Urethral Cancer: Understanding the Risks, Types, and Warning Signs

Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026

Quick Answer

Urethral cancer is a condition in which malignant cells form tumors in the lining of the urethra, more common in people over 60. Its main types are transitional cell carcinoma, squamous cell carcinoma and adenocarcinoma. Long-term inflammation, infections such as HPV and smoking raise the risk. Diagnosis uses cystoscopy, imaging and biopsy, and treatment centers on surgery. [1]

What the research says

• Survival varies widely, and stage and race matter. A national U.S. database study of 1,268 men and 869 women with primary urethral cancer found a median survival of 49 months, with 5-year and 10-year survival of 46% and 31%. Age, race, stage, grade, and other health conditions all predicted survival, and Black race was associated with higher mortality (Sui et al., Urology, 2017). [4]

• Early-stage disease does far better than late-stage disease. In 57 patients treated at 10 Japanese centers, 38% had stage IV disease at diagnosis. Overall survival did not differ significantly between stage I and stage II, but it was significantly shorter for stage III and IV. Previous urinary catheter placement and a urethral diverticulum were linked to poorer survival (Kobayashi et al., International Journal of Urology, 2026). [3]

• The cancer often comes back, and early. In 50 patients, 48% had a recurrence (12% local, 12% regional, 24% distant) at a median of 14.5 months. Recurrence-free survival was 71% at 12 months and 23% at 36 months, which the authors say supports extended follow-up at expert centers (Garaz et al., Urologic Oncology, 2026). [2]

Key Takeaways

Understanding Urethral Cancer

The urethra serves as the final pathway for urine to exit the body. When cancer develops in this delicate tube, it can disrupt urinary function and invade surrounding tissues. Urethral cancer is rare: Cleveland Clinic notes around 1,600 U.S. cases between 1973 and 2002, and it makes up less than 1% of all cancer diagnoses. Despite its rarity, it is a complex condition that requires specialized urological care.

This cancer can affect anyone, but it is more common in men, Black individuals, and people over the age of 60. Because the urethra is close to other pelvic organs, the cancer may spread to nearby tissues, such as the bladder, prostate, or vaginal tissues, if it is not caught early.

Classifications of Urethral Cancer

Urethral cancers are classified by the type of cell where the malignancy begins:

• Transitional (Urothelial) Cell Carcinoma: Usually forms in the part of the urethra closest to the bladder and is the same type of cancer as bladder cancer. Cleveland Clinic lists it as the most common type. [1]

• Squamous Cell Carcinoma: Typically appears near the end of the urethra (near the tip of the penis or the vaginal opening). Cleveland Clinic lists it as the second most common form, while the National Cancer Institute lists it as the most common, so the order can vary by series and by sex.

• Adenocarcinoma: Forms in the glands near the urethra and is the most common type in urethral outpouchings (diverticula). [1]

Symptoms and Early Warning Signs

In its earliest stages, urethral cancer often produces no noticeable symptoms. As the tumor grows, it can obstruct the flow of urine or irritate the urethral lining. [1]

Common Clinical Signs

• Hematuria: Blood in the urine, which may be visible or only detectable under a microscope. See our guide to blood in the urine. [1]

• Urinary Obstruction: A noticeably weak, interrupted, or "stop-and-go" urine stream. [1]

• Pain and Irritation: Discomfort or a burning sensation during urination (dysuria), or needing to urinate more often than usual. [1]

• Physical Changes: A lump or thickness in the penis or perineum, or clear, white, or off-white discharge from the urethra. [1]

• Lymphadenopathy: Swollen lymph nodes in the groin, which may also cause leg swelling if the flow of lymph fluid is blocked. [1]

Causes and Risk Factors

Experts are not sure what causes urethral cancer. However, there may be a link between the disease and conditions that cause long-term inflammation or infection of the urinary tract. [1]

Known Risk Factors

1. Infections: Human papillomavirus (HPV) and sexually transmitted infections (STIs). [1]

2. Chronic Inflammation: Frequent urinary tract infections or the long-term use of Foley catheters. [1]

3. Structural Issues: Conditions like urethral strictures (narrowing), urethral caruncles, or diverticula (pockets). [1]

4. Lifestyle and History: Smoking or other tobacco use, and a personal or family history of bladder cancer. [1]

Diagnosis and Clinical Testing

Because urethral cancer symptoms overlap with many benign conditions, a thorough diagnostic workup is essential.

• Physical Exams: Including pelvic and digital rectal exams to check for abnormalities. [1]

• Urine Tests: A urinalysis and urine cytology look for blood and cancer cells in a urine sample. [1]

• Imaging: CT scans and MRIs create detailed images of the pelvis to show the tumor and whether the cancer has spread.

• Cystoscopy: A urologist inserts a thin, lighted tube into the urethra to inspect the lining and the bladder.

