Can estrogen increase Skene’s gland cancer risk at 72?

Question

Hello doctor,

My 72-year-old mother was recently diagnosed with something similar to prostate cancer in women. The oncologist called it "Skene's gland adenocarcinoma" and mentioned that it is sporadic in females. She has been experiencing pelvic pain and difficulty urinating for several months. Initially, the gynecologist thought it was menopause-related bladder changes, but an MRI revealed a mass near her urethra.

Her PSA levels are elevated (8.5 ng/mL), which the doctor said is highly unusual in women. They are recommending radiation therapy, but she is concerned about its effects on her already fragile pelvic floor. She has been using estrogen cream for vaginal dryness—could that have contributed to this? We are having trouble finding reliable information about this type of cancer in women. What is the prognosis for such rare urethral cancers?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your mother’s diagnosis of Skene’s gland adenocarcinoma is indeed infrequent but medically recognized as the female equivalent of prostate cancer, since Skene’s glands are homologous to the prostate and can even produce PSA(prostate-specific antigen). An elevated PSA of 8.5 ng/mL (nanograms per milliliter) in a woman is quite unusual and supports the diagnosis.

These tumors often present with nonspecific symptoms like pelvic pain, urinary difficulties, or vaginal discomfort, which is why they are frequently misattributed to menopause-related changes at first. While the use of topical estrogen cream is generally safe and unlikely to cause this type of cancer, it can sometimes mask symptoms or make evaluation more challenging.

Radiation therapy is a reasonable option for localized control, especially if the tumor is not surgically resectable or your mother prefers to avoid surgery. However, we do consider the condition of the pelvic floor, particularly in older women with existing atrophy or incontinence.

Side effects such as bladder irritation, vaginal stenosis, or worsened pelvic floor weakness are possible, so we often collaborate with pelvic floor therapists and gynecologists throughout treatment. Because this cancer is so rare, there is limited data, but prognosis generally depends on tumor size, lymph node involvement, and response to treatment.

I hope this helps.

Please follow up if you have any further concerns.

Thank you.