Urethral Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Distal Urethral Cancer
Female Distal Urethral CancerIf the malignancy is at or just within the meatus and superficial parameters (stage 0/Tis, Ta), open excision or electroresection and fulguration may be possible. Tumor destruction using Nd:YAG or CO2 laser vaporization-coagulation represents an alternative option. For large lesions and more invasive lesions (stage A and stage B, T1 and T2, respectively), brachytherapy or a combination of brachytherapy and external-beam radiation therapy are alternatives to surgical resection of the distal third of the urethra. Patients with T3 distal urethral lesions, or lesions that recur after treatment with local excision or radiation therapy, require anterior exenteration and urinary diversion. If inguinal nodes are palpable, frozen section confirmation of tumor should be obtained. If positive for malignancy, ipsilateral node dissection is indicated. If no inguinal adenopathy exists, node dissection is not generally performed, and the nodes are followed clinically.
Urethral Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - General Information About Urethral Cancer
Incidence and MortalityUrethral cancer is rare. The annual incidence rates in the Surveillance, Epidemiology, and End Results database over the period from 1973 to 2002 in the United States for men and for women were 4.3 and 1.5 per million, respectively, with downward trends over the three decades. The incidence was twice as high in African Americans as in whites (5 million vs. 2.5 per million). Urethral cancers appear to be associated with infection with human papillomavirus (HPV), particularly HPV16, a strain of HPV known to be causative for cervical cancer.[2,3]Because of its rarity, nearly all information about the treatment of urethral cancer and the outcomes of therapy is derived from retrospective, single-center case series and, therefore, represents a very low level of evidence of 3iiiDiv. The majority of information comes from cases accumulated over many decades at major academic centers.AnatomyThe female urethra is largely contained within the anterior vaginal wall. In
Urethral Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Recurrent Bladder Cancer
Recurrent bladder cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the bladder or in other parts of the body.
Urethral Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Treatment Option Overview
Information about the treatment of urethral cancer and the outcomes of therapy is derived from retrospective, single-center case series and represents a very low level of evidence of 3iiiDiv. The majority of this information comes from the small numbers of cases accumulated over many decades at major academic centers. Therefore, the treatment in these reports is usually not standardized and the treatment also spans eras of shifting supportive care practices. Because of the rarity of urethral cancer, its treatment may also reflect extrapolation from the management of other urothelial malignancies, such as bladder cancer in the case of transitional cancers, and anal cancer in the case of squamous cell carcinomas. Role of SurgerySurgery is the mainstay of therapy for urethral cancers in both women and men.[Level of evidence: 3iiiDiv] The surgical approach depends on tumor stage and anatomic location, and tumor grade plays a less important role in treatment decisions.[1,2] Although the
Urethral Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage I Bladder Cancer Treatment
Standard Treatment Options for Stage I Bladder CancerPatients with stage I bladder tumors are unlikely to die from bladder cancer, but the tendency for new tumor formation is high. In a series of patients with Ta or T1 tumors who were followed for a minimum of 20 years or until death, the risk of bladder recurrence after initial resection was 80%. Of greater concern than recurrence is the risk of progression to muscle-invasive, locally-advanced, or metastatic bladder cancer. While progression is rare for low-grade tumors, it is common among high-grade cancers. One series of 125 patients with TaG3 cancers followed for 15 to 20 years reported that 39% progressed to more advanced stage disease, while 26% died of urothelial cancer. In comparison, among 23 patients with TaG1 tumors, none died and only 5% progressed. Risk factors for recurrence and progression include the following:[2,3,4,5,6]High-grade disease.Presence of carcinoma in situ.Tumor larger
Urethral Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - To Learn More About Bladder Cancer
For more information from the National Cancer Institute about bladder cancer, see the following:Bladder Cancer Home PageWhat You Need to Know About™ Bladder CancerBladder and Other Urothelial Cancers ScreeningUnusual Cancers of ChildhoodDrugs Approved for Bladder CancerBiological Therapies for CancerSmoking Home Page (Includes help with quitting)For general cancer information and other resources from the National Cancer Institute, see the following:What You Need to Know About™ CancerUnderstanding Cancer Series: CancerCancer StagingChemotherapy and You: Support for People With CancerRadiation Therapy and You: Support for People With CancerCoping with Cancer: Supportive and Palliative CareQuestions to Ask Your Doctor About CancerCancer LibraryInformation For Survivors/Caregivers/Advocates
Urethral Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Get More Information From NCI
Call 1-800-4-CANCERFor more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 a.m. to 8:00 p.m., Eastern Time. A trained Cancer Information Specialist is available to answer your questions.Chat online The NCI's LiveHelp® online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 8:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer. Write to usFor more information from the NCI, please write to this address:NCI Public Inquiries Office9609 Medical Center Dr. Room 2E532 MSC 9760Bethesda, MD 20892-9760Search the NCI Web siteThe NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support
Urethral Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information for Urethral Cancer
Prognosis and treatment decisions are both determined by:The anatomical location of the primary tumor.The size of the tumor.The stage of the cancer.The depth of invasion of the tumor.The histology of the primary tumor is of less importance in estimating response to therapy and survival. Endoscopic examination, urethrography, and magnetic resonance imaging are useful in determining the local extent of the tumor.[3,4]Distal Urethral CancerThese lesions are often superficial. Female: Lesions of the distal third of the urethra.Male: Anterior, or penile, portion of the urethra, including the meatus and pendulous urethra.Proximal Urethral CancerThese lesions are often deeply invasive. Female: Lesions not clearly limited to the distal third of the urethra.Male: Bulbomembranous and prostatic urethra.Urethral Cancer Associated with Invasive Bladder CancerApproximately 5% to 10% of men with cystectomy for bladder cancer may have or may develop urethral cancer distal to the urogenital
Urethral Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Overview
This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information about Bladder and Other Urothelial Cancers screening.
Urethral Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Changes to This Summary (10 / 23 / 2014)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.This summary was comprehensively reviewed and reformatted.This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.