Urethral cancer is caused by the formation of cancer cells in the tissues of the urethra, the tube that carries urine from the bladder to outside the body. Urethral cancer is rare and occurs more often in women than in men. Urethral cancer can spread to surrounding tissues, and the National Cancer Institute says that by the time it is diagnosed, the cancer has often spread to lymph nodes. It can occur at any age but is most often diagnosed in people age 65 or older.
Types
Squamous cell carcinoma, the most common type of urethral cancer, forms in the flat cells lining the urethra in women, and in the lining of the urethra in the penis in men. Sixty percent of urethral cancers in women are squamous cell and in men, 80 percent, according to the University of Miami.
Transitional cell carcinoma forms in the surface cells near the urethral opening in women, and in the part of the urethra that goes through the prostate gland in men. These types of cancer cells are called transitional because they can change shape and stretch without breaking apart.
Adenocarcinoma, from cells that make and release mucus and other fluids, can form in the glands near the urethra in men and women.
Melanoma, which develops in pigment-producing skin cells, and a type of sarcoma that develops in blood vessels, smooth muscle and connective tissues, also occur in the urethra but are extremely rare, according the University of Miami Leonard M. Miller School of Medicine.
Risks
The National Cancer Institute states that those who previously had bladder cancer or chronic inflammation of the urethra--caused by frequent urinary tract infections or sexually transmitted diseases--are at a higher risk for developing urethral cancer.
Symptoms
Symptoms of urethral cancer include interrupted, or "stop-and-go," urine flow, bleeding from the urethra or blood in the urine, a lump or thickness in the penis or the perineum--the area between the vulva and anus in women and the scrotum and anus in men, unusual discharges from the urethra or enlarged lymph nodes in the groin area. The National Cancer Institute advises people to consult a physician if any of the above symptoms are present.
Other symptoms that may accompany urethral cancer are frequent or painful urination, pain during or after sexual intercourse, recurring urinary tract infections and having to strain to urinate, according to the University of Miami.
Diagnosis
Physicians examine the urethra and bladder by inserting a thin, lighted tube called a cystoscope into the urethra. The physician will order a biopsy if a suspicious lesion is found. A biopsy involves surgically removing a small piece of tissue and examining it under a microscope for cancer cells. The biopsy is generally performed under local anesthesia in a physician's office or in a hospital's outpatient surgical center.
If the biopsy is positive, one or more imaging tests using magnetic resonance imaging, X-ray, ultrasound, or computed tomography are performed to "stage" or determine characteristics of the cancer such as type, size, and whether it has spread.
Treatments
The patient's medical team will determine the best treatment based on the stage of the cancer, the patient's age, gender and general health, and whether the cancer is new or a returning cancer.
Cancers that are superficial, or anterior, and located closest to the outside of the body can often be treated successfully, according to the University of Miami. Urethral cancers that are deep, or posterior, and located near the bladder are more difficult to treat.
Posterior urethral cancers in women may affect the entire uterus, according to the Cleveland Clinic. In men, the prostate gland may be affected.
Treatment options include radiation, chemotherapy and surgery. Surgery, done under general anesthesia, is often the first step to in urethral cancer treatment, followed by chemotherapy or radiation to kill any remaining cancer cells.
If caught early, some noninvasive urethral cancer can be treated using fulguration, which destroys cancer cells with high-frequency generated electric sparks, or laser therapy, which involves destroying or inhibiting cancer cell growth using a narrow beam of intense light, according to the University of Miami.