• Biopsy: A small tissue sample is removed and examined by a pathologist for cancer cells, which confirms the diagnosis. [1]

Management and Treatment Pathways

Treatment depends on where the cancer is in the urethra, whether it has spread, your sex, your general health, and whether it is new or has come back. The goal is to remove the cancer while preserving as much urinary and reproductive function as possible. [1]

Surgical Intervention

Surgery is the most common treatment for urethral cancer. Depending on the stage and location, a urologist may remove only the tumor or perform a larger procedure that also removes tissue or organs such as the bladder, prostate, lymph nodes, vagina, or penis. [1]

Systemic and Targeted Therapies

• Radiation Therapy: A radiation oncologist uses high-energy radiation to kill cancer cells. Learn more in our radiation therapy guide. [1]

• Chemotherapy: A medical oncologist uses cancer-fighting drugs to kill cancer cells and stop them from multiplying. [1]

• Combination Therapy: Many treatment plans combine surgery with radiation therapy or chemotherapy, especially for advanced disease. [1]

Outlook

Catching urethral cancer early makes it easier to treat, while later discovery means a greater chance that it has spread outside the urethra. Because the cancer is rare, survival figures are hard to establish. A 2017 study cited by Cleveland Clinic found that over 4 in 10 people survive five years after diagnosis and about 3 in 10 survive ten years, with earlier stages doing better than later ones. [1]

Conclusion

Urethral cancer is rare, and its symptoms often resemble a urinary infection, which is why blood in the urine, a weak or stop-and-go stream, or a new lump or discharge should always be checked, especially after age 60 or with a history of bladder cancer, HPV, or long-term urinary inflammation. Early diagnosis makes treatment easier, and care from an experienced urology team, with regular follow-up afterward, gives the best chance of a good outcome.

Frequently Asked Questions

How rare is urethral cancer?

It is rare, making up less than 1% of all cancer diagnoses.

Can urethral cancer be cured?

Sometimes. Catching it early makes it easier to treat, but it takes a long time to be sure the cancer will not return, so regular follow-up with check-ups and testing is needed.

What is the most common symptom?

Blood in the urine (hematuria) is a common sign that leads people to seek medical advice.

Is urethral cancer the same as bladder cancer?

No, but transitional (urothelial) cell urethral cancer is the same type of cancer as bladder cancer, and a personal or family history of bladder cancer raises the risk.

Does HPV cause urethral cancer?

HPV is a known risk factor for urethral cancer.

Who is most at risk?

People over age 60, men, Black individuals, and those with a history of bladder cancer or long-term inflammation of the urinary tract.

How fast does it spread?

Urethral cancer may spread quickly to nearby tissues, including lymph nodes in the groin.

What is a cystoscopy?

It is a procedure where a doctor uses a thin, lighted tube with a camera to look inside the urethra and bladder.

Can smoking cause urethral cancer?

Smoking and other tobacco use are listed as risk factors for urethral cancer.

What does a "weak stream" mean?

It refers to urine that flows slowly or stops and starts, which can be caused by a tumor blocking the urethra.

Are there different stages of urethral cancer?

Yes. Like most cancers, it is staged based on the size of the tumor and how far it has spread.

What is the 5-year survival rate?

Cleveland Clinic reports that over 4 in 10 people survive five years after diagnosis and about 3 in 10 survive ten years, though this varies greatly with the stage at diagnosis.

Can a UTI turn into cancer?

No. A single UTI does not cause cancer, but long-term inflammation and frequent infections may be linked to a higher risk.

Is surgery always necessary?

Surgery is the most common treatment, often combined with radiation therapy or chemotherapy, but your care team tailors the plan to your situation.

What is a biopsy?

A biopsy is the removal of a small piece of tissue to be tested in a lab for cancer cells.

Can urethral cancer cause leg swelling?

Yes. If the cancer spreads to lymph nodes in the groin, it can block fluid drainage and cause swelling in the leg.

Is chemotherapy painful?

Chemotherapy itself is not painful, but it can cause side effects like fatigue, nausea, and hair loss.

How long is the recovery after surgery?

It depends on the extent of the surgery. Your care team will explain what to expect during recovery.

Can urethral cancer be prevented?

It cannot always be prevented, but avoiding tobacco, treating STIs and urinary infections promptly, and avoiding long-term catheter use when possible may lower risk.

What is a "perineum"?

It is the area of skin between the genitals and the anus, where a lump from urethral cancer might be felt.

Does urethral cancer affect sexual function?

Depending on the extent of surgery, it can affect sexual function, but doctors aim to preserve it whenever possible.

What is adenocarcinoma?

It is a type of cancer that starts in glandular cells, such as the glands near the urethra.

Can an ultrasound detect urethral cancer?

