Ureteral Cancer
Ureteral cancer is a very rare form of urologic cancer. Pathologically it is similar to bladder cancer, but treatment is much more invasive and involved. The lining of the ureter is the same as the bladder, so the same type of cancers can grow in the ureter. Since the bladder stores urine, the bladder is more exposed to the chemicals in the urine that cause cancer than the ureter. Smoking is the number 1 cause of ureteral and bladder cancer. You can look at the bladder cancer section of this webpage to review some of the causes.
Symptoms:
- Hematuria- blood in the urine
- Flank pain
- Recurrent UTI- urinary tract infections
- Kidney infections- Pyelonephritis
Risk Factors:
- Smoking- current smokers, ex-smokers, second-hand smoke exposure
- Exposure to chemicals- especially cleaning supplies, dry cleaning, Agent Orange
- History of bladder cancer
Evaluation and Diagnosis:
History and Physical exam
Urinalysis- a urine test looking for blood in the urine
Urine cytology- urine test looking under the microscope for cancer cells
Imaging- CT scan is probably the best test- could show a mass or just show swelling of the kidney (which would be a sign something is blocking the kidney)
Ureteroscopy with biopsy- small camera passed into the ureter to visualize any growth and biopsy to confirm. This is done under anesthesia
Treatment:
The best treatment for ureteral cancer is surgery to remove the whole ureter and kidney on that side- nephroureterectomy. This seems like a drastic measure, but remember the lining of the bladder, ureter and the inside of the kidney are contiguous and made of the same tissue. In order to safely remove the tumor, you should not disrupt the lining and remove it all together. This prevents “leakage” of tumor. During this procedure a small portion of the bladder is also removed- where the ureter inserts into the bladder.
Before surgery, sometimes chemotherapy is used to shrink the tumor and kill any cells that may have escaped the ureter.
In certain cases, if the tumor is small or very near the bladder, we can do a partial ureterectomy. This would be just cutting out the part of the ureter with the tumor and reconnecting it to itself or to the bladder. This must be done carefully so that tumor “spillage” does not occur.
Each case can be different, so Dr. Shaba will review the details of your case with you.
For more information please visit: https://www.urologyhealth.org/urology-a-z/u/upper-urinary-tract-cancer
