Could my urethral mass be Skene’s gland cancer?

Question

Hello doctor,

I am messaging because the nurse called yesterday and mentioned that the lesion from my scan looked like prostate cancer, but I am a woman, so now I am incredibly confused and honestly scared.

She said something about paraurethral gland tissue and that sometimes radiology uses prostate-related terminology for Skene’s glands. But the moment she said cancer, my brain just froze. For months, I have had pelvic pressure, urinary urgency, and that dull ache behind my pubic bone. My CT from last week showed a small enhancing mass near the urethra.

Could this be a Skene’s gland carcinoma?
Is Skene’s gland carcinoma even a thing? I read online that it is extremely rare. My urinalysis was normal except for trace blood, and my CBC was fine. I keep thinking about my aunt who had urethral carcinoma.
Can you explain what the radiologist meant?
And what are the realistic possibilities here?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query, and I hope you are doing well and in good health.

I fully understand the amount of fear and distress you are experiencing, especially when you hear a diagnosis like prostate cancer (uncontrolled growth of cells in the prostate gland). This is particularly concerning because when you look into the topic, you will find that women do not actually have prostate cancer at all; cases are extremely rare.

However, I would like to explain the situation clearly. In women, there are prostate-like cells in the body, but they undergo atrophy because they have no functional role in the female body. Nevertheless, their location remains occupied by another group of cells that are very similar to prostate cells, known as Skene’s glands.

So, when do we suspect a malignant prostate-related condition?

We become suspicious when the PSA level is elevated. If your PSA (prostate-specific antigen) level is high, we may suspect the possibility of prostate cancer. PSA can be elevated due to two main sources: either a problem in the breast tissue or an issue related to the prostate-like tissue, meaning the Skene’s glands that are currently present.

Our first step is always to exclude any breast pathology, so we perform all the necessary breast investigations, along with a full-body scan. If we find that the problem is confined only to the Skene’s glands, which are located around the urethra, then the treatment is usually straightforward. You also need these investigations to be done, which are the PSA level and the MRI (magnetic resonance imaging) of the breast.

We generally do not prefer surgical treatment because surgery has a high rate of side effects, including permanent urinary incontinence due to sphincter damage, which can be quite troublesome. Therefore, we usually prefer treating this area with radiotherapy and hormonal therapy. Androgen deprivation therapy (ADT) is also considered.

Hormonal therapy does not significantly affect your quality of life, as it consists of hormones that are very similar to the natural hormones in your body, so it does not cause major hormonal disturbances. As for radiotherapy, it is delivered in sessions that are precisely targeted at the cancer cells themselves, while the surrounding healthy cells remain intact and unaffected. Radiotherapy is highly focused and well-defined, and its effects on neighboring tissues are minimal.

And get a follow-up every seven days.

I hope this explanation is clear to you. I want you to feel reassured and not afraid. Even if this condition were present, it is something that can be lived with for a lifetime.

Please let me know if I can assist you further.

Thank you.