The tube that connects the kidneys to the bladder is known as the ureter. Most healthy people have two kidneys and, therefore, two ureters. 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. Metastasis occurs when 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:
- blood in the urine
- persistent back pain
- unexplained weight loss
- painful or frequent urination
These symptoms are associated with malignant cancer of the ureter, but they are 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.
Causes and Risk Factors
Transitional cell cancer is less common than other kidney or bladder cancers. The causes of the disease have not 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 has not been sold in the United States since 1983
- working in the chemical industry and plastics industry
- exposure to coal, tar, and asphalt
- 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:
- a ureteroscopy to check for abnormalities in the, ureter and renal pelvis
- an intravenous pyelogram (IVP) to evaluate the flow of fluid from the kidneys to the bladder
- a CT scan of the kidneys and bladder
- an ultrasound of the abdomen
- an MRI
- a biopsy of cells from the 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 an electrical current, laser surgery, or direct tumor removal.
- 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:
- anti-cancer 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 upon a number of different factors. Your doctor will talk to you about each of these. In particular, the chance of recovery is determined by:
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 your kidney or other organs, reducing chances for survival.
Overall Kidney Health
If you have underlying kidney disorders, you will have a lower rate of survival even with treatment.
Cancer recurrences have lower cure and survival rates than initial cancers.
If the cancer has spread to other organs in the body, you will have a lower survival rate.
It is important to see your doctor for regular checkups. You should also make sure to let them know about any new symptoms you have developed. This will make it more likely that your doctor will catch potentially serious conditions in the earliest stages.