Cancer of the ureter

Ureter Cancer shown on a body diagram alongside other types

Facts and figures about ureter cancer

Cancer of the renal pelvis (small area in the centre of the kidney that the ureter arises from) and ureter are very rare. They are considered bladder cancers rather than kidney cancers. Higher incidence in men than women. The incidence rises from the age of 65 years and is even rarer under this age.

Risk factors are smoking, heavy usage of phenacetin (a pain relieve drug that is now banned) and possibly arsenic in drinking water. Over 90% of the tumours are transitional cell carcinomas.

Ureter cancer symptoms

  • Blood/blood clots in the urine (haematuria).
  • Pain in the side of lower back.
  • Pain or burning sensation on passing urine.
  • Difficulty in passing urine.

Some of these symptoms can be caused by other conditions such as infection.

Diagnosis of ureter cancer

Investigation may include:

  • Urine tests (likely to be carried out initially to investigate for possible urinary tract infection or blood in the urine if not apparent).
  • CT scan –may be a CT urogram (CT scan of the urinary tract).
  • Intravenous urogram (IVU) –x-ray of the urinary system.
  • Utereroscopy.

Ureter cancer treatment

Depends on several factors:

  • The type and grade of tumour.
  • The position of the tumour.
  • The stage of the cancer.
  • General health.

Surgery

Surgery is the main treatment and the extent and type of surgery depends on the stage of the disease and the position of the tumour.

In early stage of a tumour in the ureter, it may be possible to removes the part of the ureter affected by the tumour and some of the surrounding healthy tissue and then join the ends of the ureter back together.

If it is an early stage tumour near the bladder it may be possible to perform a ureterneocystomy, where the affected part of the ureter and the bladder cuff are removed and then the remaining ureter is joined to the bladder.

In other cases, it may involve removing the kidney, surrounding fat, ureter and the tissue where the ureter enters the bladder. Also, the adrenal gland and local lymph nodes may be removed.

Radiotherapy

Radiotherapy may be used to treat this condition which will involve treating the tumour and surrounding tissue with the intention of curing the disease or it may be used palliatively to control symptoms in more advanced cases.

Chemotherapy

Chemotherapy may be used if the disease has spread to the lymph nodes or other parts of the body. It may be advised post-surgery (adjuvant) if malignant cells are found in the lymph nodes removed during surgery to reduce the risk of recurrence.

Chemotherapy is often a combination of the following drugs gemcitabine, cisplatin, carboplatin, doxorubicin, methotrexate and vinblastine.

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