Everything You Need To Know About
Overview
Urethral cancer is a type of malignancy that appears in the urethra. It is a rare condition that is more frequent in males than in females. The urethra is an open tube connected to the bladder. The bladder stores the urine, which then passes through the urethra and out of the body. Women have a shorter tube, making them more vulnerable to urinary tract infections. In females, the urethra is above the vagina, while in males, it passes through the prostate gland and follows the length of the penis. Compared to other urological types of cancers, the urethral one is the rarest of all. In this article, we will discuss the risk factors, symptoms and signs, diagnosis, and treatment of urethral cancer.
What are the risk factors of urethral cancer?
Risk factors exist and apply in every medical condition. Some are modifiable, while others are not. You can live with the risk factors you can’t change, but avoid those that you can modify. These risk factors increase your likelihood of developing the disease in the future. You can consult your doctor and find out whether you can avoid certain behaviors that raise your chances of presenting with urethral cancer. The following are some of the most well-established risk factors regarding cancer of the urethra:
- A history of bladder cancer in the past
- Chronic urethral inflammation caused by sexually transmitted diseases (STDs)
Research suggests that human papillomavirus (HPV) type 16 raises the chances of developing urethral cancer significantly. Hopefully, vaccination can be protective against this particular STD. Physicians recommend it for both men and women. Frequent screening, however, is necessary, especially in high-risk groups. People with an increased chance of acquiring an STD are those that belong to one or more of the following categories:
- Men who have sex with men
- People with multiple partners
- Individuals whose partner has multiple partners
- Those that engage in unprotected sex
Blood in the urine and other symptoms of urethral cancer
Cancer of the urethra might present with difficulties urinating or bleeding upon urination. Sometimes it is entirely asymptomatic until it reaches an advanced stage. Signs and symptoms that might indicate urethral malignancy might be similar to those caused by a simple urinary tract infection. Therefore, it might present with trouble initiating urination or keeping the flow of the urine. The individual might experience frequent interruption while urinating. Sometimes, there is a frequent urge to urinate, especially at night, called nocturia. Others experience incontinence or urethral discharge. Finally, some individuals may notice a painless lump in the perineum, penis, or groin.
How to diagnose urethral cancer?
If your doctor suspects urethral cancer, he or she will perform a physical exam and medical history taking. The questions will be about your overall health or illnesses you had in the past, your habits, or any other factors that could potentially increase your risk for urethral cancer. Additionally, you might undergo a pelvic exam, performed in women, or a digital rectal examination (DRE), regardless of your gender. Other specific tests for cancer of the urethra are the following:
- Urine cytology and urinalysis
- Blood exam and chemistry studies
- CT-scan
- Ureteroscopy
- Biopsy
Ureteroscopy is a minimally invasive procedure to look inside the urethra, bladder, and ureters through a ureteroscope, which the physician inserts into the urethra. The doctor can also insert a narrow tool while performing the procedure and take sample tissue for biopsy, which is the gold standard for the diagnosis of the disease.
Another quite significant aspect of urethral cancer diagnosis and staging is establishing whether it spread to other parts of the body or not. To find out, doctors perform some of the following interventions:
- Chest x-ray
- CT-scan
- MRI-scan
- Urethrography
Metastasis may be local or distant, and it is the result of cancer spread through tissue, blood, or lymph system. If urethral cancer spreads in the lungs, it still is of the primary type. After diagnosis, doctors stage and locate the tumor. Treatment depends on all of the above parameters, as well as the patient’s overall health and medical history.
Treatment of urethral cancer
As mentioned previously, the treatment option is a multifactorial decision. Your doctor might choose one of the following standard treatments or a combination of some of them.
- Surgery
- Radiation therapy
- Chemotherapy
- Active surveillance
Every treatment has different types of procedures, each with its advantages and disadvantages, or side effects. Radiation therapy can be external or internal, while chemotherapy can be systemic or regional. Surgical procedures may be open or minimally invasive and using different surgical tools. For example, it might take place traditionally, endoscopically, using a laser beam or electric currents. Plastic surgery might be necessary after some procedures. Also, you might need to undergo lymph node dissection to extract potential spread of tumor in the regional lymph nodes. After treating cancer by some of the above methods, follow-up tests might be necessary. Regular screening is crucial for all those who survived cancer because recurrence might occur.
References
https://www.cancer.gov/types/urethral/patient/urethral-treatment-pdq
https://www.webmd.com/cancer/what-is-urethral-cancer#1
