The tube that connects the kidneys to the bladder is known as the ureter. Most healthy people have two kidneys and, therefor, 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. When cancer develops in the renal pelvis or ureter, it begins in the transitional cells.
This type of cancer is known as malignant neoplasm of the ureter. It is more commonly called transitional cell cancer. Neoplasm is another word for tumor or cancer.
In many instances, 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.
Transitional cell cancer is extremely rare. 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 certain pain medications or over-the-counter medications for long periods of time, primarily phenacetin, which has not been sold in the U.S. since 1983 (Colin et al., 2009)
- people who worked in the chemical industry and plastics industry, as well as people exposed to coal, tar, and asphalt (Colin et al., 2009)
In the early stages of the disease, malignant cancer of the ureter has no symptoms. However, as the tumor grows, certain symptoms may appear. These include:
- blood in the urine
- persistent pain in the back
- unexplained weight loss
- painful or frequent urination
While these symptoms are associated with malignant cancer of the ureter, they are also associated with other health conditions. Consult with your doctor to confirm the diagnosis if you experience these symptoms.
This type of cancer can be difficult to diagnose. Your doctor will initially complete a physical exam to check for signs of the disease. He or she 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 evaluate the inside of the bladder, ureter, and renal pelvis.
Additional tests may include:
- a uteroscopy 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
Proven Treatment Options
Current treatments for malignant neoplasm of the ureter include:
Nephroureterectomy: This procedure involves the removal of the kidney, ureter, and bladder tissue.
Segmental resection: This procedure involves the removal of the part of the ureter that contains the cancer.
Clinical trials are new therapies that are currently being tested for treatment of a disease. Clinical trials for the treatment of malignant neoplasm of the ureter include:
Fulguration: This is a surgical procedure that destroys cancer cells with an electrical current.
Segmental resection of the renal pelvis: This procedure involves the removal of the part of the renal pelvis that contains the cancer.
Laser surgery: Laser surgery uses laser beams to target the cancer and destroy cancer cells.
Chemotherapy: Chemotherapy is standard treatment for many types of cancers. Chemotherapy drugs are now being developed to treat malignant neoplasm of the ureter.
Regional biological therapy: This therapeutic approach uses biological agents to target the cancer cells in the ureter.
The outlook for someone diagnosed with malignant cancer of the ureter depends upon a number of different factors. In particular, the chance of recovery is determined by:
Stage of the Cancer
Patients with advanced stages of the disease will have a lower survival rate even with treatment.
Location of the Tumor
If the tumor is located in the renal pelvis, the cancer may quickly metastasize to the kidney, reducing chances for survival.
Overall Kidney Health
Patients with underlying kidney disorders will have a lower rate of survival even with treatment.
if malignant neoplasm of the ureter is treated and recurs, the patient will have a lower survival rate
If the cancer has spread to other organs in the body, the patient will have a lower survival rate