Find out how doctors use minimally invasive surgery to treat this rare cancer that forms in the tubes that connect your kidneys to your bladder.
Cancer of the ureter (ureteral cancer) is an abnormal growth of cells on the inside lining of the tubes (ureters) that connect your kidneys to your bladder. Ureters are part of the urinary tract, and they carry urine produced by the kidneys to the bladder.
Ureteral cancer is uncommon. It occurs most often in older adults and in people who have previously been treated for bladder cancer.
Ureteral cancer is closely related to bladder cancer. The cells that line the ureters are the same type of cells that line the inside of the bladder. People diagnosed with ureteral cancer have a greatly increased risk of bladder cancer, so your doctor will recommend tests to look for signs of bladder cancer.
Treatment for ureteral cancer typically involves surgery. In certain situations, chemotherapy or immunotherapy may be recommended.
Signs and symptoms of ureteral cancer include:
Make an appointment with your doctor if you have any persistent signs and symptoms that worry you.
It's not clear what causes ureteral cancer.
Ureteral cancer happens when cells on the inside lining of the ureter develop changes (mutations) in their DNA. A cell's DNA contains the instructions that tell a cell what to do. The changes tell the cells to multiply rapidly and to continue living beyond their typical life cycle. The result is a growing mass of abnormal cells that can grow to block the ureter or spread to other areas of the body.
Factors that can increase the risk of ureteral cancer include:
Tests and procedures used to diagnose ureteral cancer include:
Use of a thin, lighted tube to view the ureters. During a procedure called ureteroscopy, your doctor will insert a thin, lighted tube equipped with a camera (ureteroscope) into your urethra. The scope is passed through your bladder and into your ureters.
Ureteroscopy allows your doctor to visually inspect your ureters and, if necessary, remove a small sample of tissue for laboratory testing (biopsy).
In the laboratory, a doctor who specializes in analyzing blood and body tissue (pathologist) will carefully examine your cells for signs of cancer. This may include sophisticated analysis of the gene mutations involved in your cancer.
Ureteral cancer treatment typically involves surgery. Your treatment options for cancer of the ureter will vary depending on the size and location of your cancer, how aggressive the cells are, and your own goals and preferences.
Surgery is often recommended to remove ureteral cancer. The extent of your surgery will depend on your situation.
For very early-stage ureteral cancer, surgery may involve removing only a portion of the ureter. For more-advanced ureteral cancer, it may be necessary to remove the affected ureter, its associated kidney (nephroureterectomy) and a portion of the bladder.
Chemotherapy is a drug treatment that uses chemicals to kill cancer cells. Chemotherapy is sometimes used before surgery to shrink a tumor and make it easier to remove during surgery. Chemotherapy may be used after surgery to kill any cancer cells that may remain.
For advanced ureteral cancer, chemotherapy may be used to control signs and symptoms of the cancer.
Immunotherapy uses your immune system to fight cancer. Your body's disease-fighting immune system may not attack your cancer because the cancer cells produce proteins that help them hide from the immune system cells. Immunotherapy works by interfering with that process.
Immunotherapy might be an option for treating advanced ureteral cancer that hasn't responded to other treatments.
After your treatment, your doctor will create a schedule of follow-up exams to look for signs that your cancer has returned. These exams also look for signs of bladder cancer, since people diagnosed with ureteral cancer have an increased risk of bladder cancer.
The tests you'll undergo and the schedule of exams will depend on your situation. But expect to see your doctor every few months for the first year and then less frequently after that.
If you have any signs or symptoms that worry you, make an appointment with your doctor.
If you're diagnosed with ureteral cancer, you'll likely be referred to a doctor who specializes in conditions that affect the urinary system (urologist) or a doctor who specializes in treating cancer (oncologist).
Because appointments can be brief and because there's a lot of information to discuss, it's a good idea to be prepared.
Questions to ask your doctor at your initial appointment include:
Questions to consider if your doctor refers you to a specialist include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
Your doctor is likely to ask you a number of questions. Thinking about your answers ahead of time can help you make the most of your appointment. Your doctor may ask: