Primary Urethral Adenocarcinoma, from the CureRays guide library.

Primary urethral adenocarcinoma is a rare gland-forming cancer that begins in the urethra itself, treated with surgery and often organ-preserving chemotherapy and radiation depending on where it sits and how far it has spread.

What it is.

Primary urethral adenocarcinoma is an uncommon cancer that starts in the urethra — the tube that carries urine out of the body — and is made of gland-forming (mucus-producing) cells. It is a distinct subtype of urethral cancer; most urethral cancers are urothelial or squamous, while adenocarcinoma accounts for only a minority. It is thought to arise from glands in the urethral lining or, in some cases, from pockets of misplaced tissue. It is more common in women than men, partly because the female urethra contains more glandular tissue. Because the urethra is short and surrounded by important structures involved in continence and sexual function, treatment is carefully tailored to cure the cancer while preserving as much normal function as possible. Since it is rare, care is best delivered at an experienced center, often combining surgery, radiation, and chemotherapy.

How radiation treats it.

Radiation damages the DNA inside cancer cells so they can no longer divide, while healthy cells recover more effectively. For urethral adenocarcinoma, radiation — often combined with chemotherapy — can cure the cancer while preserving the urethra and urinary control, sparing many patients from extensive surgery. It is delivered as a series of short, painless daily sessions and, for external-beam treatment, leaves no radioactivity in your body, so you remain safe to be around family and children. When brachytherapy is used, your team will explain the brief safety precautions involved.

The ways we can treat it.

External-beam radiation (IMRT). Computer-shaped x-ray beams treat the urethra and at-risk lymph nodes while limiting dose to the bladder, rectum, and reproductive organs to protect function.

Brachytherapy. In selected cases, a radioactive source is placed very close to the tumor for a short time, delivering a high local dose while sparing surrounding tissue — useful for small, well-localized tumors.

Concurrent chemoradiation. Radiation given alongside chemotherapy that makes cancer cells more sensitive to the radiation, improving the chance of cure without removing the urethra.

Questions we hear often.

Will I lose the ability to urinate normally? Often, no. For many patients, organ-preserving treatment with radiation and chemotherapy can cure the cancer while keeping the urethra and urinary control intact. The plan depends on where the tumor is and how far it has grown, and your team will discuss the trade-offs with you.

What is a urethral diverticulum and why does it matter? A diverticulum is a small pocket that can form off the urethra. Some urethral adenocarcinomas — especially the clear cell type in women — arise inside one. Because the pocket can hide a tumor, imaging is used to find it, and the pocket is removed together with the cancer.

Is this related to bladder cancer? It can look similar under the microscope, but primary urethral adenocarcinoma starts in the urethra itself. Your team will confirm the urethra is the true origin, because that changes how the cancer is staged and treated.

This guide is informational only. It is not medical advice — please confirm anything here with your care team.