The most common type of cancer that develops in the renal pelvis and ureter is Urothelial carcinoma or Upper tract cancer. In the upper tract, cancer may be papillary or nodular, muscle-invasive or non-invasive. Upper tract cancers may range from small benign tumors to aggressive abnormal growth of cells. Upper tract Urothelial cancer generally occurs at the lining of the urinary system.
Upper tract urothelial cancers (UTUCs) are a subset of urothelial cancers:
Urothelial cells make the lining of the urethra, bladder, ureters, renal pelvis, and other nearby organs. These cells are highly elastic and change shape without breaking apart. It is also called transitional cells. Bladder cancer starts inside the lining of the bladder which is made up of urothelial cells.
UTUCs can develop low-grade tumors or high-grade tumors. Low-grade tumors confined in the kidney and ureter. High-grade tumors are fast-growing and spread from the kidney or ureter to other parts of the body. If it gets worst, the surgical removal of the kidney or ureter is the only option left and, in most cases, it is followed by chemotherapy.
When the malignant cancer cells grow in the bladder or in the ureter, the following symptoms appear:
An exact cause is not identified but there are certain risk factors such as:
The initial evaluation of cancer in a patient is done through a physical examination to check for signs of the disease.
Current treatments for upper tract cancer/urothelial carcinoma include:
The standardized treatment for upper urinary tract cancers is nephroureterectomy. It involves the removal of the kidney, ureter, and bladder tissue depending on tumor size, tumor location, and tumor aggressiveness. If there are multiple tumors, removing nearby lymph nodes and tissue are also included. Laparoscopic and endoscopic surgery targets the tumor cell in the ureter and the kidney and destroys it. Segmental resection removes the affected part of the urinary tract that contains the tumor. Radical and partial cystectomy is preferred for high-grade invasive bladder cancer.
Systemic chemotherapy is used to treat upper urinary tract cancer after the removal of the kidney and ureter. Immunotherapy is used in bladder cancer, to prevent cancer from coming back.
Radiation is used on selective patients with bladder cancer when cystectomy or surgical treatment is not possible. Radiation therapy can be used for renal pelvic and ureteral cancers if cancer is extended to lymph nodes. High-energy radiation destroys cancer cells with the preservation of nearby organs from damaging. Though, it is rarely used for treating urothelial tumors until the preservation of nearby tissue is not possible by other methods.
After treatment, you will need to continue to follow up as upper urinary tract cancer is more likely to reoccur in multiple places.
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