Urethral Cancer - Causes, Clinical Manifestations, Diagnosis, and Management

What Is Urethral Cancer?

As the name suggests, urethral cancer is a type of cancer that initiates in the urethra. The biggest problem associated with urethral cancer is that it becomes difficult to detect unless it becomes advanced. This makes it challenging for doctors to treat the condition. Cancer is a condition in which the body cells grow uncontrollably and affect the nearby organs. When cancer originates from the urethra, the condition is known as urethral cancer. It is a rare cancer affecting one or two out of 100 individuals. The major problem associated with this type of cancer is that the patient remains asymptomatic for a long time and presents with symptoms only in the advanced stage.

What Is the Urethra?

The urethra is a tube-like structure that forms an integral part of the urinary system. It is attached to a balloon-like structure known as the urinary bladder. The main function of the urethra is to carry urine outside the body. It also forms a link between the urinary bladder and the outside world. The kidneys filter the blood, form urine, and transport the urine to the tubes known as the ureters. These ureters carry the urine to the bladder, and finally, the urine leaves the body through the urethra. Males have a longer urethra compared to females, so they have fewer chances of acquiring urinary tract infections and other urologic conditions.

What Are the Causes of Urethral Cancer?

Nothing has been discovered about the exact causes of urethral cancer. However, chronic swelling and infections increase the risk of urethral cancer. Cancer usually develops when body cells grow uncontrollably, clump together, and form a mass known as a tumor. However, the exact mechanism behind the growth of cancer cells is still unknown. Researchers have discovered certain factors that increase the risk of urethral cancer. Some of those are listed below:

• Long-standing inflammation and swelling.

• History of sexually transmitted diseases.

• People suffering from a specific strain of HPV (human papillomavirus virus).

• Narrowing of the urethra (urethral stricture).

• Urethral mass or urethral diverticulum.

• Older adults are more likely to experience urethral cancer.

• People with a history of bladder cancer are more likely to experience urethral cancer.

What Are the Signs and Symptoms of Urethral Cancer?

It is difficult for doctors to detect urethral cancer in the initial stages because people present with symptoms only when the cancer is in the advanced stage. The primary signs and symptoms of urethral cancer are listed below:

• Swelling or a lump near the urethra.

• Pain and bleeding while urinating.

• Difficulty in emptying the bladder completely.

Some of the additional symptoms of urethral cancer are listed below:

• Urinary frequency (passing urine frequently).

• A strong urge to pass urine.

• Dribbling of urine.

• Inability to pass urine completely.

• Urinary incontinence or the leakage of urine.

• Bleeding or discharge from the urethra.

• Enlargement of lymph nodes in the groin.

• Frequent urination at night.

What Methods Are Used to Diagnose Urethral Cancer?

Urethral cancer is usually diagnosed and treated by a urologist. The diagnostic methods are described below:

1. Medical History and Physical Examination - The doctor will obtain a thorough medical history and conduct a physical examination to get an insight into the patient’s symptoms. The doctor checks for general signs, including swelling, and obtains information about the previous illnesses of the patient.

2. Urine Test - It is a simple diagnostic procedure wherein the patient collects the urine in a container or a sterile bag and sends the sample to the laboratory for evaluation.

3. Blood Test - In this test, the doctor injects a needle to draw small amounts of blood from the patient’s arm. After the blood sample is obtained, it is evaluated in the laboratory.

4. Pelvic Examination - A pelvic examination is done to check for swelling near the pelvic organs, including the urethra, vagina, cervix, and urinary bladder. The surgeon inserts a gloved and lubricated finger into the rectum to examine the organs.

5. Urine Culture Test - It is a simple test in which the urine sample obtained from the patient is left unattended in the laboratory for a few days. If the bacteria multiply rapidly, urinary tract infections and other urologic diseases can be suspected.

6. Computed Tomography (CT) Scan - It is a diagnostic and imaging test that provides three-dimensional (3D) images of the internal body organs. This procedure helps diagnose cancer of the urogenital tract and other urologic conditions.

7. Biopsy - It is a diagnostic procedure wherein a needle is injected into the body to obtain the tissue samples of the urethra. This tissue sample is checked under the microscope to detect cancer cells.

8. Ureteroscopy - It is a diagnostic and therapeutic procedure wherein the doctor inserts a ureteroscope into the urinary tract through the urethra to diagnose and treat urologic problems. It helps detect changes in the urethral lining.

What Are the Different Stages of Urethral Cancer?

After the doctor confirms that the patient has urethral cancer, it is categorized into stages or grades. The cancer grades are listed below:

• Low-grade cancer grows slowly and does not spread much to the surrounding organs.

• High-grade cancer grows rapidly, might recur, and can spread outside the urethra.

What Are the Different Types of Urethral Cancer?

The treatment and staging of urethral cancer depend upon the part of the urethra that is affected. It can be classified as follows:

1. Anterior Urethral Cancer - In this type, the tumor remains superficial and only affects the part of the urethra outside the body.

2. Posterior Urethral Cancer -In this type, the tumors are deep and affect the part of the urethra located close to the urinary bladder. The entire urethra is usually affected in females, whereas the prostate gland is mainly affected in males.

How Is Urethral Cancer Managed?

How Is Urethral Cancer Managed?

Numerous treatments can be done to manage urethral cancer. However, the best treatment option depends upon the type of cancer the patient has. The treatment options are described below:

• Surgery - Surgery is one of the most effective treatments for urethral cancer.

  • Open Excision - It is a surgery in which the cancer is directly removed.

  • Transurethral Resection - It is a surgical procedure in which a resectoscope is inserted into the urethra to remove the tumor.

  • Laser Surgery - In this procedure, laser beams are passed into the body to remove or destroy the cancerous tissues.

  • Lymph Node Dissection - As the name suggests, this surgery is done to remove the affected lymph nodes.

• Radiotherapy or Radiation therapy - Radiation therapy aims to kill or inhibit the growth of cancer cells. The X-ray machine revolves around the patient and emits high-frequency radiation that passes through the body to kill cancer cells. The cancer cells are damaged to a large extent. As a result, these cells are unable to repair themselves and die.

• Chemotherapy - Chemotherapy is a non-surgical procedure in which powerful drugs are administered to the patient. These drugs turn lethal to the cancer cells and kill them. These drugs might be administered before or after the surgery to reduce the tumor size.

• Action Surveillance - It is a form of treatment in which the doctor follows the patient’s condition and does not provide any treatment until the test results vary. The doctor opts for this treatment option if the tumor does not show any signs of growth. This treatment option is usually preferred for older adults who might have complications after the treatment.

Conclusion:

Urethral cancer is the one that originates in and affects the urethra. People tend to get anxious and lose hope after they are diagnosed with cancer which is wrong. Though urethral cancer is rare, several treatment options are available to manage it. In addition to surgery, non-surgical options are also available to treat cancer. So, the patient need not worry and consult the doctor at the earliest to learn more about urethral cancer to prolong the lifespan.