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National Cancer Institute

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Urethral cancer


Table of Contents

OVERVIEW OF PDQ
What is PDQ?
How to use PDQ
DESCRIPTION
What is cancer of the urethra?
STAGE EXPLANATION
Stages of cancer of the urethra
Anterior urethral cancer
Posterior urethral cancer
Urethral cancer associated with invasive bladder cancer
Recurrent urethral cancer
TREATMENT OPTION OVERVIEW
How cancer of the urethra is treated
Treatment by stage
ANTERIOR URETHRAL CANCER
POSTERIOR URETHRAL CANCER
URETHRAL CANCER ASSOCIATED WITH INVASIVE BLADDER CANCER
RECURRENT URETHRAL CANCER
TO LEARN MORE

OVERVIEW OF PDQ


What is PDQ?

PDQ is a computer system that gives up-to-date information on cancer and its prevention, detection, treatment, and supportive care. It is a service of the National Cancer Institute (NCI) for people with cancer and their families and for doctors, nurses, and other health care professionals.

To ensure that it remains current, the information in PDQ is reviewed and updated each month by experts in the fields of cancer treatment, prevention, screening, and supportive care. PDQ also provides information about research on new treatments (clinical trials), doctors who treat cancer, and hospitals with cancer programs. The treatment information in this summary is based on information in the PDQ summary for health professionals on this cancer.


How to use PDQ

PDQ can be used to learn more about current treatment of different kinds of cancer. You may find it helpful to discuss this information with your doctor, who knows you and has the facts about your disease. PDQ can also provide the names of additional health care professionals who specialize in treating patients with cancer.

Before you start treatment, you also may want to think about taking part in a clinical trial. PDQ can be used to learn more about these trials. A clinical trial is a research study that attempts to improve current treatments or finds information on new treatments for patients with cancer. Clinical trials are based on past studies and information discovered in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help patients with cancer. Information is collected about new treatments, their risks, and how well they do or do not work. When clinical trials show that a new treatment is better than the treatment currently used as "standard" treatment, the new treatment may become the standard treatment. Listings of current clinical trials are available on PDQ. Many cancer doctors who take part in clinical trials are listed in PDQ.

To learn more about cancer and how it is treated, or to learn more about clinical trials for your kind of cancer, call the National Cancer Institute's Cancer Information Service. The number is 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. The call is free and a trained information specialist will be available to answer cancer-related questions.

PDQ is updated whenever there is new information. Check with the Cancer Information Service to be sure that you have the most up-to-date information.


DESCRIPTION


What is cancer of the urethra?

Cancer of the urethra, a rare type of cancer, is a disease in which cancer (malignant) cells are found in the urethra. The urethra is the tube that empties urine from the bladder, the hollow organ in the lower abdomen that stores urine. In women, the urethra is about 1 1/2 inches long and opens to the outside of the body above the vagina. In men, the urethra is about 8 inches long and goes through the prostate gland and then through the penis to the outside of the body. Cancer of the urethra affects women more often then men.

There may be no symptoms of early cancer of the urethra. A doctor should be seen if there is a lump or growth on the urethra, or pain, bleeding, or other difficulty during urination.

If there are symptoms, a doctor will examine the patient and feel for lumps in the urethra. In men, a thin lighted tube called a cystoscope may be inserted into the penis so the doctor can see inside the urethra. If the doctor finds cells or other signs that are not normal, a small piece of tissue (called a biopsy) may be cut out and looked at under a microscope for cancer cells.

The chance of recovery (prognosis) and choice of treatment depend on the stage of the cancer (whether it is just in one area or has spread to other places) and the patient's general state of health.


STAGE EXPLANATION


Stages of cancer of the urethra

Once cancer of the urethra is found, more tests will be done to find out if cancer cells have spread to other parts of the body (staging). A doctor needs to know the stage of the disease to plan treatment. For cancer of the urethra, patients are grouped into stages depending on where the tumor is and whether it has spread to other places. The following stage groupings are used for cancer of the urethra:


Anterior urethral cancer

The part of the urethra that is closest to the outside of the body is called the anterior urethra, and cancers that start here are called anterior urethral cancers.


Posterior urethral cancer

The part of the urethra that connects to the bladder is called the posterior urethra, and cancers that start here are called posterior urethral cancers. Because the posterior urethra is closer to the bladder and other tissues, cancers that start here are more likely to grow through the inner lining of the urethra and affect nearby tissues.


Urethral cancer associated with invasive bladder cancer

Occasionally, patients who have bladder cancer also have cancer of the urethra. This is called urethral cancer associated with invasive bladder cancer.


Recurrent urethral cancer

Recurrent cancer means that the cancer has come back (recurred) after it has been treated. It may come back in the same place, or in another part of the body.


