Urethral Cancer: Chemotherapy

What is chemotherapy? 

Chemotherapy (chemo) uses medicines to kill cancer cells or keep them from growing. The medicines are made to attack and kill cancer cells that grow quickly. Some normal cells also grow quickly. Because of this, chemo can harm those cells, too. This can cause side effects.

When might chemo be used for urethral cancer?

Since urethral cancer is very rare, the best way to use chemo isn't clear. It may be used:

• To shrink the tumor before surgery. This makes it easier to remove and may allow the surgeon to leave more healthy tissue behind.

• Along with radiation after surgery. This is done to kill any cancer cells that remain. It helps decrease the chance that the cancer will come back.

• Along with radiation as the main treatment. This might be done when surgery is not possible or you've chosen not to have surgery. 

• To treat cancer that has spread to distant organs.

The medicines and the amount of them you receive will depend on whether the cancer is a transitional cell carcinoma, a squamous cell carcinoma, or an adenocarcinoma.

How chemo is given

Chemo is most often given through an IV (intravenous) tube in your arm or hand. You may also take it by mouth as a pill, or as a shot (injection). The treatment may be done as an outpatient hospital visit, where you go home the same day. Or it may be at your healthcare provider’s office, a chemo infusion center, or at home. In some cases, you may stay in the hospital during treatment.

You get chemo in cycles over a period of time. That means you may take the medicine for a set amount of time and then you have a rest period. Each period of treatment and rest is one cycle. You may have several cycles. Getting chemo in cycles helps by:

• Killing more cancer cells. This is because not all the cancer cells are dividing at the same time. Cycles allow the medicine to destroy more cells over time.

• Giving your body a rest. Treatment is hard on other cells of the body that divide quickly. This includes cells in the lining of your mouth and stomach. Damage to healthy cells like these causes side effects. These include mouth sores, low white blood cell levels, and nausea. Between cycles, your body can get a rest from the chemo and your healthy cells can heal.

• Giving your mind a rest. Having chemo can be stressful. Taking breaks between cycles can let you get an emotional break between treatments.

What are common side effects of chemo?

The side effects of chemo depend on the type of medicines you receive. Chemo affects cells that divide quickly, such as cancer cells. But healthy cells can sometimes be affected, too, including blood cells. You’ll have blood tests done often while you're getting chemo.

• If your white blood cell levels go down, your risk of infection becomes much higher. Tell your healthcare provider right away if you have any signs of an infection. Symptoms include fever and chills.

• If your platelet blood cell counts are down, you may have a higher risk of bruising and bleeding more easily from a cut or injury.

• If you have low red blood cells, you may have tiredness or shortness of breath.

Other common side effects include:

• Nausea

• Vomiting

• Loss of appetite

• Loss of hair

• Mouth sores

• Diarrhea

• Extreme tiredness (fatigue)

Most of these side effects can be treated, and most go away over time after you stop treatment.

Long-term side effects may not go away. These may include kidney injury or nerve damage that causes tingling or numbness in your hands or feet. Long-term effects depend on the medicines you receive.

Working with your healthcare provider

It's important to know which medicines you're taking. Write down the names of all your medicines. Ask your healthcare team how they work and what side effects they might have.

Talk with your healthcare team about what changes to watch for and when to call them. For instance, chemo can make you more likely to get infections, so you may need to watch for fever or chills. Make sure you know what number to call with questions. Is there a different number for evenings and weekends and holidays?

It may be helpful to keep a diary of your side effects. Write down physical, thinking, and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage your side effects.