Treatment of locally advanced primary urethral cancer
Advanced primary urethral cancer has grown into deeper layers of tissue, adjacent organs, or surrounding muscles. It has a higher chance of spreading to other parts of the body (metastatic disease) and is harder to treat.
Different types of urethral cancer are treated differently. Some urethral cancer, called urothelial carcinoma, specifically affects urothelial cells. Chemotherapy followed by surgery is critical to remove urothelial carcinoma.
Chemotherapy that contains platinum (eg, cisplatin, carboplatin) is most effective against urethral cancer. Chemotherapy combinations like MVAC (which uses the drugs methotrexate, vinblastine, Adriamycin [doxorubicin], and cisplatin) or gemcitabine and cisplatin are often prescribed.
Limited ability to perform daily activities (low performance status), other illnesses, or decreased kidney function could make you ineligible for some chemotherapies.
If you cannot take chemotherapy containing cisplatin, other combinations including carboplatin are an option with slightly decreased efficacy.
Some types of chemotherapy have a lot of side effects. Common side effects of chemotherapy drugs include nausea, vomiting, diarrhoea, hair loss, dry mouth, loss of ability to taste food, hiccups, dark urine, decreased sweating, dry skin, and other signs of dehydration.
Your chemotherapy regimen should achieve a balance between the most effective cancer treatment and your quality of life. If you are not fit or feel very sick from the cancer, side effects can be quite severe. They should be considered seriously if you cannot recover from your illness and the goal is to optimise your quality of life.
Another type of urethral cancer and the most common, is squamous cell carcinoma, which affects the epithelial cells that line the urethra. A combination of chemotherapy and radiation therapy is used to treat squamous cell carcinoma.