Urethral Cancer Treatment – Treatment for Urethral Cancer

Treatment for urethral cancer depends on how far along the urethral cancer has gotten location of the disease, and the urethral cancer patient’s age, sex, and overall health. Urethral cancer treatment options include chemotherapy, radiation, and surgery. Because urethral cancer is often invasive, surgery for urethral cancer is the primary method of treatment. Chemotherapy and radiation are often used as adjuvant urethral cancer treatment therapies.

Surgery as Treatment for Urethral Cancer

Surgical urethral cancer treatment options depend on the stage and location of the urethral cancer. Surgery is usually performed under general anesthesia and is a pretty common form of urethral cancer treatment. Early urethral cancer is treated using fulguration (destruction of cancer cells using high-frequency electric current) and laser therapy (destruction of cancer cells using a narrow beam of intense light) for the treatment of urethral cancer.

Procedures performed for advanced cases include the following:

• Removal of the bladder and urethra (cystourethrectomy)
• Removal of part of the penis (partial penectomy)
• Removal of the penis, urethra, and penile root (radical penectomy)
• Removal of the bladder and prostate (cystoprostatectomy)
• Removal of cancerous lymph nodes (lymph node dissection)
• Removal of the bladder, urethra, and vagina (anterior exenteration)

If partial penectomy, radical penectomy, or anterior exenteration is required, additional surgical procedures are performed to reconstruct the reproductive organs left behind from advanced urethral cancer. If the bladder and urethra are removed, a urinary diversion is performed to allow for the passage of urine.

Complications of surgery include the following:

• Adverse reaction to anesthesia
• Bowel obstruction
• Incontinence
• Infection
• Mortality (approximately 1–2% of cases)
• Recurrence (in approximately 50% of cases)
• Tissue death (necrosis)
• Urethral narrowing (stricture) or abnormal passage (fistula)

Radiation as Treatment for Urethral Cancer

Radiation may be used along with surgery in advanced urethral cancer treatment, or as primary treatment for early urethral cancer that is noninvasive. Radiation uses high-energy rays from a machine outside the body (called external beam radiation) or surgically implanted radioactive seeds or pellets (called brachytherapy) to destroy the urethral cancer cells. External radiation and brachytherapy are sometimes used together as forms of urethral cancer treatments.

External beam radiation usually involves treatment 5 days a week for approximately 6 weeks on the area of the urethral cancer. Brachytherapy involves surgical implantation of the seeds, which become inactive over time and remain in place.

Side effects of radiation for urethral cancer treatments are caused by the destruction of healthy tissue and include the following:

• Abnormal healing resulting in abnormal passage in the urethra (fistula)
• Burning of the skin (similar to sunburn)
• Diarrhea
• Fatigue
• Inflammation of the bladder (cystitis)
• Narrowing of the urethra (stricture; causing urination difficulty)
• Nausea

Chemotherapy as a form of Urethral Cancer Treatment

Chemotherapy involves using drugs to destroy urethral cancer cells. It is a systemic urethral cancer treatment (i.e., destroys urethral cancer cells throughout the body) that is administered orally or intravenously (through a vein; IV). Medications are often used in combination to destroy urethral cancer that has metastasized. Commonly used drugs include cisplatin (Platinol®), vincristine (Oncovin®), and methotrexate (Trexall®).

Side effects include the following:

• Anemia (causing fatigue, weakness)
• Nausea and vomiting
• Loss of appetite (anorexia)
• Hair loss (alopecia)
• Mouth sores
• Increased risk for infection
• Shortness of breath
• Excessive bleeding and bruising

Urethral Cancer Treatment and Prognosis

Five-year survival rates for noninvasive urethral cancer treated surgically or with radiation are approximately 60%. Recurrence rates for invasive urethral cancer treated with surgery, chemotherapy, and radiation combined are higher than 50%. Early diagnosis and urethral cancer treatment offers the best chance for cure.