Urethral cancer treatment is determined on many factors. Generally, the therapeutic indication depends onthe type of tumor, its localization, extension/stage, and the age and general condition of the patient. But usuallyurethra treatment options include surgery, brachytherapy, radiotherapy and chemotherapy.
Radiotherapy – Radiation therapy is a local treatment, unlike chemotherapy which is systematic, affecting the entire body. It consists of using radioactive rays to kill or damage the DNA of cancer cells, thus making them unable to reproduce. In urethral cancer treatment,radiation to the lymph nodes is essential, in addition to use it directly to the cells in the urethra. Radiotherapy is usually used in conjunction with surgery or chemotherapy to treat this cancer.
Although it is often considered as less toxic than chemotherapy, radiation to urethra can lead to disturbing side effects:
- Pain in the urethra
- Bladder irritation
- Obstructive urinary symptoms
- Rectal bleeding and/or vaginal bleeding (in women).
Chemotherapy – this is a systematic therapy consisting of using antineoplasticdrugs to kill cancercells in the entire body. It is used to treat a large number of different cancers in addition to urethral cancer. It is often given to patients in combination with surgery and /or radiotherapy. But in Urethral cancer treatment, chemotherapy is recommended in case of metastases. Common chemotherapy drugs used in Urethral cancer treatment include cisplatin (Platinol®), vincristine (Oncovin®), and methotrexate (Trexall®).
The chemotherapy agents attack mainly cells that multiply rapidly, which the main characteristic of cancer cells. But our body also has healthy cells that multiply rapidly – for instance cells of the cellsof the bone marrow, gastrointestinal tract, and hair cells of the hair follicle – which make them also greatly affected by the chemo, and thus leading to adverse reactions. Some chemotherapy side effects associated with these medications include the following:
- Fatigue and weakness
- Nausea and vomiting
- Loss of appetite (anorexia)
- Hair loss (alopecia)
- Increased risk for infection
- Shortness of breath
- Excessive bleeding and bruising
- Mouth sores (often associated with dry mouth).
Surgical Therapy – But surgery remains the most common form of urethra treatment. Type of surgical procedure performed depends on the stage of the cancer. The treatment is conservative in case of “superficial cancers”, where the tumor remains localized not invading surrounding tissues.Electro-resection with flash surgerycan also be used to treat the tumor. The procedure consists ofinserting a cystoscope into the urethra and using a loop electrocautery to remove the tumor.
Other forms of surgery which can be performed in urethral cancer treatment include:
- Open excision: Removal of the cancer by open surgery.
- Laser surgery: using laser beam to destroy or surgically remove the tumor
- Lymph node dissection: surgical procedure to remove the lymph nodes.
- Cystourethrectomy : Surgical removal of the bladder and the urethra.
- Cystoprostatectomy : Surgical removal of the bladder and the prostate.
- Anterior exenteration: major surgical intervention to remove the urethra, the bladder, and the vagina. Reconstructive surgery is needed afterwards.
- Partial penectomy: this procedure involving the removal of part of the penis surrounding the urethra where the cancer has spread. Reconstructive surgery is needed afterwards.
- Radical penectomy: Surgical procedure to remove the entire penis. Reconstructive surgery is needed afterwards.