Urethral Cancer Overview

What is urethral cancer?

Cancer is made of changed cells that grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas. And they can spread to other parts of the body. This is called metastasis.

Urethral cancer is a very rare type of cancer that starts in the urethra. This is the tube that carries urine out of your body. In women, the urethra is about 1.5 inches long. It reaches from the bladder to an opening above the vagina. In men, the urethra is about 8 inches long. It passes through the prostate and the penis to an opening on the tip of the penis (glans).

Who is at risk for urethral cancer?

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. But risk factors can make it more likely for a person to have cancer. Some risk factors may not be in your control. But others may be things you can change.

Because urethral cancer is so rare, it’s been hard for healthcare providers to find risk factors for the disease. These are possible risk factors for this cancer:

• Older age

• Long-lasting (chronic) irritation or inflammation of the urinary tract because of repeated urinary tract infections (UTIs) or sexually transmitted infections (STIs)

• Certain diseases, such as urethral diverticulum, polyps, or urethral caruncle in women and urethral strictures in men

• History of bladder cancer

• HPV (human papillomavirus) infection (especially HPV type 16) or history of other STIs

• Being African American

Talk with your healthcare provider about your risk factors for urethral cancer and what you can do about them.

Can urethral cancer be prevented?

There’s no sure way to prevent urethral cancer. But you can protect yourself from STIs to help reduce your risk for cancer and other health problems. Ask your healthcare provider if the HPV vaccine is right for you.

Are there screening tests for urethral cancer?

There are no regular screening tests for urethral cancer. Screening tests are done to check for disease in people who don’t have symptoms.

What are the symptoms of urethral cancer?

Urethral cancer can be a silent disease. It may not cause any symptoms when the cancer is small. It may cause these symptoms as the tumor grows:

• Blood in your urine

• Discharge or bleeding from the urethra

• Frequent urination or a frequent urge to urinate without passing much urine

• Trouble passing urine

• Pain, low flow, or dribbling while urinating

• Inability to control urine (urinary incontinence)

• Enlarged lymph nodes in the groin

• Lump or growth in the penis or in the area between your genitals and anus (perineum)

Many of these may be caused by other health problems. But it’s important to see a healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

How is urethral cancer diagnosed?

People are often treated for other problems first. This might be a urinary tract infection or, in men, BPH (benign prostate hyperplasia). When usual treatments don’t work, your provider may suspect urethral cancer. You may be sent to a urologist. This is a healthcare provider with special training to treat problems in the urinary system.

Your healthcare provider will ask you about your health history, your symptoms, risk factors, and family history of disease. They will do a physical exam. Men may have a digital rectal exam. Women will have a pelvic exam. These tests are done to look and feel for tumors around the urethra.

You may also have one or more of these tests:

• Urine tests

• Blood tests

• Ultrasound

• Endoscopy exams (cystoscopy or ureteroscopy)

• CT scan

• Biopsy

A biopsy is the only way to confirm cancer. Small pieces of tissue are taken out and checked for cancer cells.

After a diagnosis of urethral cancer, you’ll likely need other tests. These help your healthcare providers learn more about the cancer. They can help determine the stage of the cancer. The stage is how much and how far the cancer has spread (metastasized) in your body. It is one of the most important things to know when deciding how to treat the cancer.

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Be sure to ask your healthcare provider to explain the stage of your cancer to you in a way you can understand.

How is urethral cancer treated?

Your treatment choices depend on the type of urethral cancer you have, where it is in the urethra, your gender, test results, and the stage of the cancer. The goal of treatment may be to cure you, control the cancer, or to help ease problems caused by the cancer. Talk with your healthcare team about your treatment choices, the goals of treatment, and the possible risks and side effects.

Types of treatment for cancer are either local or systemic. Local treatments remove, destroy, or control cancer cells in one area. Surgery and radiation are local treatments. Systemic treatment is used to destroy or control cancer cells that may have traveled around your body. When taken by pill or injection, chemotherapy is a systemic treatment. You may have just one treatment or a combination of treatments.

Urethral cancer may be treated with:

• Surgery

• Radiation therapy

• Chemotherapy

Another option in some cases is active surveillance. This means the cancer is not treated right away. Instead, your healthcare provider closely watches it with regularly scheduled exams and tests. If the tests show that it’s started to grow or the cancer starts to cause problems, then you can start treatment. This option lets you delay or even not have treatments that can cause major side effects and other problems.

Talk with your healthcare providers about your treatment options. Make a list of questions. Think about the benefits and possible side effects of each option. Talk about your concerns with your healthcare provider before making a decision.

What are treatment side effects? 

Cancer treatment such as chemotherapy and radiation can damage normal cells. This can cause side effects such as hair loss, mouth sores, and vomiting.

Talk with your healthcare provider about side effects you might have and ways to deal with them. There may be things you can do and medicines you can take to help prevent or control side effects.

Coping with urethral cancer 

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be hard on your mind and body. Keep talking with your healthcare team about any problems or concerns you have. Work together to ease the effect of cancer and its symptoms on your daily life.

Here are tips:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with a focus on high-protein foods.

• Drink plenty of water, fruit juices, and other liquids.

• Keep physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

When should I call my healthcare provider?

Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:

• New symptoms or symptoms that get worse

• Signs of an infection, such as a fever

• Side effects of treatment that affect your daily function or don’t get better with treatment

Ask your healthcare provider what signs to watch for and when to call. Know how to get help after office hours and on weekends and holidays.

Next steps 

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.