An ultrasound can show abnormalities, but cystoscopy, CT, MRI, and biopsy are used to diagnose and stage the cancer.

Is it hereditary?

There is no strong evidence that it is directly inherited, but a family history of bladder cancer can increase risk.

What is a urethral stricture?

It is a narrowing of the urethra, often from scar tissue, and it is listed as a risk factor for urethral cancer.

Can a Foley catheter cause cancer?

Long-term use of a Foley catheter is listed as a risk factor, likely because of chronic irritation of the urethra.

Is blood in the urine always cancer?

No, it is much more commonly caused by infections, stones, or benign prostate issues.

What is urine cytology?

It is a lab test that looks for cancer cells in a sample of urine.

Can radiation therapy be used alone?

Radiation is usually part of a combined plan with surgery and/or chemotherapy, but your oncology team decides based on your case.

What is the average age of diagnosis?

Urethral cancer is more common in people who are 60 or older.

Does the cancer affect the kidneys?

Not directly, but a blockage in the urethra can cause urine to back up and stress the kidneys.

What is a "diverticulum"?

It is a small pocket or outpouching in the urethral wall where cancer can sometimes form.

Is urethral cancer more common in women?

No, it is more common in men.

Can a physical exam find urethral cancer?

A doctor may feel a lump or thickness during a physical, pelvic, or rectal exam.

What is "urothelial" cancer?

It is cancer that starts in the transitional cells that line the urinary tract.

Are there support groups for this cancer?

Yes. Your care team can direct you to support groups and other resources.

Can a lump be the only symptom?

Yes, some people first notice a lump or thickness near the urethra, in the penis, or in the perineum before other symptoms appear.

What is "dysuria"?

The medical term for painful or difficult urination.

Who performs the surgery?

A urologist, often one who specializes in cancer, removes the tumor. A radiation oncologist and a medical oncologist may also be part of your team.

Can urethral cancer cause discharge?

Yes. Clear, white, or off-white fluid coming from the urethra can be a symptom.

How often should follow-up tests be done?

Your care team sets the schedule. Follow-up usually includes regular check-ups and tests such as CT or MRI imaging and cystoscopy.

What is "metastasized" cancer?

Cancer that has spread from its original location to other parts of the body.

Can a CT scan show the stage of cancer?

Yes, it helps show the size of the tumor and whether the cancer has spread.

Is there a vaccine for urethral cancer?

The HPV vaccine helps prevent HPV infection, which is a risk factor, but no vaccine has been proven to prevent urethral cancer itself.

Does the cancer cause weight loss?

Sudden, unexplained weight loss should be reported to your care team, especially during treatment.

Can urethral cancer cause back pain?

Only if it spreads to the bones or causes significant urine backup.

Is the survival rate improving?

Because urethral cancer is rare, survival statistics are hard to establish, and advances in surgery and combined treatment aim to improve outcomes.

What is a "radiation oncologist"?

A doctor who specializes in treating cancer using radiation.

Can urethral cancer be misdiagnosed as a UTI?

Yes. Because the symptoms overlap, it can be mistaken for an infection at first, which is why symptoms that do not go away need further evaluation.

What is the most important factor for survival?

Catching the cancer early, before it has spread outside the urethra.

Related Reading

Blood in Urine (Hematuria): Symptoms, Causes, and Treatment explains the causes of blood in the urine and when to worry.

Cystoscopy: Purpose, Procedure, Recovery and Risks describes the camera test used to look inside the urethra and bladder.

Urethral Stricture: Symptoms, Causes, Diagnosis, and Treatment Explained covers narrowing of the urethra and how it is treated.

Urethral Caruncle: A Comprehensive Guide to Symptoms, Causes, and Care explains a common benign growth that can look like urethral cancer.

References

1. Cleveland Clinic. Urethral Cancer. Cleveland Clinic Health Library. Last updated April 16, 2026. https://my.clevelandclinic.org/health/diseases/6223-urethral-cancer

2. Garaz R, Rausch S, Mirvald C, et al. Recurrence patterns in primary urethral carcinoma: prognostic impact of inguinal and pelvic lymphadenectomy. Urol Oncol. 2026;44(6):41-52. PMID 41934020. https://doi.org/10.1016/j.urolonc.2026.111086

3. Kobayashi K, Daizumoto K, Tsujino T, et al. Clinical outcomes and clinicopathological features of primary urethral carcinoma: a multicenter retrospective study in Japan. Int J Urol. 2026;33(2):e70367. PMID 41623205. https://doi.org/10.1111/iju.70367

4. Sui W, RoyChoudhury A, Wenske S, et al. Outcomes and prognostic factors of primary urethral cancer. Urology. 2017;100:180-186. PMID 27720774. https://doi.org/10.1016/j.urology.2016.09.042

Disclaimer

This article is for informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.