Treatment Option Overview
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.
Three types of standard treatment are used:
Surgery 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.
- Electro-resection 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 is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. 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 and stage of the cancer being treated.
Watchful waiting is closely monitoring a patient’s condition without giving any treatment until symptoms appear or change.
New types of treatment are being tested in clinical trials.
This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web site 1.
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 and stage of the cancer being treated.
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. This is sometimes called re-staging.
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.
Glossary Termsabdomen (AB-doh-men)The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.adjuvant therapy (A-joo-vunt THAYR-uh-pee) Additional cancer treatment given after the primary treatment to lower the risk that the cancer will come back. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, targeted therapy, or biological therapy.anterior pelvic exenteration (an-TEER-ee-er PEL-vik eg-ZEN-teh-RAY-shun) Surgery to remove the urethra, lower part of the ureters, uterus, cervix, vagina, and bladder.bladder (BLA-der) The organ that stores urine.cancer (KAN-ser) A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.catheter (KA-theh-ter) A flexible tube used to deliver fluids into or withdraw fluids from the body.cavity (KA-vih-tee) A hollow area or hole. It may describe a body cavity (such as the space within the abdomen) or a hole in a tooth caused by decay.cell (sel) The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.cerebrospinal fluid (seh-REE-broh-SPY-nul FLOO-id) The fluid that flows in and around the hollow spaces of the brain and spinal cord, and between two of the meninges (the thin layers of tissue that cover and protect the brain and spinal cord). Cerebrospinal fluid is made by tissue called the choroid plexus in the ventricles (hollow spaces) in the brain. Also called CSF.chemotherapy (KEE-moh-THAYR-uh-pee) Treatment with drugs that kill cancer cells.clinical trial (KLIH-nih-kul TRY-ul) A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.condition (kun-DIH-shun) In medicine, a health problem with certain characteristics or symptoms.continent reservoir (KON-tih-nent REH-ser-vwar) A pouch formed from a piece of small intestine to hold urine after the bladder has been removed.cystoprostatectomy (SIS-toh-pros-tuh-TEK-toh-mee) Surgery to remove the bladder (the organ that holds urine) and the prostate. In a radical cystoprostatectomy, the seminal vesicles are also removed. The prostate and seminal vesicles are glands in the male reproductive system that help make semen. Also called prostatocystectomy.cystourethrectomy (SIS-toh-yoo-ree-THREK-toh-mee) Surgery to remove the bladder (the organ that holds urine) and urethra (the tube through which urine leaves the body).diagnosis (DY-ug-NOH-sis) The process of identifying a disease, such as cancer, from its signs and symptoms.drain (drayn) In medicine, to remove fluid as it collects; or, a tube or wick-like device used to remove fluid from a body cavity, wound, or infected area.drug (drug) Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.excision (ek-SIH-zhun) Removal by surgery.external radiation therapy (...RAY-dee-AY-shun THAYR-uh-pee) A type of radiation therapy that uses a machine to aim high-energy rays at the cancer from outside of the body. Also called external-beam radiation therapy.follow-up (FAH-loh-up) Monitoring a person's health over time after treatment. This includes keeping track of the health of people who participate in a clinical study or clinical trial for a period of time, both during the study and after the study ends.fulguration (ful-guh-RAY-shun) A procedure to destroy tissue (such as a tumor) using an electric current. Also called electrofulguration.groin (groyn) The area where the thigh meets the abdomen.injection (in-JEK-shun) Use of a syringe and needle to push fluids or drugs into the body; often called a "shot."internal radiation therapy (in-TER-nul RAY-dee-AY-shun THAYR-uh-pee) A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called brachytherapy, implant radiation therapy, and radiation brachytherapy.laser (LAY-zer) A device that forms light into intense, narrow beams that may be used to cut or destroy tissue, such as cancer tissue. It may also be used to reduce lymphedema (swelling caused by a buildup of lymph fluid in tissue) after breast cancer surgery. Lasers are used in microsurgery, photodynamic therapy, and many other procedures to diagnose and treat disease.laser surgery (LAY-zer SER-juh-ree) A surgical procedure that uses the cutting power of a laser beam to make bloodless cuts in tissue or to remove a surface lesion such as a tumor.lymph node (limf node) A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.lymph node dissection (limf node dy-SEK-shun) A surgical procedure in which the lymph nodes are removed and a sample of tissue is checked under a microscope for signs of cancer. For a regional lymph node dissection, some of the lymph nodes in the tumor area are removed; for a radical lymph node dissection, most or all of the lymph nodes in the tumor area are removed. Also called lymphadenectomy.monitor (MAH-nih-ter) In medicine, to regularly watch and check a person or condition to see if there is any change. Also refers to a device that records and/or displays patient data, such as for an electrocardiogram (EKG).NCI NCI, part of the National Institutes of Health of the United States Department of Health and Human Services, is the Federal Government's principal agency for cancer research. It conducts, coordinates, and funds cancer research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer. Access the NCI Web site at http://www.cancer.gov. Also called National Cancer Institute.organ (OR-gun) A part of the body that performs a specific function. For example, the heart is an organ.ostomy (OS-toh-mee) An operation to create an opening (a stoma) from an area inside the body to the outside. Colostomy and urostomy are types of ostomies.pelvis (PEL-vus) The lower part of the abdomen, located between the hip bones.penectomy (pee-NEK-toh-mee) Surgery to remove part or all of the penis (an external male reproductive organ).penis (PEE-nis) An external male reproductive organ. It contains a tube called the urethra, which carries semen and urine to the outside of the body.plastic surgery (PLAS-tik SER-juh-ree) An operation that restores or improves the appearance of body structures.prostate (PROS-tayt) A gland in the male reproductive system. The prostate surrounds the part of the urethra (the tube that empties the bladder) just below the bladder, and produces a fluid that forms part of the semen.radiation (RAY-dee-AY-shun) Energy released in the form of particle or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, medical x-rays, and energy given off by a radioisotope (unstable form of a chemical element that releases radiation as it breaks down and becomes more stable).radiation therapy (RAY-dee-AY-shun THAYR-uh-pee) The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.radioactive (RAY-dee-oh-AK-tiv) Giving off radiation.radioactive seed (RAY-dee-oh-AK-tiv...) A small, radioactive pellet that is placed in or near a tumor. Cancer cells are killed by the energy given off as the radioactive material breaks down and becomes more stable.recur (ree-KER) To come back or to return.regional chemotherapy (REE-juh-nul KEE-moh-THAYR-uh-pee) Treatment with anticancer drugs directed to a specific area of the body.research study (reh-SERCH STUH-dee) A scientific study of nature that sometimes includes processes involved in health and disease. For example, clinical trials are research studies that involve people. These studies may be related to new ways to screen, prevent, diagnose, and treat disease. They may also study certain outcomes and certain groups of people by looking at data collected in the past or future.resection (ree-SEK-shun) Surgery to remove tissue or part or all of an organ.side effect (side eh-FEKT) A problem that occurs when treatment affects healthy tissues or organs. Some common side effects of cancer treatment are fatigue, pain, nausea, vomiting, decreased blood cell counts, hair loss, and mouth sores.small intestine (... in-TES-tin) The part of the digestive tract that is located between the stomach and the large intestine.stage (stayj) The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.standard therapy (... THAYR-uh-pee) Treatment that experts agree is appropriate, accepted, and widely used. Also called best practice, standard medical care, and standard of care.stoma (STOH-muh) A surgically created opening from an area inside the body to the outside.surgeon (SER-jun) A doctor who removes or repairs a part of the body by operating on the patient.surgery (SER-juh-ree) A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.symptom (SIMP-tum) An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.systemic chemotherapy (sis-TEH-mik KEE-moh-THAYR-uh-pee) Treatment with anticancer drugs that travel through the blood to cells all over the body.tissue (TIH-shoo) A group or layer of cells that work together to perform a specific function.tumor (TOO-mer) An abnormal mass of tissue that results when cells divide more than they should or do not die when they should. Tumors may be benign (not cancer), or malignant (cancer). Also called neoplasm.urethra (yoo-REE-thruh) The tube through which urine leaves the body. It empties urine from the bladder.urethral cancer (yoo-REE-thrul KAN-ser) A rare cancer that forms in tissues of the urethra (the tube through which urine empties the bladder and leaves the body). Types of urethral cancer include transitional cell carcinoma (cancer that begins in cells that can change shape and stretch without breaking apart), squamous cell carcinoma (cancer that begins in flat cells lining the urethra), and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids).urinary diversion (YOOR-ih-NAYR-ee dih-VER-zhun) A surgical procedure to make a new way for urine to leave the body. It may involve redirecting urine into the colon, using catheters to drain the bladder, or making an opening in the abdomen and collecting urine in a bag outside the body.urine (YOOR-in) Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra.urostomy (yoo-ROS-toh-mee) An operation to create an opening from inside the body to the outside, making a new way to pass urine.vagina (vuh-JY-nuh) The muscular canal that goes from the uterus to the outside of the body. During birth, the baby passes through the vagina. Also called birth canal.vein (vayn) A blood vessel that carries blood to the heart from tissues and organs in the body.watchful waiting (WACH-ful WAY-ting) Closely watching a patient’s condition but not giving treatment unless symptoms appear or change. Watchful waiting is sometimes used in conditions that progress slowly. It is also used when the risks of treatment are greater than the possible benefits. During watchful waiting, patients may be given certain tests and exams. Watchful waiting is sometimes used in prostate cancer. It is a type of expectant management.x-ray (EX-ray) A type of radiation used in the diagnosis and treatment of cancer and other diseases. In low doses, x-rays are used to diagnose diseases by making pictures of the inside of the body. In high doses, x-rays are used to treat cancer. |
Table of Links | |
| 1 | http://cancer.gov/clinicaltrials |
