Urethral Cancer: Frequently Asked Questions

What is urethral cancer?

A: Urethral cancer is a rare type of cancer that starts in the urethra.

The urethra is a tube that carries urine from the bladder to an opening on the outside of the body. In women, the urethra is about 1-1/2 inches long. It reaches from the bladder to an opening in front of the vagina. In men, the urethra is about eight inches long. It passes through the prostate gland and the penis to an opening on the glans, or the tip of the penis.

How is urethral cancer treated?

Treatment for urethral cancer is either local or systemic. Local treatments remove, destroy, or control the cancer cells in a certain area. Surgery and radiation are local treatments. Systemic treatments are used to destroy or control cancer cells throughout the entire body. Chemotherapy (chemo) is a systemic treatment. You may have just one treatment or a combination of treatments:

• Surgery. The goal of surgery is to remove the tumor from the urethra, while leaving as much of the urethra as possible intact.

• Radiation. The goal of radiation is to kill cancer cells by using powerful X-rays. This treatment may be used to shrink a tumor before surgery or to treat any cancer cells that are left after surgery. If surgery isn’t possible, you may have radiation alone.

• Chemotherapy. The goal of chemo is to shrink the cancer when it’s spread to other parts of your body.

• Watchful waiting or active surveillance. In some cases, your healthcare provider may watch the cancer closely. He or she may not treat it until it starts to grow.

Healthcare providers are always looking for new ways to treat urethral cancer. These new methods are tested in clinical trials. Before starting treatment, you should ask your healthcare provider if there are any clinical trials you should consider.

Who is at risk for urethral cancer?

Certain factors can make one person more likely to get urethral cancer than another. These are called risk factors. However, just because a person has one or more risk factors does not mean he or she will get urethral cancer. In fact, a person can have all of the risk factors and still not get cancer. On the other hand, a person can have no known risk factors and still get urethral cancer.

Since urethral cancer isn’t common, it can be hard for healthcare providers to identify risk factors for the disease. The following are possible risk factors for urethral cancer:

• Chronic irritation or inflammation of the urethra. This may be caused by repeated urinary tract infections or sexually transmitted diseases (STDs)

• Other cancers of the urinary tract, including bladder cancer

• Human papillomavirus (HPV) infection and other STDs

What are the symptoms of urethral cancer?

Urethral cancer can be a silent disease. This means that it doesn’t often cause symptoms in its early stages. In time, people with urethral cancer may get any or all of the following symptoms:

• Lump or growth on the urethra. You may feel this in your penis or perineum, which is the area between the genitals and the anus.

• Urethral discharge or bleeding or blood in your urine

• Urinating often or feeling an urge to urinate without passing much urine

• Pain, low flow, or dribbling when urinating

• Swollen lymph nodes in your groin area

Note that all of these symptoms can be caused by many other health problems. If you have any of these symptoms, see your healthcare provider right away.

What are clinical trials?

Clinical trials are studies of new kinds of cancer treatments. Healthcare providers do clinical trials to learn about how well new treatments work and what their side effects are. If they look promising, they are compared to the current treatment to see if they work better or have fewer side effects. People who participate in these studies may benefit from access to new treatments before the U.S. Food and Drug Administration (FDA) approves them. Participants also help further the understanding of cancer and help future cancer patients. The website, www.clinicaltrials.gov, is a good place to find clinical trial options.

Should everyone get a second opinion?

Many people with cancer get a second opinion from another healthcare provider. There are many reasons to get a second opinion. Here are some of those reasons:

• Not feeling comfortable with the treatment decision

• Being diagnosed with a rare type of cancer

• Having several options for how to treat the cancer

• Not being able to see a cancer expert

How can I get a second opinion?

There are many ways to get a second opinion:

• Ask a primary care healthcare provider. He or she may be able to recommend a specialist. These can include a surgeon, medical oncologist, or radiation oncologist. Sometimes these doctors work together at cancer centers or programs.

• Call the National Cancer Institute's Cancer Information Service. The number is 800-4-CANCER (800-422-6237). This service has information about treatment facilities, including cancer centers and other programs supported by the National Cancer Institute.

• Seek other options. Check with a local medical society, a nearby hospital, a medical school, or local cancer advocacy groups. Or talk with other people who've had urethral cancer to get names of specialists who can give you a second opinion.