Alternate Names: Cancer - kidney or ureter; Transitional cell cancer of the kidney or ureter; Cancer - renal pelvis or ureter

Causes and Risks:

Carcinoma of the renal pelvis or ureter includes 2 types of cancers. As a group, renal pelvis or ureter carcinomas affect 8 out of 100,000 people. It affects men twice as often as women, especially those over age 65.

Transitional cell cancer is associated with analgesic nephropathy. It is responsible for about 10% of all kidney cancers, and unlike most kidney cancers, it typically is found in middle-aged women. Squamous cell carcinoma accounts for a smaller proportion of kidney tumors in adults.

The causes of this cancer or not known. Chronic irritation of the kidney from harmful substances excreted in the urine may be a factor. Risks for carcinoma of the renal pelvis or ureter include a history of previous renal carcinoma, analgesic nephropathy, and smoking or other tobacco use.

Risks also include occupational or other exposure to nephrotoxic agents including dyes, lubricants, solvents, chemicals used in the manufacturing of leather goods, textiles, plastics, or rubber, etc.

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

Symptoms:

• Back pain, located where ribs and spine meet
• Bloody urine
• Burning or discomfort with urination
• Dark, rust or brown colored urine
• Fatigue
• Flank pain
• Need to urinate frequently at night
• Unintentional weight loss
• Urinary frequency or urgency
• Urinary hesitancy
• Urination, painful

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.

• Urine cytology (microscopic examination of cells) obtained during a cystoscopy.
• Urine cytology obtained from a urine sample.

• IVP
• Kidney ultrasound
• Abdominal CT scan
• MRI of abdomen
• Renal scan

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. Chemotherapy may be used in some cases.

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 and kidney disease - support group.

Prognosis: The outcome varies depending on the exact location of the tumor, and whether the cancer has spread (metastasized).

Complications:

• Local spread of the tumor with increasing pain
• Metastasis of the cancer
• Renal failure

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