Procedure
Two types of radiation therapy can be used to treat urethral cancer: external beam radiation therapy and brachytherapy. External radiation therapy is provided on an outpatient basis, is non-invasive (and therefore does not require anesthesia), and can thus be easily integrated into daily life, both personal and professional. In this type of radiation therapy, the energy beams come from outside the body and are focused inside your body on the tumor. In brachytherapy, or internal radiation therapy, a radioactive material is placed directly in or near the tumor. Sometimes both types of radiation therapy are used together. Close and personal support is a matter of course for us.
Radiation therapy alone is rarely used as the first-line treatment for penile cancer in men. However, it can be used before surgery to shrink the tumor so that it can be removed more easily, or after surgery to kill any remaining cancer cells and thus cure the disease (curative radiation therapy). For women, radiation therapy alone may be a curative option for some early-stage cancers. Certain types of chemotherapy help radiation therapy kill cancer cells more effectively. For this reason, a combination of radiation therapy and chemotherapy is often used to achieve better outcomes in the treatment of advanced-stage urethral cancer. Radiation therapy can also be used before or after surgery for cancers that have spread to a large portion of the urethra near the bladder.
Radiation therapy can also be used if the urethral cancer has already spread: in such cases, radiation therapy can prevent or alleviate symptoms caused by metastases, for example, in the brain or bones (palliative radiation therapy).
The Department of Radiation Oncology at the USZ uses only the most advanced techniques for the precise treatment of urethral cancer with minimal side effects. You will be cared for by recognized 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 radiation therapy for the various stages of urethral cancer.
Urethral cancer at an early stage
For early-stage urethral cancer, surgical removal of the tumor is the treatment of choice for patients who are otherwise healthy. If microscopic tumor remnants remain after surgery or if other risk factors are present, postoperative radiation therapy—often combined with chemotherapy—is frequently necessary. Even if surgery is not possible or is not desired, definitive radiation therapy can be used. In some cases, however, urethral function may be preserved. The results of radiation therapy appear to be similar to those reported in surgical series, but because urethral cancer is so rare, there are no large studies available to allow for a definitive comparison. Radiation therapy alone may be sufficient for patients with small, localized urethral tumors, but it is often combined with radiosensitizing chemotherapy.
To minimize damage to the surrounding healthy tissue as much as possible, the radiation is divided into many small “doses”: the therapy is administered in fractions over approximately 30 treatment sessions on weekdays, spanning a period of about 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 a local recurrence. This therapy consists of just a few sessions, which are conducted at 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
For locally advanced urethral cancer, when the tumor has already spread to the lymph nodes, radiation therapy combined with chemotherapy is the treatment of choice. Depending on the extent and type of the tumor, a combination of surgery, radiation therapy, and chemotherapy may also be necessary. To minimize damage to the surrounding healthy tissue as much as possible, the radiation is divided into many small “doses”: the treatment is administered in fractions over approximately 30 weekday sessions spread out over a period of about 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 form of cancer that often spreads to other parts of the body as the disease progresses; 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.
