Urethral Cancer: Radiation Therapy

Radiation therapy, also called radiotherapy, uses rays of energy to kill cancer cells. It may be used to treat urethral cancer. This depends on the type of cancer and where it is in your urethra.

Two types of radiation can be used in the treatment of urethral cancer: external beam radiation and brachytherapy. In external beam radiation, the X-rays are delivered from a machine outside of your body. They’re aimed at the area on your body to be treated. In brachytherapy, or internal radiation, radioactive material is placed directly in or around the tumor. Sometimes both types of radiation are used together.

Radiation alone is not often used as the first option to treat male urethral cancer. However, it may be used before surgery to shrink a tumor or after surgery to kill any areas of cancer that may remain. In women, radiation alone may be an option for some early stage cancers. It’s usually combined with chemotherapy. 

Radiation is often used with chemotherapy to get better outcomes when treating urethral cancer. Radiation may also be used before or after surgery for more advanced cancers.

Deciding a radiation treatment plan

You’ll work with a radiation oncologist for your treatment plan. This is a doctor who specializes in both cancer and radiation. This doctor decides:

• The goal of radiation

• The type of radiation you need and when you should get it. For instance, with or without chemotherapy or before or after surgery.

• The dose you need

• How long you need treatment

It may help to bring a family member or friend with you to appointments. Make a list of questions and concerns you want to talk about. During your visit, ask what the goal of radiation is. Also ask what you can expect to feel during and after the treatments.

What to expect during radiation therapy

External radiation

Radiation is often given once a day, 5 days a week, for a set number of weeks.

External radiation treatment is like getting an X-ray. The radiation comes from a large machine. The machine doesn't touch you during the treatment. The treatments are quick and don't hurt.

Before you start treatment, you’ll have imaging scans. This is done to see the exact location of the tumor so the beams of radiation can be focused there. Small marks may be put on your skin to mark the treatment area. This ensures that the radiation reaches the tumor, and not healthy parts of your body.

On the day of treatment, your healthcare provider will carefully put you into the right position. You may see lights from the machine lined up with the marks on your skin. These help the therapist know you’re in the right position. The therapist will leave the room while the machine sends radiation to your tumor. During this time, he or she can see you, hear you, and talk to you. When the machine sends radiation to your tumor, you’ll need to be very still, but you do not have to hold your breath. The process will likely take less than an hour.

Brachytherapy

In this treatment, your healthcare provider puts radioactive seeds or pellets into or near the tumor. This is often done by putting the seeds into a thin tube that's put in your urethra. The radiation the seeds give off travels a very short distance. This helps make sure it affects the tumor with very little effect on nearby tissue.

There are different ways to give brachytherapy. Talk to your radiation oncologist to find out what you can expect.

Side effects of radiation

Talk with your healthcare provider about what you might feel like during and after radiation. All cancer treatments have side effects. Side effects often get worse as treatment goes on, but they can be treated. Side effects get better or go away over time after treatment ends.

Side effects of radiation can include:

• Nausea

• Diarrhea

• Skin irritation. This can lead to redness, dryness, and soreness.

• Bladder pain

• Burning during urination

• Urinating more often or a more urgent need to urinate

• Urinary incontinence

• Rectal pain and bleeding

• Vaginal bleeding in women

• Fatigue

• Hair loss in only the area being treated

In most cases, these side effects go away after treatment. Many side effects can be managed with certain medicines.

Some side effects may last a long time. These can include urethral or vaginal strictures (narrowing because of scar tissue). This may require surgery or dilatation. Some long-term side effects of radiation may not show up for many years after you finish treatment. These depend on the dose and type of radiation. They also depend on how many times you had treatment.

Talk with your healthcare provider about what side effects you can expect. Ask what can be done to prevent or ease them. Ask your healthcare provider what symptoms to watch out for. In some cases, you should call your healthcare team. They may want you to call if you have signs of infection, such as fever or pain that gets worse. Be sure you know what number to call and what to do if you need help at night, on weekends, and on holidays.