In females, a mass (or caruncle) or outpouching (called urethral diverticulum) can increase risks.
- Race. Cases of urethral cancer are
two times higher in Black people than in white people, according to the National Cancer Institute. - Age. Older adults are more likely to develop this type of cancer.
- Bladder cancer. People who’ve had bladder cancer previously are more likely to develop urethral cancer, even if the bladder was removed during treatment.
If your health care provider suspects you have urethral cancer, they may refer you to a urologist. This is a type of doctor who’s specially trained to treat urological diseases and conditions, like urethral cancer.
Physical exam and health history review
The urologist will likely conduct a full physical exam. They may also request urine and blood samples to rule out other issues.
During the physical exam, the doctor will discuss your health history. This will include risk factors like STIs, bladder cancer, chronic urinary tract infections, and other issues.
Additional screening tests
With this information, your doctor may determine that additional tests are needed to diagnose a possible cancer. Three common types of tests are used for this:
- Cystoscopy. Your doctor may pass a cystoscope, or a small tool with a lens and a light, into the urethra. With this, they can see signs of a tumor or other possible issues. This procedure is typically done as an outpatient with local anesthesia.
- Biopsy. A biopsy is needed to confirm a cancer diagnosis. To do a biopsy, your doctor may remove a sample of tissue from the suspicious area. This tissue sample is then passed to a pathologist who can examine the cells and make a diagnosis.
- Imaging. Tests like a CT scan or MRI scan can help your doctor see exactly where the tumor is and if it has spread (metastasized).
Urethral cancer grades and stages
Once your doctor confirms a cancer diagnosis, they’ll give the cancer a stage and a grade. These classifications tell your doctor and other health care providers a lot about your cancer.
Cancer grade: Grades identify how quickly the tumor can grow and spread.
- A low-grade cancer is growing slowly and unlikely to spread.
- A high-grade cancer is growing quickly and may recur, spreading outside the urethra.
Cancer stage: A stage tells if the cancer has spread beyond the urethra. The higher the number, the greater the spread. For example, a stage 1 tumor is still localized to the urethra and nearby tissue, but a stage 4 tumor has spread to other organs.
Several treatments are available for urethral cancer. The best option for you depends on the type of urethral cancer you have, where it is, and what stage the cancer is.
Work closely with your doctor to understand your best option. Each of these treatments do have some risk of side effects. Select a treatment option that makes you feel confident and prepared for all possible outcomes.
Surgery
Surgery is the most common treatment for urethral cancer. During surgery, a doctor can remove the tumor from either inside the urethra or from outside. They may also remove nearby lymph nodes if they’re impacted by the cancer.
Radiation therapy
This treatment targets and destroys cancer cells with beams of intense energy from outside your body. Radiation therapy can be used alone, but it’s frequently used with surgery or chemotherapy.
Chemotherapy
These anti-cancer drugs can be used prior to surgery to shrink the tumor and decrease the extent of surgery needed to treat the cancer. Chemotherapy can also be used after surgery to prevent the disease from coming back or if the cancer has spread beyond the primary tumor site.
Surveillance
Active surveillance is also an option for urethral cancer treatment. In fact, it’s a treatment that doesn’t require treatment — if the tumor isn’t causing any issues and doesn’t show signs of growing or spreading, your doctor may choose surveillance.
This is a common option for older adults with health issues that may complicate other types of treatment. If the tumor begins to change and show that it’s becoming more aggressive, then you may consider other treatment options.
Treating urethral cancer can remove the tumor or mass, but it doesn’t eliminate the possibility that the cancer may return. That’s why it’s important for you to have regular visits with your doctor to catch a recurrence early and prevent possible spread.
Likewise, your doctor may want to conduct regular CT or MRI scans, especially in the first few years after your original cancer diagnosis. These imaging tests look for signs of cancer elsewhere in the body.
Survival rates are largely based on the person’s age and the stage of cancer when it’s diagnosed. The earlier the cancer is found and diagnosed, the better the outcome.
After urethral cancer diagnosis and treatment, your prognosis depends largely on several factors, including:
- the tumor’s location
- the tumor’s size and stage
- how advanced the cancer was when it was discovered
Talk with your doctor about what you can expect after treatment. The two of you can lay the groundwork for a lifetime of prevention, as well as an idea of what to look for in order to catch any future issues quickly.
