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Urethral Cancer: Stages 

What does the stage of a cancer mean?

The stage of a cancer is how much and how far the cancer has spread in your body. Your healthcare provider uses exams and tests to find out the size of the cancer and where it is. Scans can also show if the cancer has grown into nearby areas and if it has spread to other parts of your body. The stage of a cancer is one of the most important things to know when deciding how to treat it.

Using the TNM system for urethral cancer

The system most commonly used to stage urethral cancer is the TNM system from the American Joint Committee on Cancer (AJCC). Staging is complex and can be confusing. Ask your healthcare provider to explain the stage of your cancer in a way that you can understand.

The first step in staging is to find the value for each part of the TNM system. Here's what the letters stand for in the TNM system:

  • T tells how far the main tumor has spread into the layers of the urethra and nearby tissue.

  • N tells if lymph nodes in the area of the original tumor have cancer in them.

  • M tells if the cancer has spread ( metastasized) to distant parts of the body, such as the liver, lung, or bone.

Numbers or letters after T, N, and M provide more details about each of these factors. There are also 2 other values that can be assigned:

  • X means the provider does not have enough information to tell the extent of the main tumor (TX), or if the lymph nodes have cancer cells in them (NX).

  • 0 means no sign of cancer, such as no sign of the main (primary) tumor (N0).

The grade of the cancer is a measure of how quickly the cancer is likely to grow and spread. It’s based on how much the cancer cells look like normal cells. The urethral cancer cells are graded on a scale from 1 to 3. Lower grade cancers look more like normal cells. They are less likely to grow and spread slowly. Grade 3 cancers look very abnormal, and tend to grow and spread quickly.

What are the stage groupings of urethral cancer?

Stage groupings are made by combining the T, N, and M values from the TNM system. These groupings give an overall description of the cancer. A stage grouping can have a value of 0 or numerals 1, 2, 3, and 4. The higher the number, the more advanced the cancer is.

These are the stage groupings of urethral cancer and what they mean:

Stage 0. The cancer cells are only in the innermost lining of the urethra. Stage 0 is also called carcinoma in situ.

Stage 1. The cancer cells have grown into the layer of tissue below the urethral lining. The cancer is only in the urethra.

Stage 2. The cancer has spread into the deeper muscle layer of the urethra. The tissue in the penis outside the urethra or the part of the prostate gland that surrounds the urethra may contain cancer cells. It has not spread to nearby lymph nodes or to organs in other parts of the body.

Stage3. The cancer has not spread to other parts of the body, and 1 of the following is true:

  • The cancer cells have grown into the layer of tissue below the urethral lining. And cancer is found in 1 nearby lymph node.

  • The cancer has spread through the wall of the urethra. It has spread to the tissue in the penis outside the urethra or to the part of the prostate gland that surrounds the urethra. Cancer is found in only 1 nearby lymph node.

  • The cancer has spread to tissues beyond the urethra. It has spread to the vagina. Or it's in the fatty tissue around the prostate or the deep tissues of the penis. Cancer may or may not be in 1 nearby lymph node.

Stage 4. One of the following is true:

  • The cancer has spread to the bladder, rectum, or prostate. It has not spread to nearby lymph nodes or to organs in other parts of the body.

  • The cancer has spread to the bladder, rectum, or prostate. Cancer is found in only 1 nearby lymph node. It has not spread to organs in other parts of the body.

  • The cancer may or may not have spread beyond the urethra to nearby tissues or organs. It has spread to 2 or more nearby lymph nodes. It has not spread to organs in other parts of the body.

  • The cancer has spread to distant lymph nodes or to organs in other parts of the body, like a lung, the liver, or bones.

Talking with your healthcare provider

Once your cancer is staged, talk with your healthcare provider about what the stage means for you. Ask any questions and talk about your concerns.

Medical Reviewers:

  • Amy Finke RN BSN
  • Howard Goodman MD
  • Jessica Gotwals RN BSN MPH
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