Urine is produced in kidney and drained into funnel shaped Renal Pelvis. Renal Pelvis narrows at distal end to form ureter. Urine passes through Ureter and collected in Urinary Bladder. Cancer is more common in Renal pelvis than ureter.
Ureteral cancer is a rare type of cancer, which originates in the upper end of ureter known as renal pelvis cancer as well as middle and lower section of ureter. Ureter is a tubular organ, which connects kidney and urinary bladder. Urine is produced in kidney and conduit into renal pelvis. The urine from renal pelvis passes through ureter and collected in urinary bladder. Renal pelvis is funnel shape and larger in diameter than ureter. The cells which line the ureters are known as urothelial cells or transitional cells. Ureteral cancer usually begins in transitional epithelial cells. Ureteral cancer is also known as transitional cell cancer or urothelial cancer. If ureteral cancer is diagnosed in the early stages, the chances of a cure are quite high. Surgery is the common treatment done in this cancer; other than this, chemotherapy and radiation therapy are also used.
Causes and Risk Factors of Ureteral Cancer or Ureter Cancer or Renal Pelvis Cancer
The cause for ureteral cancer or many of the transitional cell cancers is not known. However, there are risk factors such as:
- Individuals who smoke are at a higher risk for developing this cancer.
- Individuals who are exposed to certain chemicals, such as industrial dyes or who work with plastics, rubber, pesticides and aluminium are at a higher risk for developing this cancer.
- Certain medicines, such as cyclophosphamide and phenacetin, increase the risk for developing ureteral cancer.
Signs and Symptoms of Ureteral Cancer or Ureter Cancer or Renal Pelvis Cancer
- Hematuria (blood in the urine).
- Frequent urination.
- Urethral stricture causing decreased urine output and difficulty in urination.
- There is increase in nighttime urination (also known as nocturia).
- There is tissue hardening in the labia, perineum or penis.
- Dyspareunia, which is pain felt during or after having sexual intercourse.
- Dysuria, which is pain when urinating.
- Patient has recurrent urinary tract infections.
- There is swelling in the urethra.
- There is discharge from the urethra.
- Persistent back pain.
Investigations for Ureteral Cancer or Ureter Cancer or Renal Pelvis Cancer
- Urine cytology.
- Retrograde pyelography.
- CTU (Computed Tomography Urography).
- FISH (Fluorescence In-Situ Hybridization) test.
- MRU (Magnetic Resonance Urography).
- IVP (Intravenous Pyelography).
Treatment for Ureteral Cancer or Ureter Cancer or Renal Pelvis Cancer
Treatment depends on the stage of the cancer, patient’s general health and treatment choices and it includes: Surgery, chemotherapy and radiation therapy.
Surgery for Ureteral Cancer or Ureter Cancer or Renal Pelvis Cancer
Ureterectomy for Ureteral Cancer or Ureter Cancer or Renal Pelvis Cancer
This is a procedure where the involved ureter is removed. It could be a radical ureterectomy where the complete ureter is removed or segmental ureterectomy where only the part affected by cancer is removed. In advanced ureteral cancers, the entire ureter along with the entire kidney and a portion of the bladder may be removed.
Chemotherapy for Ureteral Cancer or Ureter Cancer or Renal Pelvis Cancer
This is treatment done with the help of medicines or drugs, which kills the cancer cells. Either a single drug or more than one drug is used. Chemotherapy can be given intravenously or orally. Chemotherapy can be done before the surgery to shrink the tumor or after the surgery to kill off any remaining cancer cells. A combination of more than one drug helps in cutting down the risk of recurrence after the surgery. Chemotherapy can also be done in conjunction with radiation therapy.
Radiation Therapy for Ureteral Cancer or Ureter Cancer or Renal Pelvis Cancer
Radiation therapy involves the use of high energy beams, like x-rays, which are targeted at specific points on the body where the cancer is, to kill cancer cells. In ureteral cancer, radiation therapy is done in advanced stages, i.e. if the cancer has metastasized. Radiation therapy can be done after the surgery to reduce the chances of cancer recurrence and can also be done in combination with chemotherapy.