Primary urethral cancer

What is primary urethral cancer?

You have been diagnosed with primary urethral cancer. This means you have a cancerous growth (malignant tumour) in your urethra. The urethra carries urine out of the body from the bladder, also known as urinary bladder. In men, the urethra runs through the prostate and the penis (Fig. 1a). In women, it leads to the genital area in front of the vagina (Fig. 1b).

Primary urethral cancer is rare and is found more frequently in men and in patients older than age 75
years. It is not contagious.

A tumour that grows towards the centre of the urethra without growing into deeper layers or adjacent organs is superficial and represents an early stage of cancer. Urethral cancer becomes advanced as it grows into deeper layers of tissue; into the penis, the vagina, or adjacent organs; or into the surrounding muscles. This type of cancer has a higher chance of spreading to other parts of the body (metastatic disease) and is harder to treat. In some cases, it may be fatal.

If urethral cancer spreads to other parts of the body such as the lymph nodes or other organs, it is called metastatic urethral cancer. At this stage, cure is unlikely, and treatment is limited to controlling the spread of the disease and reducing symptoms.

Fig. 1a: The genital tract in men.
Fig. 1a: The genital tract in men.
Fig. 1b: The genital tract in women.
Fig. 1b: The genital tract in women.

Follow-up

After surgery, your doctor will schedule you for a series of check-ups. During these visits, a urine sample will be checked for cancer cells, and your urethra will be examined with a cystoscope (urethrocystoscopy) and with imaging. Please be sure to attend these visits.

Regular check-ups are critical to ensuring that complications or disease recurrences are found early.

A specialist, usually the urologist, should coordinate and interpret the results from the follow-up visits. That specialist should also be the main contact for questions about your disease or related issues.

Support

Talk to family or friends and people who are close to you. It can help to discuss things with someone outside your inner circle. Your doctor may be able to refer you to a counsellor or specialist nurse.

Efforts are being made to promote patient advocacy for urethral cancer. Ask your oncologist if a urethral cancer patient representative is available near you. It may be helpful talk to a patient representative because urethral cancer is rare. Some of the treatments and side effects are comparable to those for bladder cancer.

Access to clinical trials

If your urethral cancer has come back after treatment or has spread to other organs, you may be referred to centres where clinical trials are available. These experimental studies are typically designed to test how a treatment works among patients with specific characteristics. Your doctor will provide all information you might need before participating in a trial. Your symptoms and general condition will be monitored more often and more closely than during regular treatment.

It is important to know that you can stop your participation in a clinical trial at any time. You will not need to explain your reasons.

This information was produced by the European Association of Urology (EAU) Patient Information Working Group, November 2016.