Key Points for This Section

After urethral cancer has been diagnosed, tests are done to find out if cancer cells have spread within the urethra or to other parts of the body. There are three ways that cancer spreads in the body. Urethral cancer is staged according to which part of the urethra is affected. Treatment is also based on this grouping. Anterior urethral cancer Posterior urethral cancer The following stages are also used to describe urethral cancer: Stage 0 (Carcinoma in Situ) Stage A Stage B Stage C Stage D Urethral cancer may be associated with invasive bladder cancer.

After urethral cancer has been diagnosed, tests are done to find out if cancer cells have spread within the urethra or to other parts of the body.

The process used to find out if cancer has spread within the urethra or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following procedures may be used in the staging process:

• Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
• CT scan (CAT scan) of the pelvis and abdomen: A procedure that makes a series of detailed pictures of the pelvis and abdomen, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
• MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of the urethra, nearby lymph nodes, and other soft tissue and bones in the pelvis. A substance called gadolinium is injected into the patient through a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).
• Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease in the organ or tissue that produces it.
• Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
  • The number of red blood cells, white blood cells, and platelets.
  • The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
  • The portion of the blood sample made up of red blood cells.

There are three ways that cancer spreads in the body.

The three ways that cancer spreads in the body are:

• Through tissue. Cancer invades the surrounding normal tissue.
• Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
• Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.

When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.

Urethral cancer is staged according to which part of the urethra is affected. Treatment is also based on this grouping.

Urethral cancer is staged and treated based on the part of the urethra that is affected and how deeply the tumor has spread into tissue around the urethra. Urethral cancer can be described as anterior or posterior.

Anterior urethral cancer

In anterior urethral cancer, the tumors are not deep and they affect the part of the urethra that is closest to the outside of the body.

Posterior urethral cancer

In posterior urethral cancer, the tumors are deep and affect the part of the urethra closest to the bladder. In women, the entire urethra may be affected. In men, the prostate gland may be affected.

The following stages are also used to describe urethral cancer:

Stage 0 (Carcinoma in Situ)

In stage 0, abnormal cells are found in the inside lining of the urethra. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Stage A

In stage A, cancer has formed and spread into the layer of tissue beneath the lining of the urethra.

Stage B

In stage B, cancer is found in the muscle around the urethra. In men, the penile tissue surrounding the urethra may be affected.

Stage C

In stage C, cancer has spread beyond the tissue surrounding the urethra, and:

• in women, may be found in the vagina, vaginal lips, or nearby muscle;
• in men, may be found in the penis or in nearby muscle.

Stage D

Stage D is divided into stage D1 and stage D2, based on where the cancer has spread.

• In stage D1, cancer has spread to nearby lymph nodes in the pelvis and groin.
• In stage D2, cancer has spread to distant lymph nodes or to other organs in the body, such as the lungs, liver, and bone.

Urethral cancer may be associated with invasive bladder cancer.

A small number of patients who have bladder cancer are also diagnosed with cancer of the urethra, or will develop it in the future.

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