When you use the bathroom, urine moves from your bladder through a tube called the urethra.
The urethra goes through the prostate and the penis in men. In women, the tube is shorter and ends just above the opening to the vagina. If you have urethral cancer, cells in the area grow abnormally and out of control.
Who’s at Risk?
People over age 60, most often. Your risk might be higher, too, if you’ve had frequent urinary tract infections or sexually transmitted diseases that lead to an inflammation of the urethra.
Urethral cancer has been linked to human papillomavirus, especially HPV 16. The HPV vaccine protects against type 16. Doctors recommend it for girls and boys at ages 11 or 12. The FDA has approved the Gardasil 9 HPV vaccine for males and females ages 9 to 45.
Symptoms of Urethral Cancer
You may not have any symptoms at first. Over time, you might notice it’s hard for you to pee. Maybe you have a weak urine flow or can’t hold it when you do have to go. Or perhaps you go to the bathroom more often, especially at night. You might have pain with urination.
You might see blood in the toilet or notice a discharge from your urethra. A swollen spot or a painless lump may appear in your groin or penis. These aren’t always signs of cancer, but can be signs of something else. See your doctor to know for sure.
Types of Urethral Cancer
There are three -- squamous cell carcinoma, transitional cell carcinoma, and adenocarcinoma.
Squamous cell carcinoma. In women, it starts in the part of the urethra near the bladder. In men, it forms in the cells that line the urethra in the penis. This is the most common kind of urethral cancer.
Transitional cell carcinoma. In women, cancer cells grow near where the urethra opens. In men, they grow where the tube passes through the prostate.
Adenocarcinoma. In this form of the disease, cancerous cells begin to grow in the glands around the urethra.
How Is It Diagnosed?
If you have problems when you pee or any of the symptoms listed above, see your doctor. They’ll ask questions about your medical history and do a physical exam. This may include a pelvic and rectal exam. Your doctor might order blood tests and ask for a urine sample to look for abnormal cells.
They may recommend a cystoscopy. That’s where they use a tool called a cystoscope to examine the inside of your urethra.
They may do a biopsy. That means they’ll take cells from the urethra and bladder and look at them under a microscope to see if they’re cancerous.
If your doctor finds that you have urethral cancer, they’ll order more tests to see if the cancer has spread to other parts of your body. (Cancer cells can move to other parts of your body through tissue, blood, and the lymph system. ) These tests may include chest X-rays, a CT scan of the pelvis and abdomen, or a magnetic resonance imaging test (MRI) of the pelvis.
A procedure called urethrography can help your doctor see if there’s cancer in tissue close to the urethra. This is a series of X-rays your doctor performs after they inject contrast dye into the urethra and bladder.
How Is It Treated?
Most often, through surgery. But that depends on where the cancer is located. Sometimes, doctors can get rid of it just by removing the tumor. Other times, the urethra and bladder may be taken out. Your surgeon will need to make a new place for your body to store urine and build another way for the body to release it. After surgery, you may need to wear a bag outside your body to collect the urine.
The vagina or part or all of the penis might also be removed. Plastic surgery may be performed to reconstruct the reproductive organs.
Your doctor may use radiation or chemotherapy (“chemo”), either with or without surgery, to kill cancer cells.
They may also use something called “active surveillance” to monitor the cancer. This means you’re not given treatment right away. Instead, your doctor will perform tests often to see if the cancer gets worse. If it does, they’ll develop a treatment plan.
