Procedure
Two types of radiation can be used in the treatment of urethral cancer: external radiation and brachytherapy. External radiation therapy is carried out as an outpatient treatment, is non-invasive (i.e. does not require anesthesia) and can therefore be easily integrated into everyday private and professional life. With this type of radiation, the energy beams come from outside and are focused on the tumor inside your body. In brachytherapy or internal radiation, a radioactive material is placed directly in or near the tumor. Sometimes both types of radiation are used together. Close and personal support is a matter of course for us.
Radiotherapy alone is rarely used as the first option for treating urethral cancer in men. However, it can be used before an operation to shrink the tumor so that it can be removed more easily, or after an operation to kill any remaining cancer cells and thus cure the disease (curative radiotherapy). In women, radiotherapy alone can be a curative option for some early-stage cancers. Certain chemotherapies help radiation to kill cancer cells more effectively. Therefore, the combination of radiotherapy and chemotherapy is often used to achieve better results in the treatment of advanced stage urethral cancer. Radiotherapy can also be used before or after surgery for cancers that have spread to a large part of the urethra near the bladder.
Radiotherapy can also be used if the urethral cancer has already spread: radiotherapy can then prevent or alleviate symptoms caused by metastases, e.g. in the brain or bones(palliative radiotherapy).
The Department of Radiation Oncology at the USZ uses only the most modern techniques for precise and low side-effect irradiation of urethral cancer. You will be looked after by proven experts in the research and treatment of urethral cancer.
For many patients, we are already offering the treatment of tomorrow: in clinical trials, we are continuously working on improving the treatment of urethral cancer to make it even more effective and tolerable. To the overview of currently open studies.
In the following, we will describe radiotherapy for the different stages of urethral cancer.
Urethral cancer at an early stage
In early-stage urethral cancer, surgical removal of the tumor is the treatment of first choice in fit patients. If microscopically small tumor remnants remain after the operation or other risk factors exist, postoperative radiotherapy, often combined with chemotherapy, is often necessary. Even if surgery is not possible or not desired, definitive radiotherapy can be used. In some cases, urethral function can be preserved. The results of radiotherapy appear to be similar to those in surgical series, but because urethral cancer is so rare, large studies are lacking for a definitive comparison. Radiotherapy alone may be sufficient for patients with small and limited urethral tumours, but is often combined with radiosensitizing chemotherapy.
In order to protect the surrounding healthy tissue as much as possible, the radiation is divided into many small “portions”: the therapy is fractionated over approximately 30 treatment sessions per working day over a period of around 6 weeks. Spreading the radiation treatment over several weeks improves the tolerability of the treatment, which is mainly carried out on an outpatient basis and can be easily integrated into the patient’s private and professional life. In certain situations, the additional use of brachytherapy may be necessary to reduce the risk of local recurrence. This therapy consists of just a few sessions, which are carried out in the day clinic or during a short inpatient stay.
For many patients, we are already offering the treatment of tomorrow: in clinical trials, we are continuously working on improving the treatment of urethral cancer to make it even more effective and tolerable. To the overview of currently open studies.
Locally advanced stage of urethral cancer
In locally advanced urethral cancer, when the tumor has already spread to the lymph glands, radiotherapy combined with chemotherapy is the treatment of first choice. Depending on the extent and type of tumor, a combination of surgery, radiotherapy and chemotherapy may also be necessary. In order to protect the surrounding healthy tissue as much as possible, the radiation is divided into many small “portions”: the therapy is fractionated over approximately 30 treatment sessions per working day over a period of around 6 weeks. Spreading the radiation treatment over several weeks improves the tolerability of the treatment, which is mainly carried out on an outpatient basis and can be easily integrated into the patient’s private and professional life.
For many patients, we are already offering the treatment of tomorrow: in clinical trials, we are continuously working on improving the treatment of urethral cancer to make it even more effective and tolerable. To the overview of currently open studies.
Metastases of urethral cancer, e.g. in the brain or bones
Urethral cancer is an aggressive type of cancer that often forms metastases during the course of the disease: this is called metastasis. Common sites of metastasis are the lung, adrenal gland, bones, liver or brain. Radiotherapy is a highly effective method with few side effects to prevent or treat symptoms caused by metastases. This is usually done in combination with chemotherapy, immunotherapy or other targeted therapy. The smaller the metastases are and the earlier they are irradiated, the better the results. Today, metastases in the body can be treated in a focused manner in just a few effective radiation sessions.
For tumor foci in the abdominal area, e.g. liver or upper abdomen, we carry out body stereotactic radiotherapy (SBRT) on our MRI hybrid accelerator. State-of-the-art radiation technology is combined with MRI images. The radiation is thus carried out under MRI monitoring of the tumor, so that the highest precision is combined with the best imaging. Our clinic was the first in Switzerland to introduce this technology back in 2019. We are still the only clinic in German-speaking Switzerland to offer the highest level of expertise in this field.
Today, brain metastases are treated at our center in most patients by means of a single high-dose radiation treatment: this is called radiosurgery. Metastases at other locations in the body can now also be treated in a focused manner in just a few effective radiation sessions. Metastatic urethral cancer is a clinical and scientific focus of our clinic. We pass on our knowledge in a large number of international courses and congresses. We are active as international experts in guideline commissions.
State-of-the-art equipment and experienced medical physicists and MTRAs contribute to treatment of optimum quality and safety. At the same time, we work closely with our colleagues in medical oncology to guarantee “one-stop” treatment. We also consult with our colleagues in palliative medicine at an early stage.
In clinical trials, we are continuously trying to improve the treatment of urethral cancer in order to make it even more effective and tolerable. Overview of currently open trials.
