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What are the Grades and Stages of Urethral Cancer?

If cancer cells are found, your doctor will need to know the tumor stage and grade. Then the health care team can develop a treatment plan.

Grading

The grade tells how fast the tumor can grow and spread. The most common grading systems use 2 main grades:

  • Low-grade tumors grow more slowly. Though they may come back (recur) after treatment, they rarely spread to other parts of the body. The cells of low-grade tumors have only minor differences from normal cells.
  • High-grade tumors grow more quickly. They often recur after treatment and are more likely to spread to other parts of the body. The cells are disorganized and look abnormal.

Staging

Your doctor must learn if the cancer cells have spread. This is called staging. Your doctor wants to find out:

  • If the tumor has entered nearby tissues
  • If the cancer has spread to other parts of the body

In general, a higher stage cancer (4 is the highest) is more serious. The table lists the stages using the TNM (Tumor, Node, Metastasis) system.

Primary Tumor (T)

Tx

Primary tumor cannot be assessed

T0

No evidence of primary tumor

Ta

Noninvasive papillary, polypoid or verrucous carcinoma

Tis

Carcinoma in situ

T1

Tumor invades subepithelial connective tissue

T2

Tumor invades corpus spongiosum, prostate or periurethral muscle

T3

Tumor invades corpus cavernosum, beyond prostatic capsule, anterior vagina or bladder neck

T4

Tumor invades other nearby organs (i.e. bladder)

Regional Lymph Nodes (N)

Nx

Regional lymph nodes cannot be assessed

N0

No regional lymph node metastasis

N1

Metastases in a single lymph node, 2 cm or smaller

N2

Metastases in a single node 2 to 5 cm, or in multiple nodes (none larger than 5 cm)

N3

Metastases in lymph node larger than 5 cm

Distant Metastases (M)

Mx

Distant metastases cannot be assessed

M0

No distant metastases

M1

Distant metastases

More tests can be done to find out if cancer cells have spread to other parts of the body, such as:

  • CT scan of the abdomen and pelvis: to check the lymph nodes that collect drainage from the urethra
  • MRI: to look at the local extent of the tumor
  • Chest X-ray: to make sure that the tumor has not spread to the lungs
  • Bone scan: may be needed to see if it has spread to your bones.
  • Excretory urography or retrograde pyelography: if the urethral cancer is a certain type called transitional cell carcinoma, this is used to see the lining of the kidney and ureter to make sure there are no other sites of cancer.