Question: What are the treatments for Urethral Cancer ?
Answer: Key Points - There are different types of treatment for patients with urethral cancer. - Four types of standard treatment are used: - Surgery - Radiation therapy - Chemotherapy - Active surveillance - New types of treatment are being tested in clinical trials. - Patients may want to think about taking part in a clinical trial. - Patients can enter clinical trials before, during, or after starting their cancer treatment. - Follow-up tests may be needed. There are different types of treatment for patients with urethral cancer. Different types of treatments are available for patients with urethral cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment. Four types of standard treatment are used: Surgery Surgery to remove the cancer is the most common treatment for cancer of the urethra. One of the following types of surgery may be done: - Open excision: Removal of the cancer by surgery. - Transurethral resection (TUR): Surgery to remove the cancer using a special tool inserted into the urethra. - Electroresection with fulguration: Surgery to remove the cancer by electric current. A lighted tool with a small wire loop on the end is used to remove the cancer or to burn the tumor away with high-energy electricity. - Laser surgery: A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove or destroy tissue. - Lymph node dissection: Lymph nodes in the pelvis and groin may be removed. - Cystourethrectomy: Surgery to remove the bladder and the urethra. - Cystoprostatectomy: Surgery to remove the bladder and the prostate. - Anterior exenteration: Surgery to remove the urethra, the bladder, and the vagina. Plastic surgery may be done to rebuild the vagina. - Partial penectomy: Surgery to remove the part of the penis surrounding the urethra where cancer has spread. Plastic surgery may be done to rebuild the penis. - Radical penectomy: Surgery to remove the entire penis. Plastic surgery may be done to rebuild the penis. If the urethra is removed, the surgeon will make a new way for the urine to pass from the body. This is called urinary diversion. If the bladder is removed, the surgeon will make a new way for urine to be stored and passed from the body. The surgeon may use part of the small intestine to make a tube that passes urine through an opening (stoma). This is called an ostomy or urostomy. If a patient has an ostomy, a disposable bag to collect urine is worn under clothing. The surgeon may also use part of the small intestine to make a new storage pouch (continent reservoir) inside the body where the urine can collect. A tube (catheter) is then used to drain the urine through a stoma. Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. Radiation therapy Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy: - External radiation therapy uses a machine outside the body to send radiation toward the cancer. - Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type of cancer and where the cancer formed in the urethra. External and internal radiation therapy are used to treat urethral cancer. Chemotherapy Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type of cancer and where the cancer formed in the urethra. Active surveillance Active surveillance is following a patient's condition without giving any treatment unless there are changes in test results. It is used to find early signs that the condition is getting worse. In active surveillance, patients are given certain exams and tests, including biopsies, on a regular schedule. New types of treatment are being tested in clinical trials. Information about clinical trials is available from the NCI website. Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward. Patients can enter clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment. Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's listing of clinical trials. Follow-up tests may be needed. Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups. Treatment Options for Urethral Cancer Distal Urethral Cancer Treatment of abnormal cells in the mucosa (inside lining of the urethra that have not become cancer, may include surgery to remove the tumor (open excision or transurethral resection), electroresection with fulguration, or laser surgery. Treatment of distal urethral cancer is different for men and women. For women, treatment may include the following: - Surgery to remove the tumor (transurethral resection), electroresection and fulguration, or laser surgery for tumors that have not spread deeply into tissue. - Brachytherapy and/or external radiation therapy for tumors that have not spread deeply into tissue. - Surgery to remove the tumor (anterior exenteration) for tumors that have spread deeply into tissue. Sometimes nearby lymph nodes are also removed (lymph node dissection). Radiation therapy may be given before surgery. For men, treatment may include the following: - Surgery to remove the tumor (transurethral resection), electroresection and fulguration, or laser surgery for tumors that have not spread deeply into tissue. - Surgery to remove part of the penis (partial penectomy) for tumors that are near the tip of the penis. Sometimes nearby lymph nodes are also removed (lymph node dissection). - Surgery to remove part of the urethra for tumors that are in the distal urethra but not at the tip of the penis and have not spread deeply into tissue. Sometimes nearby lymph nodes are also removed (lymph node dissection). - Surgery to remove the penis (radical penectomy) for tumors that have spread deeply into tissue. Sometimes nearby lymph nodes are also removed (lymph node dissection). - Radiation therapy with or without chemotherapy. - Chemotherapy given together with radiation therapy. Check the list of NCI-supported cancer clinical trials that are now accepting patients with distal urethral cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Proximal Urethral Cancer Treatment of proximal urethral cancer or urethral cancer that affects the entire urethra is different for men and women. For women, treatment may include the following: - Radiation therapy and/or surgery (open excision, transurethral resection) for tumors that are of an inch or smaller. - Radiation therapy followed by surgery (anterior exenteration with lymph node dissection and urinary diversion). For men, treatment may include the following: - Radiation therapy or radiation therapy and chemotherapy, followed by surgery (cystoprostatectomy, penectomy, lymph node dissection, and urinary diversion). Check the list of NCI-supported cancer clinical trials that are now accepting patients with proximal urethral cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Urethral Cancer that Forms with Invasive Bladder Cancer Treatment of urethral cancer that forms at the same time as invasive bladder cancer may include the following: - Surgery (cystourethrectomy in women, or urethrectomy and cystoprostatectomy in men). If the urethra is not removed during surgery to remove the bladder, treatment may include the following: - Active surveillance. Samples of cells are taken from inside the urethra and checked under a microscope for signs of cancer. Check the list of NCI-supported cancer clinical trials that are now accepting patients with urethral cancer associated with invasive bladder cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website. Metastatic or Recurrent Urethral Cancer Treatment of urethral cancer that has metastasized (spread to other parts of the body) is usually chemotherapy. Treatment of recurrent urethral cancer may include one or more of the following: - Surgery to remove the tumor. Sometimes nearby lymph nodes are also removed (lymph node dissection). - Radiation therapy. Check the list of NCI-supported cancer clinical trials that are now accepting patients with recurrent urethral cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.