Urethral Cancer

Urethral cancer is when cancerous (malignant) cells form tumors in the tissues in your urethra. Your urethra is the tube that carries pee out of your body.

Urethral cancer can affect anyone. But it isn’t common. In the U.S., there were around 1,600 cases of urethral cancer between 1973 and 2002. Fewer than 1 out of every 10 cancer diagnoses are urethral cancer.

Types

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.” These include:

• Transitional (urothelial) cell carcinoma: This type usually forms in the part of the urethra closer to your urinary bladder. It’s the same type of cancer as bladder cancer. It’s the most common type of urethral cancer.
• Squamous cell carcinoma: This type usually forms at the end of the urethra — near the tip of your penis or near your vaginal opening. It’s the second most common type of urethral cancer.
• Adenocarcinoma: This 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).

What are the signs of urethral cancer?

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

• Blood in your pee (hematuria)
• A weak or stop-and-go pee stream
• Pain when peeing (dysuria)
• 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
• Swollen lymph nodes in your groin

Is it fast-growing?

Urethral cancer may spread quickly. It may spread to other nearby tissues, including lymph nodes in your groin area. This may cause swelling in your leg.

How painful is it?

It depends. Some people don’t have any symptoms. But others may experience discomfort if the tumor gets big enough. It may range from irritation to pain, especially when you pee.

Urethral cancer causes

Experts aren’t sure what causes it. But there may be a link between urethral cancer and long-term inflammation and infections. The following conditions may increase your risk of developing it:

• Sexually transmitted infections (STIs)
• Human papillomavirus (HPV)
• Smoking and other tobacco products
• Urethral stricture
• Urethral caruncle
• Urethral diverticulum
• Long-term use of Foley catheters

Risk factors

Urethral cancer more commonly occurs in people who:

• Are 60 or older
• Are Black
• Are male
• Have a personal or biological family history of bladder cancer
• Have conditions that cause inflammation in the urethra, such as frequent urinary tract infections (UTIs) or STIs
• Have HPV

How doctors diagnose urethral cancer

If you have urethral cancer symptoms, your healthcare provider will first:

• Ask about your symptoms
• Ask if you have a personal or biological family history of bladder or urethral cancer
• Conduct a complete physical exam

They may also recommend other tests to help them make a diagnosis.

Tests that are used

Your healthcare provider may order the following tests to help diagnose urethral cancer:

• Pelvic exam: They’ll examine your uterus, cervix, vagina, fallopian tubes, ovaries, bladder and rectum. They’ll look for tumors or any other abnormalities. They may also take cell samples and send them to a lab.
• Digital rectal exam: They’ll check your rectum and anus for abnormalities. If you have a prostate, they’ll also check that.
• Blood tests: They’ll take a small amount of blood to look at your blood cell levels and kidney function.
• Urinalysis: You’ll provide a pee sample. They’ll examine its color and contents, including sugar, protein and blood cell levels.
• Urine cytology: They’ll examine your pee sample for cancer cells.
• Cystoscopy: They’ll insert a thin, lighted tube (cystoscope) into your urethra. They’ll look inside your urethra and bladder. They may also take a tissue sample to examine.
• CT scan: They’ll take images of your pelvis and abdomen to create 3D images of the tissues in those areas.
• Biopsy: They’ll remove cells from your urethra, bladder or prostate and examine them for signs of cancer.

How is urethral cancer treated?

Treatment depends on:

• Where cancer is in your urethra
• Whether it has spread to other areas of your body
• Your sex
• Your general health
• Whether it just appeared, or you had urethral cancer before and it’s come back

Your healthcare provider may recommend:

• Surgery: A urologist will remove the tumor. They may also remove other tissues or organs including your bladder, urethra, prostate, lymph nodes, vagina or penis. This is the most common treatment for urethral cancer.
• Radiation therapy: A 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 these treatments as part of your treatment plan. They’ll explain each option in detail and help you understand which ones are best for you.

Recovery time

Your body is unique, and urethral cancer treatments vary. Your response to treatment may differ from others. Your healthcare provider will explain what you should expect as you recover.

When should I see my healthcare provider?

You should see your healthcare provider any time you notice any changes around your urethra or changes to your bathroom habits. Some other conditions have similar symptoms to urethral cancer. Your provider can rule out any other conditions and make an official diagnosis.

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

• A fever higher than 101 degrees Fahrenheit (38 degrees Celsius)
• Severe headaches
• Chills
• Persistent coughing
• Shortness of breath (dyspnea)
• Sudden weight loss of five pounds (2.25 kilograms) or more
• Excessive vomiting
• Blood in your pee

During your appointments, you may wish to ask questions like:

• What tests do you recommend to diagnose urethral cancer?
• Has it 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?

What can I expect if I have urethral cancer?

Your treatment plan and your chance of recovery depend on many factors. These include:

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

Catching urethral cancer early means it’s easier to treat. Discovering it later means there’s a greater chance that it has spread outside of your urethra.

Is it curable?

Yes and no. A cure means that you no longer have urethral cancer, you don’t need any more treatment and your care team doesn’t think it’ll come back. But it takes 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 to show that you don’t have any signs of urethral cancer. These may include CT or MRI imaging and cystoscopy. The longer you’re cancer-free, the greater your chances that it won’t come back.

Is it fatal?

In some instances, urethral cancer can be fatal. It may grow and spread to other areas of your body. When this happens, it’s more challenging to treat and more likely to be life-threatening.

What is the survival rate?

Urethral cancer is rare. That makes it difficult for experts to establish survival rates. A 2017 study shows that the average survival rate for urethral cancer is about four years. But this depends on the stage. Survival for earlier stages is longer than for later stages. Over 4 out of 10 people survive five years after diagnosis. About 3 out of 10 people survive 10 years after diagnosis.

Is there anything I can do to feel better?

You may have side effects from your treatment. Your healthcare provider will review some of the best ways to help take care of yourself. These may include:

• Eating lots of fresh fruits and vegetables
• Getting regular physical activity
• Keeping a healthy weight for you
• Cutting back on alcohol

Be sure to talk to your provider before making any changes to your lifestyle, including what you eat and drink.