The top of each ureter is found in the middle of the kidney in an area known as the renal pelvis. Urine collects in the renal pelvis and is drained by the ureter into the bladder.
The renal pelvis and the ureter are lined with specific types of cells called transitional cells. These cells are able to bend and stretch without breaking apart. Cancer that begins in the transitional cells is the most common type of cancer that develops in the renal pelvis and ureter.
In some cases, transitional cell cancer metastasizes, which means that cancer from one organ or part of the body spreads to another organ or part of the body.
In the early stages of the disease, cancer of the ureter may not have symptoms. However, as the cancer grows, symptoms may appear. These include:
These symptoms are associated with malignant cancer of the ureter, but they’re also associated with other health conditions. It’s important to see your doctor if you are experiencing any of these symptoms so that you can get a proper diagnosis.
Transitional cell cancer is less common than other kidney or bladder cancers. The causes of the disease haven’t been fully identified. However, genetic factors have been noted to cause the disease in some patients.
Other potential risk factors for the development of this type of cancer include:
- abuse of phenacetin (a pain medication that hasn’t been sold in the United States since 1983)
- working in the chemical or plastics industry
- exposure to coal, tar, and asphalt
- use of cancer treating drugs cyclophosphamide and ifosfamide
This type of cancer can be difficult to diagnose. Your doctor will initially complete a physical exam to check for signs of the disease. They will order a urinalysis to check your urine for blood, protein, and bacteria.
Based on the results of these tests, your doctor may order additional tests to further evaluate the bladder, ureter, and renal pelvis.
Additional tests may include:
- ureteroscopy to check for abnormalities in each ureter and renal pelvis
- intravenous pyelogram (IVP) to evaluate the flow of fluid from the kidneys to the bladder
- CT scan of the kidneys and bladder
- ultrasound of the abdomen
- biopsy of cells from each renal pelvis or ureter
Current treatments for transitional cell carcinoma include:
- Endoscopic resection, fulguration, or laser surgery. Through a ureteroscope, physicians can destroy or remove cancer cells with direct tumor removal, electrical current, or laser.
- Segmental resection. This procedure involves the removal of the part of the ureter that contains the cancer.
- Nephroureterectomy. This procedure involves the removal of the kidney, ureter, and bladder tissue.
Your doctor may also use other treatments to make sure the cancer doesn’t come back. These can include:
- anticancer drugs
- biological therapies that kill cancer cells or prevent them from growing
The outlook for someone diagnosed with cancer of the renal pelvis and ureter depends on a number of factors that your doctor will discuss with you. In particular, the chance of recovery is dependent on:
- Stage of the cancer. People with advanced stages of the disease will have a lower survival rate, even with treatment.
- Location of the tumor. If the tumor is located beyond the ureter and renal pelvis, the cancer may quickly metastasize to the kidney or other organs, reducing chances for survival.
- Overall kidney health. If there are underlying kidney disorders, the survival rate is lower, even with treatment.
- Cancer recurrence. Cancer recurrences have lower cure and survival rates than initial cancers.
- Metastasis. If the cancer has spread to other organs in the body, the survival rate is lower.
It’s important to see your doctor for regular checkups and to let them know about any new symptoms you’ve developed. This helps your doctor catch potentially serious conditions in the earliest stages.