Urethral Cancer

What is urethral cancer?

Urethral cancer is a condition in which cancerous (malignant) cells form tumors in the tissues of your urethra. Your urethra is the tube through which urine (pee) flows out of your bladder.

If you’re a man or assigned male at birth (AMAB), your urethra is about 8 inches (in.) long and passes through your prostate and penis to the outside of your body. It also carries semen and sperm (ejaculate) out of your body.

If you’re a woman or assigned female at birth (AFAB), your urethra is about 2 inches long. It’s just above your vagina, within your labia.

There are different types of urethral cancer that begin in cells that line your urethra. They all fall under the umbrella term of “urethral cancer:”

• Transitional (urothelial) cell carcinoma. This type of urethral cancer usually forms in the part of the urethra closer to the bladder. It’s the same kind of cancer as bladder cancer, and it’s the most common type of urethral cancer.
• Squamous cell carcinoma. This type of cancer usually forms at the end of the urethra in men and people AMAB (near the tip of the penis) and women and people AFAB (near the vagina). It’s the second most common type of urethral cancer.
• Adenocarcinoma. This cancer type forms in glands near your urethra. It’s the most common type of urethral cancer in the pockets (outpouchings) in your urethra (urethral diverticulum).

Is urethral cancer fatal?

In some instances, urethral cancer can be fatal. It may grow and spread to other areas of your body, which is challenging to treat and more likely to be life-threatening.

What is my life expectancy if I have urethral cancer?

Urethral cancer is rare, which makes it difficult to establish survival rates. Recent studies show that the average survival rate for urethral cancer is about four years. The likelihood of surviving five years after diagnosis is 46%, and the likelihood of surviving 10 years after diagnosis is 31%.

The following may affect your chances of recovering from urethral cancer:

• Your overall health.
• The size of your tumor.
• The stage of cancer.
• If your cancer has spread to other areas of your body.

Who does urethral cancer affect?

Anyone can get urethral cancer. However, you may be more likely to get urethral cancer if you:

• Are 60 or older.
• Are Black.
• Are male or AMAB.
• Have a personal or family history of bladder cancer.
• Have conditions that cause inflammation in your urethra, such as frequent urinary tract infections (UTIs) or a sexually transmitted infection (STI).
• Have human papillomavirus (HPV).

How common is urethral cancer?

Urethral cancer is rare. In the United States, there were only 1,615 cases of urethral cancer between 1973 and 2002. Less than 1% of all cancer diagnoses are urethral cancer.

At what age can you get urethral cancer?

You’re more likely to get urethral cancer if you’re 60 or older.

What are the signs of urethral cancer?

Many people don’t notice any signs of urethral cancer in its earliest stages. If you have symptoms, they usually include:

• Blood in your pee (hematuria).
• Weak or interrupted (stop-and-go) pee stream.
• Pain when peeing.
• Peeing more than usual.
• A lump or thickness in your penis or the space between your genitals and rectum (perineum).
• Clear, white or off-white fluid that comes out of your urethra (urethral discharge).
• Enlarged lymph nodes in your groin area.

What causes urethral cancer?

Healthcare providers and medical researchers aren’t sure what causes urethral cancer. However, there may be a link to long-term (chronic) swelling and infections. The following conditions may add to your risk of developing urethral cancer:

• STIs.
• HPV.
• Smoking.
• Urethral stricture.
• Urethral caruncle.
• Urethral diverticulum.
• Long-term catheters that drain your bladder through your urethra (indwelling catheterization).

Where does urethral cancer spread first?

Typically, urethral cancer first spreads to the tissues around your urethra. It may spread to lymph nodes in your groin area. As a result, you may occasionally see swelling in your leg.

How is urethral cancer diagnosed?

A healthcare provider will conduct a complete physical examination if you have urethral cancer symptoms. They’ll also ask if you have a personal or family history of bladder or urethral cancer.

They may also order or conduct other tests to help diagnose urethral cancer. These tests may include the following:

• Pelvic exam. A healthcare provider will examine your uterus, cervix, vagina, fallopian tubes, ovaries, bladder and rectum to detect any tumors or other abnormalities. They may also take cell samples to study under a microscope at a lab.
• Digital rectal exam. A provider will examine your rectum and anus for abnormalities. If you have a prostate, they’ll also check that.
• Blood tests. A provider will use a thin needle to withdraw a small amount of blood from a vein in your arm. They’ll look at various things, including kidney function and blood cell levels.
• Urinalysis. You’ll pee into a special cup, and a provider will send it to a lab. A technician will examine your pee’s color and contents, including sugar, protein and blood cell levels.
• Urine cytology. You’ll provide a pee sample, and a provider will examine it for cancer cells from the cells that line your bladder and the section of your urethra closest to your bladder.
• Cystoscopy. A provider will insert a thin, lighted tube (cystoscope) into your urethra up to your bladder. They’ll look inside your urethra and bladder. They may also take a tissue sample to examine under a microscope.
• Ureteroscopy. A provider may insert a thin, lighted tube with a lens (ureteroscope) into your urethra to examine your kidneys and ureters (two long, skinny tubes that carry pee from your kidneys to your bladder). They may also take tissue to examine under a microscope.
• CT (computed tomography) scan. A provider will take a series of detailed pictures of your pelvis and abdomen to create a 3D image of the tissues in the area.
• Biopsy. A provider will remove cells or tissue from your urethra, bladder or prostate. The urologist will then send the samples to a lab where a lab technician will check them for signs of cancer.

