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Table of Contents General Information About Transitional Cell Cancer of the Renal Pelvis and Ureter
Stages of Transitional Cell Cancer of the Renal Pelvis and Ureter
Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter
Treatment Option Overview
Treatment Options for Transitional Cell Cancer of the Renal Pelvis and Ureter
To Learn More About Transitional Cell Cancer of the Renal Pelvis and Ureter
Get More Information From NCI
Changes to This Summary (06/26/2008)
About PDQ
General Information About Transitional Cell Cancer of the Renal Pelvis and Ureter
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Transitional cell cancer of the renal pelvis and ureter is a disease in which malignant (cancer) cells form in
the renal pelvis and ureter.
The renal pelvis is part of the kidney and the ureter connects the kidney to the bladder. There are 2 kidneys, one on each side of the backbone, above the waist. The kidneys of an adult are about 5 inches long and 3 inches wide and are shaped like a kidney bean. The kidneys clean the blood and produce urine to rid the body of waste. The urine collects in the middle of each kidney in a large cavity called the renal pelvis. Urine drains from each kidney through a long tube called the ureter, into the bladder, where it is stored until it is passed from the body through the urethra.
The renal pelvis and ureters are lined with transitional cells. These cells can change shape and stretch without breaking apart. Transitional cell cancer starts in these cells. Transitional cell cancer can form in the renal pelvis or the ureter or both.
Renal cell cancer is a more common type of kidney cancer. Refer to the PDQ summary on Renal Cell Cancer Treatment for more information.
Misuse of certain pain medicines can affect the risk of developing transitional cell cancer of the renal pelvis and ureter.
Risk factors include the following:
- Misusing certain pain medicines, including over-the-counter pain medicines, for a long time.
- Being exposed to certain dyes and chemicals used in making leather goods, textiles, plastics, and rubber.
- Smoking cigarettes.
Possible signs of transitional cell cancer of the renal pelvis and ureter include blood in the urine and back pain.
These and other symptoms may be caused by transitional cell cancer of the renal pelvis and ureter. Other conditions may cause the same symptoms. There may be no symptoms in the early stages. Symptoms may appear as the tumor grows. A doctor should be consulted if any of the following problems occur:
- Blood in the urine.
- A pain in the back that doesn't go away.
- Extreme tiredness.
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Weight loss with no known reason.
- Painful or frequent urination.
Tests that examine the abdomen and kidneys are used to detect (find) and diagnose transitional cell cancer of the renal pelvis and ureter.
The following tests and procedures may be used:
- Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
- Urinalysis: A test to check the color of urine and its contents, such as sugar, protein, blood, and bacteria.
- Ureteroscopy: A procedure to look inside the ureter and renal pelvis to check for abnormal areas. A ureteroscope (a thin, lighted tube) is inserted through the urethra into the bladder, ureter, and renal pelvis. Tissue samples may be taken for biopsy.
- Urine cytology: Examination of urine under a microscope to check for abnormal cells. Cancer in the kidney, bladder, or ureter may shed cancer cells into the urine.
- Intravenous pyelogram (IVP): A series of x-rays of the kidneys, ureters, and bladder to check for cancer. A contrast dye is injected into a vein. As the contrast dye moves through the kidneys, ureters, and bladder, x-rays are taken to see if there are any blockages.
- CT scan (CAT
scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- Ultrasound: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. An ultrasound of the abdomen may be done to help diagnose cancer of the renal pelvis and ureter.
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis (chance of recovery) depends on the stage and grade of the tumor.
The treatment options depend on the following:
- The stage and grade of the tumor.
- Where the tumor is.
- Whether the patient's other kidney is healthy.
- Whether the cancer has recurred.
Most transitional cell cancer of the renal pelvis and ureter can be cured if found early.
Back to Top Stages of Transitional Cell Cancer of the Renal Pelvis and Ureter
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After transitional cell cancer of the renal pelvis and ureter has been diagnosed, tests are done to find out if cancer cells have spread within the renal pelvis and ureter or to other parts of the body.
The process used to find out if cancer has spread within the renal pelvis and ureter or to other
parts of the body is called staging. The information gathered from the
staging process determines the stage of the disease. It is important to know
the stage in order to plan treatment. The following tests and
procedures may be used in the staging process:
- Intravenous pyelogram (IVP): A series of x-rays of the kidneys, ureters, and bladder to find out if cancer has spread within these organs. A contrast dye is injected into a vein. As the contrast dye moves through the kidneys, ureters, and bladder, x-rays are taken to see if there are any blockages.
- CT scan (CAT
scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- Ultrasound: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
- Ureteroscopy: A procedure to look inside the ureter and renal pelvis to check for abnormal areas. A ureteroscope (a thin, lighted tube) is inserted through the urethra into the bladder, ureter, and renal pelvis. Tissue samples may be taken for biopsy.
- Surgery: Tissues removed during surgery to treat the transitional cell cancer will be examined by a pathologist.
There are three ways that cancer spreads in the body.
The three ways that cancer spreads in the body are:
- Through tissue. Cancer invades the surrounding normal tissue.
- Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
- Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.
When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
The following stages are used for transitional cell cancer of the renal pelvis and/or ureter:
Stage 0 (Papillary Carcinoma and Carcinoma in Situ)
In stage 0, abnormal cells are found in tissue lining the inside of the renal pelvis or ureter. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is divided into stage 0a and stage 0is, depending on the type of tumor:
Stage I
In stage I, cancer has formed and spread through the lining of the renal pelvis and/or ureter, into the layer of connective tissue.
