Urethral Cancer

Urethral cancer is a disease in which malignant (cancer) cells form in the tissues of the urethra.

The urethra is the tube that carries urine from the bladder to outside the body. In women, the urethra is about 1½ inches long and is just above the vagina. In men, the urethra is about 8 inches long, and goes through the prostate gland and the penis to the outside of the body. In men, the urethra also carries semen.

Urethral cancer is a rare cancer that occurs more often in women than in men. There are different types of urethral cancer that begin in cells that line the urethra. These cancers are named for the types of cells that become malignant (cancerous):

  • Squamous cell carcinoma is the most common type of urethral cancer. It forms in cells in the part of the urethra near the bladder in women, and in the lining of the urethra in the penis in men.
  • Transitional cell carcinoma forms in the area near the urethral opening in women, and in the part of the urethra that goes through the prostate gland in men.
  • Adenocarcinoma forms in glands near the urethra in both men and women.

Urethral cancer can metastasize (spread) quickly to tissues around the urethra and is often found in nearby lymph nodes by the time it is diagnosed.

Age and a history of bladder cancer can affect the risk of developing urethral cancer.

Risk factors include the following:

  • Having a history of bladder cancer.
  • Having conditions that cause chronic inflammation in the urethra, including:
  • Sexually transmitted diseases (STDs).
  • Frequent urinary tract infections (UTIs).
  • Being 60 or older.
  • Being a white female.

Possible signs of urethral cancer include bleeding or trouble with urination.

These and other symptoms may be caused by urethral cancer. Other conditions may cause the same symptoms. Sometimes early cancer of the urethra does not cause any symptoms at all. A doctor should be consulted if any of the following problems occur:

  • Bleeding from the urethra or blood in the urine.
  • Weak or interrupted ("stop-and-go") flow of urine.
  • Frequent urination.
  • A lump or thickness in the perineum or penis.
  • Discharge from the urethra.
  • Enlarged lymph nodes in the groin area.

Tests that examine the urethra and bladder are used to detect (find) and diagnose urethral cancer.

The following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.
  • Laboratory tests: Medical procedures that test samples of tissue, blood, urine, or other substances in the body. These tests help to diagnose disease, plan and check treatment, or monitor the disease over time.
  • Urine cytology: Examination of urine under a microscope to check for abnormal cells.
  • Urinalysis: A test to check the color of urine and its contents, such as sugar, protein, blood, and white blood cells. If white blood cells (a sign of infection) are found, a urine culture is usually done to find out what type of infection it is.
  • Digital rectal exam: An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel for lumps or anything else that seems unusual. This procedure may be done while the patient is under anesthesia.
  • Pelvic exam: An exam of the vagina, cervix, uterus, fallopian tubes, ovaries, and rectum. The doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and places the other hand over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. A speculum is also inserted into the vagina and the doctor or nurse looks at the vagina and cervix for signs of disease. This may be done while the patient is under anesthesia.
  • Cystoscopy: A procedure to look inside the urethra and bladder to check for abnormal areas. A cystoscope (a thin, lighted tube) is inserted through the urethra into the bladder. Tissue samples may be taken for biopsy.
  • Biopsy: The removal of cells or tissues from the urethra, bladder, and, sometimes, the prostate gland, so they can be viewed under a microscope by a pathologist to check for signs of cancer.
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