How is urethral cancer treated?

Treatment depends on the following:

• The affected area of your urethra.
• Whether it has spread to other areas of your body.
• Your biological sex.
• Your general health.
• Whether it just appeared or if you had urethral cancer before and it’s come back.

Urethral cancer treatments include:

• Surgery. A healthcare provider who specializes in the treatment and diagnosis of diseases and conditions that affect your urinary system (urologist) removes your tumor. They may also remove your bladder, urethra, prostate, lymph nodes, vagina or penis. Surgery is the most common treatment for urethral cancer.
• Radiation therapy. A healthcare provider who specializes in diagnosing and treating cancer (radiation oncologist) uses radiation to kill cancer cells.
• Chemotherapy. A medical oncologist uses special cancer-fighting drugs to kill cancer cells and prevent them from multiplying.

Your provider may recommend a combination of cancer treatments as part of your treatment. Talk to them about what type of treatments are best for you.

How do I take care of the side effects of urethral cancer treatment?

Talk to your healthcare provider about the best way to take care of your side effects. They may recommend:

• Maintaining a healthy diet, including lots of fresh fruits and vegetables.
• Exercising regularly.
• Keeping a healthy weight for you.
• Limiting the amount of alcohol you drink.

Be sure to talk to a provider before you make any changes to your diet or lifestyle.

How soon after treatment will I feel better?

Urethral cancer treatments vary, and your body is unique. Your response to urethral cancer treatments may differ from others. Your team of healthcare providers can explain what you should expect as you recover.

How can I prevent urethral cancer?

Because urethral cancer is rare, healthcare providers and medical researchers are still learning the best ways to prevent it. You may be able to help prevent it by:

• Practicing safe sex. Wearing a condom will help prevent STIs.
• Practicing good hygiene. For women and people AFAB, it’s important to wipe from front to back after peeing or having a bowel movement (pooping) to help prevent UTIs. People who menstruate should also regularly change their pads, tampons or other period hygiene products. It’s also a good idea to regularly wash the skin around your vagina and rectum with clean water and, if you’d like, a mild, unscented soap.
• Avoiding smoking and using other tobacco products. Reach out to a healthcare provider if you need help quitting smoking.

What can I expect if I have urethral cancer?

Hearing that you have urethral cancer can make you feel sad, angry, frustrated and scared. These feelings are normal and may quickly shift as you process your diagnosis and go through treatment. Your healthcare provider may refer you to support groups for people with urethral cancer, which can help you feel less lonely. They can also guide you through what to expect as you explore urethral cancer treatment options.

Is urethral cancer curable?

Yes and no. A cure means that you no longer have urethral cancer, you don’t need any more treatment and healthcare providers don’t think it’ll come back. However, it takes providers a long time to be sure that urethral cancer won’t return. You’ll need follow-up care with regular check-ups and testing to ensure it hasn’t come back.

After successful treatment, providers must perform tests (including CT or MRI imaging and cystoscopy) to show that you don’t have any signs of urethral cancer. The longer you’re cancer-free, the greater your chances that urethral cancer won’t come back.

When should I see a healthcare provider?

See a healthcare provider if you have any signs of urethral cancer, including any changes to your peeing habits, discharge from your urethra, blood in your pee or lumps in your penis or perineum.

As you’re undergoing urethral cancer treatment, talk to your healthcare provider if you have the following:

• A fever greater than 101 degrees Fahrenheit (38 degrees Celsius).
• Severe headaches.
• Chills.
• Persistent coughing.
• Shortness of breath.
• Sudden weight loss greater than five pounds.
• Excessive vomiting.

What questions should I ask a healthcare provider?

• How do you know that I have urethral cancer?
• Has urethral cancer spread to other parts of my body?
• What are my odds of survival?
• What treatments do you recommend?
• What’s the complete list of risks and benefits of your recommended treatment?
• Are there any clinical trials that are a good option for me?
• Can you recommend any support groups?

A note from Cleveland Clinic

Urethral cancer is a rare cancer that affects your urethra. You may feel a wide range of emotions as you come to terms with your diagnosis and how urethral cancer may affect your life. Be honest with your healthcare provider about your feelings. They can answer your questions and work with you to create the best treatment plan.