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Cancer - renal pelvis or ureter

Cancer of the renal pelvis or ureter is cancer that forms in the kidney's pelvis or the tube that carries urine from the kidney to the bladder (ureter).

Alternative Names

Transitional cell cancer of the renal pelvis or ureter

Causes

Cancer can grow in the urine collection system, but it is uncommon. Renal pelvis and ureter cancers affect men more often than women and are more common in people older than 65.

The causes of this cancer are not completely known. Long-term (chronic) irritation of the kidney from harmful substances removed in the urine may be a factor. This irritation may be caused by:

  • Kidney damage due to overexposure to medicines, especially ones for pain (analgesic nephropathy )
  • Exposure to certain dyes and chemicals used to manufacture leather goods, textiles, plastics, and rubber
  • Smoking

Patients with a history of bladder cancer are also at risk.

Symptoms

Symptoms may include any of the following:

Exams and Tests

The health care provider will perform a physical exam, and examine your belly area (abdomen). In rare cases, this may reveal an enlarged kidney.

If tests are done:

  • Urinalysis may show blood in the urine.
  • A complete blood count (CBC ) may show anemia .
  • Urine cytology (microscopic examination of cells) taken during a cystoscopy or urine clean catch sample may reveal cancer cells.

Other tests that may be ordered include:

These tests may reveal a tumor or show that the cancer has spread from the kidneys.

Treatment

The goal of treatment is to eliminate the cancer.

Surgery to remove all or part of the kidney (nephrectomy ) is usually recommended. This may include removing part of the bladder and tissues around it, or the lymph nodes. If the tumor is in the ureter, it may be possible to remove it while preserving the kidney.

When the cancer has spread outside of the kidney or ureter, chemotherapy is often used. Because these tumors are similar to a form of bladder cancer , they are treated with a similar type of chemotherapy.

Support Groups

You can ease the stress of illness by joining a cancer support group . Sharing with others who have common experiences and problems can help you not feel alone.

Outlook (Prognosis)

The outcome varies depending on the location of the tumor and whether the cancer has spread. Cancer that is only in the kidney or ureter can be cured with surgery.

Cancer that has spread to other organs is usually not curable.

Possible Complications


  • Kidney failure
  • Local spread of the tumor with increasing pain
  • Spread of the cancer

When to Contact a Medical Professional

Call your health care provider if you have the symptoms listed above.

Prevention

  • Follow your health care provider's advice regarding medications, including over-the-counter pain medicine.
  • Stop smoking.
  • Wear protective equipment if you may be exposed to substances that are toxic to the kidneys.

References

Delacroix SE, Wood CG, Jonasch E. Renal neoplasia. In: Taal MW, Chertow GM, Marsden PA, et al., eds. Brenner and Rector's The Kidney. 9th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 40.

National Cancer Institute: PDQ Transitional Cell Cancer of the Renal Pelvis and Ureter Treatment. Bethesda, MD: National Cancer Institute. Date last modified 03/12/2014. Available at http://cancer.gov/cancertopics/pdq/treatment/transitionalcell/HealthProfessional. Accessed May 29, 2014.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Version 3.2014. Available at http://www.nccn.org/professionals/physician_gls/pdf/kidney.pdf. Accessed May 29, 2014.

Updated: 5/29/2014

Yi-Bin Chen, MD, Leukemia/Bone Marrow Transplant Program, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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