Ureter and Renal Pelvis Cancer
The ureters are hollow muscular tubes that carry urine from the kidneys to the bladder. The renal pelvis is the lower part of each kidney that connects to each ureter.
Cancers affecting the ureter and renal pelvis are rare. Cancer of the ureter and renal pelvis tends to affect more men than women, and is rare under the age of 65.
The main type of cancer affecting the ureter and renal pelvis is called transitional cell carcinoma (TCC). This type of cancer develops in cells, known as transitional cells, which form the lining of the bladder, ureters and renal pelvis. Usually only one ureter or renal pelvis is affected.
Another, more common, type of cancer that can affect the kidney is known as renal cell cancer (RCC). Very rarely, other types of cancer can start in the ureter or renal pelvis. These include some types of lymphoma (a cancer that starts from the cells of the lymphatic system) and sarcoma (a cancer that develops from the supporting tissues of the body, such as muscle or cartilage).
Cancer that starts in the ureter or renal pelvis is known as primary cancer. When cancer spreads from another part of the body to the ureter it is known as secondary or metastatic cancer in the ureter or renal pelvis.
Treatment
Treatment will depend on a number of factors, including your age, general health and the position, type, stage and grade of the cancer.
Surgery is the most common treatment for cancer of the ureter and renal pelvis. The extent of surgery will depend on many factors, such as the stage and the grade of the cancer.
After surgery, sometimes further treatment will be recommended, such as radiotherapy or chemotherapy. This is known as adjuvant treatment. The aim of adjuvant treatment is to get rid of any remaining cancer cells and to reduce the chance of the cancer coming back. The effectiveness of adjuvant treatment for cancer of the ureter and renal pelvis is unknown.
If surgery is not possible, other treatments may be more appropriate. These may include chemotherapy or radiotherapy. The aim of these treatments is to reduce the size of the and help control symptoms.
Surgery
Nephro-ureterectomy means the removal of the kidney, ureter and top part of the bladder. Sometimes the surrounding lymph glands, fat and tissue may also be removed.
Segmental ureterectomy resection is the removal of the affected part of the ureter. The remaining parts are then rejoined. This procedure is usually only possible if the is small, low-grade and contained within the ureter.
Ureteroneocystomy (or reimplantation) is the removal of the lower part of the ureter, and sometimes a small part of the bladder. The remaining part of the ureter is then connected to the bladder. This is usually done if the is only in the lower part of the ureter.
Occasionally, a may affect just the surface of the ureter. The cancer may be removed either by laser treatment or electrosurgery. These two surgical treatments are in the early stages of development.
Radiotherapy
Radiotherapy treats cancer by using high-energy rays, which destroy the cancer cells and shrink the while doing as little harm as possible to normal cells.
Chemotherapy
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy the cancer cells. They work by disrupting the growth and division of cancer cells. The chemotherapy may be given directly into the vein (intravenously).
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