Is Urethral Cancer More Common in Men or Women?

Despite being rare in both sexes, urethral cancer is proportionally more common in women, who account for the majority of reported cases. This phenomenon is thought to be related to anatomical differences. The female urethra is shorter and lined with transitional and squamous epithelium across a smaller surface area. In men, urethral cancer most commonly involves the bulbomembranous urethra. Histologically, the type of cancer depends on the location: squamous cell carcinoma predominates in distal urethral segments, while transitional cell (urothelial) carcinoma is more common proximally.

Types of Urethral Cancer

The histological type of urethral cancer depends on the location within the urethra, as different segments are lined by different cell types.

Squamous Cell Carcinoma: The most common type of urethral cancer, arising from the squamous epithelium lining the distal (outer) urethra. It accounts for the majority of cases in both men and women.

Transitional Cell (Urothelial) Carcinoma: Arises from the urothelium lining the proximal (inner) urethra, near the bladder. It is more common in the proximal urethra and bulbomembranous urethra in men.

Adenocarcinoma: Arises from glandular elements — including urethral glands, paraurethral (Skene's) glands in women, or Cowper's and Littre's glands in men. Clear cell adenocarcinoma of the urethra is a recognised but rare subtype.

Melanoma: Primary urethral melanoma is exceptionally rare. It behaves aggressively and is treated with wide surgical excision.

Undifferentiated Carcinoma: Rare; requires individualised treatment.

In women, squamous cell carcinoma is the most common type. In men, squamous cell carcinoma predominates in the anterior (penile) urethra, while transitional cell carcinoma is more common in the posterior urethra. This anatomical and histological variation is a key reason why treatment plans must be individualised for each patient.

​Symptoms of Urethral Cancer

Urethral cancer symptoms are non-specific and can easily be attributed to benign urological conditions. Common presentations include:

• Blood in the urine (haematuria) or blood at the urethral opening

• A weak or interrupted urinary stream

• Difficulty urinating or a sense of incomplete bladder emptying

• Urethral discharge

• A palpable lump or thickening along the urethra or in the perineal region

• Pelvic pain in advanced cases

Any persistent or unexplained urinary symptom — particularly haematuria — in a patient without an obvious benign cause should prompt specialist review by a rare cancer specialist in Noida or a urologic oncologist.

How Is Urethral Cancer Diagnosed?

Diagnosis requires a combination of clinical examination, cystourethroscopy, which allows examination of both the bladder and urethra simultaneously, and biopsy for histological confirmation. Imaging, including MRI of the pelvis and CT scan of the chest, abdomen and pelvis, is essential for staging to assess local tumour extent, lymph node involvement and distant metastases. PET-CT may be used in selected cases.

Treatment Options

Treatment of urethral cancer depends heavily on tumour location, histological type, stage and patient fitness. A rare cancer specialist and multidisciplinary oncology team review is strongly recommended.

Surgery: Urethral cancer surgery in India may range from local excision for small, superficial distal tumours to more extensive procedures such as urethrectomy or anterior exenteration, a more extensive surgery involving removal of multiple pelvic organs required in selected advanced cases. Urinary diversion may be required following radical resection. Patients undergoing urinary diversion typically require six to twelve weeks of initial recovery, followed by ongoing rehabilitation, though timelines vary by individual.

Radiation Therapy: External beam radiation, sometimes combined with chemotherapy (chemoradiation), may be recommended for certain stages, particularly for proximal or locally advanced urethral tumours where organ preservation is desired, or surgery carries high morbidity.

Chemotherapy: Systemic chemotherapy, often using cisplatin-based regimens, may be considered for locally advanced or metastatic disease.

The urethral cancer treatment cost depends on the stage, treatment modality, and individual patient needs.