Urethral Cancer: Causes, Symptoms & Treatment

Urethral cancer or urethral carcinoma predominantly affects patients who are over 50 years old. At the first warning signs, such as blood in the urine or pain when urinating, a urologist should definitely be consulted. If the disease is detected at an early stage, there is a fairly good chance of cure for urethral cancer.

What is urethral cancer?

Schematic diagram showing the anatomy and structure of the urinary bladder. Click to enlarge. In urethral cancer, the patient’s urethra is affected by malignant growths. Other names for urethral cancer are urethral carcinoma and urether carcinoma. Urethral cancer is an extremely rare cancer, such that only about 0.3 percent of all cancer patients suffer from this rare form of cancer. Women are affected about twice as often as men. This is due to the anatomically shorter urethra in women and the associated higher susceptibility to infection for inflammation of the urinary tract. Most patients do not develop urethral cancer until later in life.

Causes

The causes of urethral cancer are not clearly established. However, current science suggests that there is a link between frequent urinary tract infections and the occurrence of urethral cancer. Because of the shorter urethra, women are more likely to suffer from these infections, which is why they are more likely to be affected by urethral cancer. Also, people who suffer from venereal disease have an increased risk of developing urethral cancer. Another risk factor for this cancer is certain sexual preferences that can cause injury to the sensitive urethra. In some patients, urethral cancer also develops from an initially benign growth in the urethra, which later continues to grow and may eventually develop into a malignant form of tumor called urethral cancer.

Symptoms, complaints and signs

At the beginning of urethral cancer, there are still no symptoms or only nonspecific symptoms. In a more advanced stage, the urinary stream progressively weakens. There is an increased urge to urinate, but the bladder is no longer emptied completely. The urinary stream is sometimes also split or twisted. In the further course, the patient then complains of urinary dribbling. In addition, pain occurs during urination even without inflammation. Frequently, blood is also found in the urine during laboratory tests. This symptom, known as microhematuria, is not visible to the naked eye. Microhematuria occurs with urethral tumors, especially after sexual intercourse. However, macrohematuria can also occur, in which the urine turns reddish due to blood admixtures. More and more urine gradually accumulates in the urethra. This increases the risk of infections in the urinary tract. In extreme cases, there is complete urinary retention with severe flank pain that can radiate to the groin. The backlog of urine into the kidneys causes long-term damage to them with the development of severe kidney failure. Further progressive growth of the tumor can lead to abscesses and fistulas. In later stages of the disease, patients suffer from severe weight loss. There is also increased sweating at night. With timely treatment, urethral cancer is still completely curable. After the formation of metastases, the chances of cure decrease.

Diagnosis and course

If a patient is suspected of having urethral cancer, a urology specialist should be consulted so that he or she can make the diagnosis. Symptoms of urethral cancer may include pain when urinating, blood in the urine, and a decreased stream of water when going to the toilet. After questioning the patient about his symptoms and examining the urine, the urologist will usually arrange for a cystoscopy. This provides information about the cell structure in the bladder and urethra. Patients will also be advised by the urologist to make an appointment with their gynecologist to rule out a condition affecting the gynecologic area. Another way to detect urethral cancer is urethroscopy, which is an endoscopic examination of the urethra and bladder that may include taking a tissue sample of the tumor.A thorough diagnosis also includes the search for metastases, which is usually performed with the aid of ultrasound or other imaging procedures such as MRI or CT. The earlier the disease is detected and treated, the higher the chances of recovery from urethral cancer.

Complications

In many cases, urethral cancer can be treated well if it is diagnosed early so that treatment can be started early. In most cases, urethral cancer results in traces of blood in the urine. In this case, bloody urine can cause many people to have a panic attack. When urinating, burning pain occurs, which complicates the daily life of the affected person. It is therefore not uncommon for people to intentionally take less fluid in order to directly prevent this pain. However, this leads to dehydration of the body, which is a very unhealthy condition. The stream of water during urination is relatively weak in most cases, which not infrequently can also lead to psychological discomfort and depression. Like any other cancer, urethral cancer can spread to other regions of the body and cause discomfort and tissue destruction in these regions as well. Irreversible secondary damage can occur if urethral cancer is not treated in time. The treatment is carried out with the help of surgical interventions or by means of radiation. However, the success depends on the time of diagnosis, so that no positive course of the disease can be guaranteed. It is not uncommon for urethral cancer to reduce the patient’s life expectancy.

When should you go to the doctor?

