Cancer - renal pelvis or ureter Health Article

Definition

Cancer of the renal pelvis or ureter is cancer that forms in the pelvis or the tube that carries urine from the kidney to the bladder.

Alternative Names

Transitional cell cancer of the renal pelvis or ureter

Causes, incidence, and risk factors

Cancer can grow in the urine collection system, but is uncommon. As a group, renal pelvis and ureter cancers account for no more than 5% of all cancers of the kidney and upper urinary tract. They affect men more often 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. Long-term (chronic) irritation of the kidney from harmful substances removed in the urine may be a factor. This irritation may be caused by:

• Analgesic nephropathy
• Exposure to certain dyes and chemicals used to manufacture leather goods, textiles, plastics, and rubber
• Smoking

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

Symptoms

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

Signs and tests

A physician will examine the abdomen by touch. Rarely is there a lump (mass) or enlarged kidney. The patient may have blood in the urine. A complete blood count (CBC) may show anemia.

Cancer cells may appear on the following tests:

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

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

• Abdominal CT scan
• Intravenous pyelogram (IVP)
• Kidney ultrasound
• MRI of abdomen
• Renal scan

An x-ray, CT scan, or MRI of other areas of the body may show that the cancer has spread from the kidneys.