Urethral Cancer

Urethral cancer is cancer of the urethra. The urethra is a tube that allows urine to leave the body. Cancer of the urethra is a rare and aggressive cancer. Less than 1 out of 100 cancers worldwide are urethral cancer.^1,2

In women, the urethra is about 1½ inches long and runs from the bladder to outside the body. In men, it is about 8 inches long and goes through the prostate gland and penis to outside the body. In men, it also carries semen.¹

Who is at risk?

Cancer of the urethra is nearly 3 times more common in men than women. While it is rare, doctors know some things increase your chances of developing this cancer, including:^1,2

1. A history of bladder cancer
2. A history of sexually transmitted infections (STIs)
3. HPV (human papillomavirus) infection, especially the strain HPV16 that also causes cervical cancer
4. Conditions that cause long-term inflammation of the urethra, such as frequent urinary tract infections or using a catheter

One study found 3 out of 10 people with cancer of the urethra also had an HPV infection.²

In the United States, this cancer is twice as high in Black people than in white people. Risk is also higher in people ages 75 and older.^2,3

Signs of urethral cancer

There may be no early symptoms of urethral cancer. The most common symptoms of this cancer are:¹

• Problems urinating (trouble starting or weak, interrupted peeing)
• Frequent urination, especially at night
• Incontinence
• Bleeding from the urethra or blood in the urine
• A lump or swelling in the groin area

Diagnosing cancer of the urethra

The same tests used to diagnose bladder cancer are used to diagnose urethral cancer. These tests include:¹

• Physical exam and health history
• Pelvic exam, in women
• Rectal exam
• Lab tests to check for abnormal cells in the urine
• Lab tests to check for sugar, protein, blood, or white blood cells in the urine
• Blood chemistry tests and a complete blood count (CBC)
• CT scan (CAT scan)
• Ureteroscopy (a test to look inside the urethra)
• Biopsy

Once urethral cancer has been diagnosed, additional tests will be needed. These tests help your doctor understand if the cancer has grown or spread and where. This process is called staging and may require:¹

• X-rays of the chest and urethra
• CT scan of the lower belly
• MRI

Types of urethral cancer

There are 3 basic types of cancer of the urethra. Each is named for the type of tissue where the abnormal cells grow. This includes:¹

1. Squamous cell carcinoma
2. Transitional cell carcinoma
3. Adenocarcinoma

Squamous cells are thin, flat cells that exist in the part of the urethra closest to the bladder in women and the lining of the urethra in the penis men. Transitional cells are near the opening of the urethra in women and in the part that goes through the prostate gland in men. Adenocarcinoma forms in the glands around the urethra in both men and women.¹

Your doctor will run tests to see which type of urethral cancer you have. Once it is staged, you may also hear the terms distal and proximal:¹

Distal urethral cancer usually has not spread deeply into the tissue.
Proximal urethral cancer has most often spread deeply. This type may occur at the same time as bladder or prostate cancer in men.

Treatments for cancer of the urethra

The 3 types of treatment for urethral cancer are:¹

1. Surgery
2. Radiation
3. Chemotherapy

The combination of treatments will depend on:¹

• The person's gender
• Where the cancer is located
• How much it has spread and where
• If the person has another type of cancer at the same time

Something called active surveillance may also be an option. In this case, your doctor follows you closely to watch for early signs the cancer is getting worse. This will require a regular schedule of tests and exams.¹

Because cancer of the urethra is so rare, there are still many questions about the best treatments. If you develop urethral cancer, joining a clinical trial may offer you the most advanced treatment option and contribute to our understanding of this disease.