Urethral Cancer: Diagnosis

How is urethral cancer diagnosed?

If your healthcare provider thinks you might have urethral cancer, you will need tests to be sure. Diagnosing urethral cancer starts with your healthcare provider asking you questions. You'll be asked about your health history, your symptoms, risk factors, and your family history of disease. Your healthcare provider will also do a physical exam. This may include a rectal exam. You may have a gynecological exam to help find out if the cancer has spread to the vulva, vagina, uterus, or ovaries.

What tests might I need to find out if I have urethral cancer?

You may have 1 or more of these tests used to diagnose urethral cancer:

• Blood and urine tests

• Cystoscopy

• CT scan

• Biopsy

Blood and urine tests

Your healthcare provider may do tests to check your blood cell counts and see how well your organs are working. These can include your liver and kidneys. Blood tests can give an idea of your overall health.

Your provider will collect your pee to see if there are cancer cells in it. This is called urine cytology. Your pee may also be collected to check for protein, blood, and signs of infection.

Cystoscopy

In a cystoscopy, a thin, lighted tube is put into your urethra to look at the inside lining of the urethra and your bladder. This is often done in an outpatient setting using local anesthesia to numb the urethra.

Your provider can often find the exact place and size of the tumor using this test.

CT scan

A CT scan uses a series of X-rays taken from different angles and a computer to make detailed pictures of the inside of your body. During the test, you lie still on a table as it slides into the ring-shaped CT scanner. A CT scan doesn't hurt. You may be asked to hold your breath one or more times during the scan.

In order to get the best CT scan images, you may be given a contrast dye (contrast medium). Usually, you will drink the contrast before the scan. During the CT scan, the radiology tech may give you contrast by IV (intravenous) line through a vein in your arm. The contrast helps show certain parts of your body more clearly. When the contrast is injected into your blood, you may have a warm feeling from your chest to your groin. The contrast will pass through your body. It will exit through your pee or poop.

This test can show tumors and other changes in and around your urethra. It can also help show if the tumor has spread to nearby organs or lymph nodes in your chest, pelvis, or belly (abdomen).

Biopsy

If your healthcare provider thinks you have cancer, they may take a tiny piece of tissue (called a sample) from that part of the urethra. This is called a biopsy. The sample might be taken out through the same tube used to do a cystoscopy. A pathologist will look at it under a microscope to see if there are cancer cells in it. A pathologist is a healthcare provider who specializes in looking for and testing for cancer cells in biopsy tissue.

Getting your test results 

When your healthcare provider has the results of your biopsy and other tests, they will contact you. They will talk with you about other tests you may need if urethral cancer is found. Make sure you understand the results and what follow-up you need.

What tests might I need after being diagnosed?

If you have urethral cancer, you’ll need imaging tests to learn more about the cancer. These tests can help show if the cancer has grown into nearby areas or spread to other parts of your body. The test results help your healthcare providers decide the best ways to treat the cancer. If you have any questions about these or other tests, talk with your healthcare team.

Types of imaging tests

MRI)

An MRI scan is a test that uses powerful magnets and radio waves to take pictures of the inside of your body, much like a CT scan. MRI scans do not use X-rays. During the test, you’ll lie still on a table as it passes into a long, narrow scanner tube. If you have problems being in small spaces, your healthcare provider may give you a sedative before having this test.

A contrast medium called gadolinium may be put into your blood through a vein to get better pictures. Like a CT scan, an MRI scan can be used to look for the spread of cancer to other organs in your pelvis.

Ultrasound

This test uses sound waves to look for problems in the organs in your belly. These include your liver, spleen, kidneys, uterus, and ovaries. The sound waves bounce off body parts and send back an image. A computer then uses the signals sent back by the sound waves to create an image of the inside of your body. In people with a vagina, a special form of ultrasound (transvaginal ultrasound) can be helpful. It is used to see if cancer has spread to the uterus, vagina, or other nearby organs.

Urethrography

This test is a series of X-rays taken after contrast has been put into your urethra and bladder. The contrast shows up on the X-rays as it fills these areas. It can help find blockages and tumors on the linings of your urethra and bladder. This is often done in people with a penis.

Chest X-ray

You may have a chest X-ray to see if the cancer has spread to your lungs or the lymph nodes in your chest.

Working with your healthcare provider

Your healthcare provider will talk with you about which tests you'll have. Make sure to get ready for the tests as instructed. Ask questions and talk about any concerns you have.