Urethral Cancer: Chemotherapy

What is chemotherapy? 

Chemotherapy (chemo) uses anticancer medicines to kill cancer cells. The medicines are made to attack and kill cancer cells that grow quickly. Some normal cells also grow quickly. Because of this, chemo can also harm those cells. This can cause side effects.

When might chemo be used for urethral cancer?

Since urethral cancer is very rare, the role of chemo is somewhat unclear. It may be used in these circumstances:

  • To shrink the cancer before surgery. This makes it easier to remove (resect) the cancer.

  • To treat the cancer with a combination of chemo and radiation after surgery. This is done to kill any cancer cells that remain. It helps decrease the chance that the cancer will come back

  • To treat the cancer with chemo and radiation when surgery is not possible or you have chosen not to have surgery. 

  • To treat cancer that has spread to distant organs

The medicines and the amount of them you receive will depend on whether the cancer is a transitional cell carcinoma, a squamous cell carcinoma, or an adenocarcinoma.

How chemo is given

Chemo medicine is most often given intravenously (through an IV). You may also take it by mouth as a pill, or as an injection. The treatment may be done as an outpatient visit to a hospital, where you go home the same day. Or it may be at your healthcare provider’s office, a chemo clinic, or at home. In some cases, you may stay in the hospital during treatment.

You get chemo in cycles over a period of time. That means you may take the medicine for a set amount of time and then you have a rest period. Each period of treatment and rest is 1 cycle. You may have several cycles. Having treatment in cycles helps by:

  • Killing more cancer cells. The medicine can kill more cancer cells over time. This is because cells aren't all dividing at the same time. Cycles allow the medicine to fight more cells.

  • Giving your body a rest. Treatment is hard on other cells of the body that divide quickly. This includes cells in the lining of your mouth and stomach. This causes side effects. These include mouth sores and nausea. Between cycles, your body can get a rest from the chemo.

  • Giving your mind a rest. Having chemo can be stressful. Taking breaks between cycles can let you get an emotional break between treatments.

What are common side effects of chemo?

The side effects of chemo depend on the type of medicines you receive. Chemo attacks cells that divide quickly, such as cancer cells. However, healthy cells can sometimes be affected, too, including blood cells. You’ll have blood tests done regularly while you're getting chemo to make sure you aren't having harmful reactions.

  • If white blood cell levels are affected by chemo, the risk of infection becomes much higher. Tell your healthcare provider right away if you have any signs of an infection. Symptoms include a fever.

  • If your platelet blood cell counts are down, you may have a higher risk of bruising and bleeding more easily from a cut or injury.

  • If you have low red blood cells, you may have tiredness or shortness of breath.

Other common side effects include:

  • Nausea

  • Vomiting

  • Loss of appetite

  • Loss of hair

  • Mouth sores

  • Diarrhea

  • Fatigue

Many of these side effects can be treated, and most of them go away after you stop treatment.

Other longer-term side effects may include kidney injury or nerve damage. This may cause tingling or numbness in hands or feet. These side effects depend on the medicines you receive.

Working with your healthcare provider

It's important to know which medicines you're taking. Write your medicines down, and ask your healthcare team how they work and what side effects they might have.

Talk with your healthcare team about what signs to look for and when to call them. For instance, chemo can make you more likely to get infections, so you may need to watch for fever or chills. Make sure you know what number to call with questions. Is there a different number for evenings and weekends?

It may be helpful to keep a diary of your side effects. Write down physical, thinking, and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage your side effects.