Cancerof the renal pelvis or ureter involves the growth of cancerous cells in the collection system of the kidney. This includes the part of the kidney (the pelvis and its subdivisions or calyces) that empties urine into the ureter, which leads to the bladder.

Alternative Names

Transitional cell cancer of the renal pelvis or ureter

Causes, incidence, and risk factors

As a group, renal pelvis and ureter carcinomas are uncommon and account for no more than 5% of all cancers of the kidney and upper genitourinary tract. They affect men more commonly than women and are more common in people older than 65. Tumors of the renal pelvis and ureter are usually transitional cell cancers. Approximately 10% are squamous cell carcinomas. The causes of this cancer are not completely known. Chronic irritation of the kidney from harmful substances excreted in the urine may be a factor and may result from the following:

Smoking

Analgesic nephropathy

Exposure to aniline dyes and chemicals used in the manufacturing of leather goods, textiles, plastics, and rubber

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

Signs and tests

Examination by touch (

palpation ) of the abdomen rarely reveals a mass or an enlarged kidney.

Blood in the urine

may appear.

CBC

may show

anemia . Carcinoma cells may appear on the following tests:

Urine cytology

(microscopic examination of cells) obtained during a

cystoscopy

Urine cytology obtained from a urine sample

The tumor , or signs of urinary obstruction , may appear on:

IVP

Kidney ultrasound

Abdominal CT scan

MRI of abdomen

Renal scan

An

X-ray , CT scan, or MRI of other areas of the body may show metastasis of cancer from the kidneys.

Treatment

The goal of treatment is to eliminate the cancer . Surgical removal of all or part of the kidney ( nephrectomy ) is usually recommended. This may include removal of part of the bladder or surrounding tissues or 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 behave similarly to transitional cell carcinoma of the bladder, the chemotherapy regimens used are similar to those used for bladder cancer .

Support groups

The stress of illness can often be helped by joining a support group where members share common experiences and problems. See cancer - support group .

Expectations (prognosis)

The outcome varies depending on the exact location of the tumor and whether the cancer has spread (metastasized). Cancer localized to the kidney or ureter can be cured with surgery. Cancer that has metastasized to other organs is usually not curable, though there are exceptions.

Complications

Local spread of the

tumor with increasing pain

Metastasis

of the

cancer

Renal failure

Calling your health care provider

Call your health care provider if symptoms indicate carcinoma of the kidney may be present.

Prevention

Wear protective equipment if exposure to nephrotoxic (kidney-poisoning) substances is likely. Minimize or stop smoking . Follow your health care provider's advice regarding use of medications, including over-the-counter analgesics .