TREATMENT OPTION OVERVIEW


How cancer of the urethra is treated

There are treatments for all patients with cancer of the urethra. Three kinds of treatment are used:

Surgery is the most common treatment of cancer of the urethra. A doctor may take out the cancer using one of the following operations:

If the urethra is removed, the doctor will need to make a new way for the urine to pass from the body. This is called urinary diversion.

If the bladder is removed, the doctor will need to make a new way for the patient to store and pass urine. There are several ways to do this. Sometimes the doctor will use part of the small intestine to make a tube through which urine can pass out of the body through an opening (stoma) on the outside of the body. This is sometimes called an ostomy or urostomy. If a patient has an ostomy, a special bag will need to be worn to collect urine. This special bag, which sticks to the skin around the stoma with a special glue, can be thrown away after it is used. This bag does not show under clothing, and most people take care of these bags themselves. The doctor may also use part of the small intestine to make a new storage pouch (a continent reservoir) inside the body where the urine can collect. The patient would then need to use a tube (catheter) to drain the urine through a stoma.

Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes (internal radiation therapy) in the area where cancer cells are found. Radiation may be used alone or with surgery and/or chemotherapy.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by mouth, or it may be put in the body through a needle in a vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body and can kill cancer cells outside the urethra.


Treatment by stage

Treatment depends on where the cancer is found, whether it has spread to other areas in the body, and the patient's sex, age, and overall health.

Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are going on in many parts of the country for patients with cancer of the urethra. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.


ANTERIOR URETHRAL CANCER

Treatment is different for men and women.

For women, treatment may be one of the following:

1. Electrofulguration.

2. Laser therapy.

3. External and/or internal radiation therapy.

4. Radiation therapy followed by surgery or surgery alone to remove the urethra and the organs in the lower pelvis (anterior exenteration), or the tumor only, if it is small. A new way is made for urine to pass out of the body (urinary diversion).

For men, treatment may be one of the following:
1. Electrofulguration.

2. Laser therapy.

3. Surgery to remove a part of the penis (partial penectomy).

4. Radiation therapy.


POSTERIOR URETHRAL CANCER

Treatment is different for men and women.

For women, treatment will probably be radiation therapy followed by surgery or surgery alone to remove the urethra, the organs in the lower pelvis (anterior exenteration), or the tumor only, if it is small. Lymph nodes in the pelvis are usually removed (lymph node dissection), and lymph nodes in the upper thigh may or may not be removed. A new way is made for urine to pass out of the body (urinary diversion).

For men, treatment will probably be radiation therapy followed by surgery or surgery alone to remove the bladder and prostate (cystoprostatectomy) and the penis and urethra (penectomy). Lymph nodes in the pelvis are usually removed (lymph node dissection), and lymph nodes in the upper thigh may or may not be removed. A new way is made for urine to pass out of the body (urinary diversion).


URETHRAL CANCER ASSOCIATED WITH INVASIVE BLADDER CANCER

Because people with bladder cancer sometimes also have cancer of the urethra, the urethra may be removed at the same time the bladder is taken out (cystourethrectomy). If the urethra is not removed during surgery for bladder cancer, the doctor may follow the patient closely so treatment can be started if cancer of the urethra develops.


RECURRENT URETHRAL CANCER

Treatment depends on what treatment the patient received before. If the patient had surgery, treatment may be radiation therapy and surgery to remove the cancer. If the patient had radiation therapy, treatment may be surgery to remove the cancer. Clinical trials are testing chemotherapy for cancer of the urethra that has spread to other parts of the body.


TO LEARN MORE

TO LEARN MORE..... CALL 1-800-4-CANCER

To learn more about cancer of the urethra, call the National Cancer Institute's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615. By dialing this toll-free number, you can speak with a trained information specialist who can answer your questions.

The Cancer Information Service also has booklets about cancer that are available to the public and can be sent on request. The following general booklets on questions related to cancer may be helpful:

What You Need To Know About Cancer
Taking Time: Support for People with Cancer and the People Who Care About
Them
What Are Clinical Trials All About?
Chemotherapy and You: A Guide to Self-Help During Treatment
Radiation Therapy and You: A Guide to Self-Help During Treatment
Eating Hints for Cancer Patients
Advanced Cancer: Living Each Day
When Cancer Recurs: Meeting the Challenge Again

There are many other places where people can get material and information about cancer treatment and services. The social service office at a hospital can be checked for local and national agencies that help with getting information about finances, getting to and from treatment, getting care at home, and dealing with problems.

For more information from the National Cancer Institute, please write to this address:

National Cancer Institute
Office of Cancer Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580

Date Last Modified: 07/1998


If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.


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