Stage II
In stage II, cancer has spread through the layer of connective tissue to the muscle layer of the renal pelvis and/or ureter.
Stage III
In stage III, cancer has spread:
Stage IV
In stage IV, cancer has spread to at least one of the following:
Transitional cell cancer of the renal pelvis and ureter is also described as localized, regional, or metastatic:
Localized
The cancer is found only in the kidney.
Regional
The cancer has spread to tissues around the kidney and to nearby lymph nodes and blood vessels in the pelvis.
Metastatic
The cancer has spread to other parts of the body.
Back to Top Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter
Recurrent transitional cell cancer of the renal pelvis and ureter is cancer that has recurred (come back) after it has been treated. The cancer may come back in the renal pelvis, ureter, or other parts of the body.
Back to Top Treatment Option Overview
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There are different types of treatment for patients with transitional cell cancer of the renal pelvis and ureter.
Different types of treatments are available for patients with transitional cell cancer of the renal pelvis and ureter. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
One type of standard treatment is used:
Surgery
One of the following surgical procedures may be used to treat transitional cell cancer of the renal pelvis and ureter:
- Nephroureterectomy: Surgery to remove the entire kidney, the ureter, and the bladder cuff (tissue that connects the ureter to the bladder).
- Segmental resection of the ureter: A surgical procedure to remove the part of the ureter that contains cancer and some of the healthy tissue around it. The ends of the ureter are then reattached.
This treatment is used when the cancer is superficial and in the lower third of the ureter only, near the bladder.
New types of treatment are being tested in clinical trials.
This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI Web
site.
Fulguration
Fulguration is a surgical procedure that destroys tissue using an electric current. A tool with a small wire loop on the end is used to remove the cancer or to burn away the tumor with electricity.
Segmental resection of the renal pelvis
This is a surgical procedure to remove localized cancer from the renal pelvis without removing the entire kidney. Segmental resection may be done to save kidney function when the other kidney is damaged or has already been removed.
Laser surgery
A laser beam (narrow beam of intense light) is used as a knife to remove the cancer. A laser beam can also be used to kill the cancer cells. This procedure may be called laser therapy or laser fulguration.
Regional chemotherapy and regional biologic therapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. Biologic therapy is a treatment that uses the patient's immune system to fight cancer; substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. Regional treatment means the anticancer drugs or biologic substances are placed directly into an organ or a body cavity such as the abdomen, so the drugs will affect cancer cells in that area. Clinical trials are studying the effectiveness of chemotherapy or biologic therapy using drugs placed directly into the renal pelvis or the ureter.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. See the Treatment Options section that follows for links to current treatment clinical trials. These have been retrieved from NCI's clinical trials database.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests. This is sometimes called re-staging.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Back to Top Treatment Options for Transitional Cell Cancer of the Renal Pelvis and Ureter
A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.
Localized Transitional Cell Cancer of the Renal Pelvis and Ureter
Treatment of localized transitional cell cancer of the renal pelvis and ureter may include the following:
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with localized transitional cell cancer of the renal pelvis and ureter. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Regional Transitional Cell Cancer of the Renal Pelvis and Ureter
Treatment of regional transitional cell cancer of the renal pelvis and ureter is usually done in a clinical trial.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with regional transitional cell cancer of the renal pelvis and ureter. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Metastatic Transitional Cell Cancer of the Renal Pelvis and Ureter
Treatment of metastatic transitional cell cancer of the renal pelvis and ureter is usually done in a clinical trial, which may include chemotherapy.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with metastatic transitional cell cancer of the renal pelvis and ureter. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter
Treatment of recurrent transitional cell cancer of the renal pelvis and ureter is usually done in a clinical trial, which may include chemotherapy.
Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with recurrent transitional cell cancer of the renal pelvis and ureter. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site.
Back to Top To Learn More About Transitional Cell Cancer of the Renal Pelvis and Ureter
For more information from the National Cancer Institute about transitional cell cancer of the renal pelvis and ureter, see the following:
For general cancer information and other resources from the National Cancer Institute, see the following:
Back to Top Get More Information From NCI
Call 1-800-4-CANCER
For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. The call is free and a trained Cancer Information Specialist is available to answer your questions.
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For more information from the NCI, please write to this address:
- NCI Public Inquiries Office
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Search the NCI Web site
The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. For a quick search, use our “Best Bets” search box in the upper right hand corner of each Web page. The results that are most closely related to your search term will be listed as Best Bets at the top of the list of search results.
There are also many other places to get materials and information about cancer treatment and services. Hospitals in your area may have information about local and regional agencies that have information on finances, getting to and from treatment, receiving care at home, and dealing with problems related to cancer treatment.
Find Publications
The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.
Back to Top Changes to This Summary (06/26/2008)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Several enhancements have been made to this summary to better explain certain medical concepts and to help readers find information about clinical trials. The following changes were made:
- Text describing the way cancer spreads in the body was added to the Stages section.
- Information about patients taking part in clinical trials and about follow-up tests was added to the Treatment Option Overview section.
- Links to ongoing clinical trials listed in NCI’s PDQ Cancer Clinical Trials Registry were added to the Treatment Options section.
- A new section called “ To Learn More ” was added. It includes links to more information about this type of cancer and about cancer in general.
- The “Get More Information from NCI” section (originally called “To Learn More”) was revised.
Back to Top About PDQ
PDQ is a comprehensive cancer database available on NCI's Web site.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.
PDQ also contains information on clinical trials.
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Listings of clinical trials are included in PDQ and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
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