Urethral Cancer

Urethral cancer can develop from cells that line the urethra in a few different ways. These cancers have names that correspond to the cell types that give rise to cancerous cells. These include:

• Squamous cell carcinoma: This is the most frequently occurring type of urethral cancer. In women, it begins in the flat cells that line the urethra near the bladder, and in men, it begins in the urethra's lining in the penis.
• Transitional cell carcinoma: Develops in cells found close to the prostate gland in men and the urethral opening in women.
• Adenocarcinoma: Begins in the cells that create and exude mucus and other fluids.

Urethral cancer may be a silent disease. When the tumor is small, it may not exhibit any symptoms.

The following signs and symptoms could appear as the tumor grows:

• Blood in the urine
• Bleeding or discharge from the urethra
• Urge to urinate frequently 
• Difficulty urinating
• Urinary discomforts such as insufficient flow or dribbling
• Urinary incontinence (inability to control urination)
• Groin lymph nodes that are enlarged
• A lump or growth located in the penis or between the genitalia and anus

Urethral cancer is rare. According to the Surveillance, Epidemiology, and End Results Program database, the yearly incidence rate of urethral cancer in the United States from 1973 to 2002 was 4.3 per million in men and 1.5 per million in women, with declining trends throughout the three decades.

• African Americans had an incidence rate (of five per million), which was twice as high as that of Caucasians (2.5 per million)
• Human papillomavirus (HPV) infection, particularly HPV16, a variant known to cause cervical cancer, seems to be linked to urethral malignancies.

Urethral cancer is staged and graded depending on the size, metastasis (if cancer has spread to other parts of the body), and the appearance of the cancer cells under a microscope. Your doctors can decide the best course of treatment for you with staging and grading.

Urethral cancer can be staged using the TNM staging system, where:

• T (tumor) stands for the tumor's size and depth.
• N (nodes) indicates whether cancer has spread to nearby lymph nodes.
• M (metastasis) indicates whether cancer has spread to other parts of the body.

This system can be used to describe five stages of urethral cancer, which are as follows:

1. Stage 0: At this stage, cancer cells are still localized (or “in situ”) and have not disseminated to surrounding tissue.
2. Stage I: Cancer cells have already begun to spread to adjacent tissues. It is not deeply buried in the surrounding tissue or has spread to the lymph nodes. This stage is also known as early-stage cancer.
3. Stage II: Cancer cells have penetrated further into the surrounding tissue. Lymph nodes may or may not be affected. This also goes by the label of localized cancer.
4. Stage III: The malignancy has expanded and moved further into the surrounding tissue. At this stage, lymph nodes are typically affected. Another name for this is localized cancer.
5. Stage IV: The malignancy has spread to more human organs and tissues. It is commonly named metastatic or advanced cancer.

Although the exact etiology of urethral cancer is still unknown, the following factors may heighten the risk:

• Age: The risk of urethral carcinoma increases with age. Most people with this malignancy are in their 70s or 80s when they are diagnosed.
• Previous infections: Urethral cancer risk is higher in people who have had bladder or kidney infections.
• Smoking: Besides other urinary tract malignancies such as kidney and bladder cancer, smoking tobacco raises the risk of urethral cancer.
• Family history: Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer, increases the risk of colon cancer and other types of cancer, such as urethral cancer. If there is a significant history of cancer in your family, consult your doctor. You and your partner can decide whether to investigate genetic testing for cancer syndromes, such as Lynch syndrome and others that are inherited.