A doctor must be consulted as soon as the affected person suffers from unpleasant discomfort during urination for several days. Pain or pulling sensations in the lower abdomen are a cause for concern and should be presented to a doctor. If there is a feeling of pressure in the bladder region, blood in the urine or a burning sensation when urinating, a doctor is needed. If the urine stream is greatly reduced or urine can only be passed in dribs and drabs, a doctor should be consulted. If the symptoms increase steadily, a doctor should be consulted immediately. If there is exhaustion, inner restlessness or behavioral abnormalities, clarification of the symptoms is necessary. Changes in libido, social withdrawal or general malaise should be examined by a doctor. If anxiety or panic attacks set in, action is required. A visit to the doctor should be made as soon as possible. If reduced fluid intake occurs as a result of the symptoms, a life-threatening condition may develop. A doctor should therefore be consulted as soon as a feeling of internal dryness sets in. If there is a decrease in the usual level of performance, mental disturbances, increased fatigue or a general feeling of illness, a doctor should be consulted. Since urethral cancer can lead to a fatal course, it is advisable to have the clarification of the described symptoms immediately.

Treatment and therapy

In the case of urethral cancer, the first attempt is to remove the malignant tumor from the urethra with the help of surgery. Depending on the size and physician of the urethral cancer, radiation or chemotherapy are also used. Surgery is often very difficult, especially with larger tumors, which is why many patients first try to reduce the size of the urethral cancer with the help of radiation or chemotherapy. In this way, better surgical conditions can be created and the area to be operated on can be kept smaller. In the case of very large tumors that require immediate surgery, it may even be necessary to remove the entire urinary bladder or, in men, part of the penis. However, following the removal and cancer treatment, reconstruction can be done using parts of the intestine. After removal of the tumor, most patients are advised to continue treatment with radiation and/or chemotherapy to safely fight all cancer cells and prevent recurrence of urethral cancer.

Outlook and prognosis

Urethral cancer is the rarest type of urologic cancer, with fewer than 2000 known cases. In addition, the differences in urethral anatomy between men and women, as well as the location of the tumor in the tissue, significantly influence the treatment options and thus the prognosis.The prognosis and treatment options depend as much on factors such as:

Whether the cancer has spread through the mucosa lining the urethra to surrounding tissues, lymph nodes, or other parts of the body such as organs. Furthermore, the general health of the patient and whether the cancer was diagnosed for the first time or has recurred. As a result, diagnosed cases of urethral cancer thus usually lead to an individualized course of treatment for each patient. Different types of urethral cancer develop inside different types of cells, in different parts of the urethra. About 60% of patients of non-invasive urethral cancer treated surgically or chemotherapeutically show survival of more than five years. The recurrence rate for invasive urethral cancer treated with a combination of surgery, chemotherapy and radiation is over 50%. Early diagnosis and treatment offers the best chance of cure.

Prevention

Effective prevention of urethral cancer is not yet known. Since frequent urethritis as well as sexually transmitted diseases can promote its development, it is advisable to seek treatment from a specialist at an early stage if one of these conditions occurs. A healthy lifestyle can also help prevent the development of urethral cancer.

Follow-up care

Follow-up care for urethral cancer is urgent. In this regard, follow-up care should be tailored to the individual patient’s disease history. In this regard, a more closely meshed follow-up is usually necessary if the course of the disease is severe. It is also relevant whether the patient is symptom-free or not. The type and extent of follow-up examinations can therefore vary greatly from patient to patient. In addition, it is important to detect the formation of metastases in other organs of the body in good time. Various examinations are performed for this purpose. In addition to imaging procedures such as CT, MRI and X-rays, certain blood tests support the follow-up treatment, and preventive measures should be taken to avoid the occurrence of a recurrence. To this end, care should be taken to reduce the risk factors that can lead to inflammation of the urinary tract. Rehabilitation of the patient after treatment of urethral carcinoma is also conceivable. Both inpatient and outpatient measures are available in special tumor aftercare centers. The aim of a successful rehabilitation measure is to increase the patient’s quality of life. This includes not only the physical factors, but also the psychological, social and professional situation. As a rule, the physician and patient decide by consensus whether such a measure is necessary and purposeful or not.

What you can do yourself

Urethral cancer is a serious and life-threatening disease that does not heal on its own. A lengthy treatment and therapy under medical supervision is mandatory. Possible self-therapies or healing attempts with home remedies are strongly discouraged. Nevertheless, patients can contribute to the positive course of the disease. First and foremost, a positive attitude towards life and a hopeful attitude towards the disease play a role. Those who give up on themselves have poorer chances of recovery. A positive attitude includes trust in the doctor or doctors. If this is not the case, a change of doctor can be considered. If the doctor and his competence are trusted, it is also easier to follow the recommendations and therapy prescriptions. If an operation takes place, the patient can support his recovery by not only listening to many tips for his further life in the subsequent rehabilitation measure, but also putting them into practice to the best of his knowledge. A general improvement in living conditions, dietary habits and overall physical condition will make the body more resistant to upcoming treatment steps. Alcohol should be consistently avoided while taking pills. Instead, it is very important to drink a particularly large amount so that the body is sufficiently detoxified by the kidney activity. The consumption of nicotine should also be completely avoided.