What is Ureter Cancer?

Cancer is the growth of abnormal cells, which can grow together to form masses called tumors. Ureter cancer begins in the cells that line the tubes (ureters) connecting the kidneys to the bladder. Part of the urinary tract, the ureters carry urine produced by the kidneys to the bladder.

This type of cancer is uncommon. Ureter cancer symptoms, treatments and prognosis depends on its type, size, stage and the location of lesions. Most cases of ureter cancer are transitional cell carcinomas. Another type, squamous cell carcinoma, may develop in patients with chronic kidney infection or kidney stones. 

Baptist Health is known for advanced, superior care for patients with cancer and the diagnosis, treatment and management of ureter cancer. Our accredited, award-wining cancer care includes a wide array of supportive programs, including dietetics, genetic counseling, psychology , nurse navigators and financial counseling.

You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health.

Signs and Symptoms

Symptoms of ureter cancer may include:

• Blood or blood clots in the urine
• Cramps or back pain
• Dark urine
• Discomfort or burning during urination
• Fatigue
• Frequent or urgent urination
• Pain in the back at the juncture of the ribs and spine
• Unintentional weight loss

Diagnosis

To determine if someone has ureter cancer, we perform a physical examination and ask questions about symptoms. We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures are similar to those used to detect bladder cancer and can include:

Urine test: A urinalysis can analyze the urine for any abnormalities. A urine cytology test looks for abnormal, or cancerous, cells in a urine sample.

Ureteroscopy: During this test, a narrow, lighted tube is inserted through the urethra. The scope is passed through the bladder and into the ureters. A small sample of the cells in the ureters may be collected to check for cancer.

Contrast-enhanced CT Scan: A thin tube (catheter) is inserted into a blood vessel and dye is injected to make the ureters visible to X-rays. Computers capture the images and produce a highly detailed view of the urinary tract.

Intravenous pyelogram (IVP): In this test, a contrast material is injected to show the details of the kidney, ureters and bladder on an X-ray.

Magnetic resonance imaging (MRI): A large magnet, radio waves and a computer are used to produce pictures of the urinary tract.

Causes

There are a number of genetic, lifestyle and environmental factors that can increase the risk of ureter cancer, including:

• Misusing certain pain medications, even over-the-counter varieties, for an extended time
• Smoking

Risk Factors

Risk factors that can contribute to ureter cancer include:

Age: Ureter cancer occurs most often in older adults. 

Being male: Men are more likely to develop ureter cancer than women.

Chronic kidney infections or stones: Squamous cell carcinoma (cancer that begins in squamous cells, which are thin, flat cells found in the tissue that forms the lining of the ureter) may develop in people who have chronic kidney infections or stones.

Exposure to certain chemicals: Exposure to certain dyes and chemicals used in making textiles, plastics, rubber and leather goods can increase the risk of developing ureter cancer.

Hereditary disease: People with the cancer syndrome known as Lynch syndrome are at higher risk of ureter cancer. Lynch Syndrome is also known as Hereditary Non-Polyposis Colorectal Cancer (HNPCC). 

History of bladder cancer: Ureter cancer more frequently affects people with a history of bladder cancer. Some treatments for bladder cancer, such as radiation of the pelvis and some cancer drugs, can increase the risk of ureter cancer.

Prevention

While some risk factors cannot be controlled, there are ways you can help to prevent ureter cancer:

Avoid exposure to chemicals: When possible, avoid exposure to industrial chemicals.

Don’t overuse pain medications: Take only the recommended dose for the recommended time. Talk to your physician about safe use of these medications.

Don’t smoke: Smoking is a known causes of urinary tract irritation that may lead to cancer.

Prognosis

Prognosis depends upon how early the cancer is diagnosed, the size and location of the tumor, and if it has spread. Cancer present only in the ureter, or ureter and kidney, is typically curable.

Treatment and Recovery

Ureter cancer treatment depends upon how far the condition has progressed. The goal is to eliminate the cancer.

Chemotherapy

After surgery, or if cancer has spread elsewhere in the body, special drugs designed to kill cancer cells can be given as a pill or injected into the bloodstream. 

Electrosurgery

If the cancer is detected at an early stage or only appears on the ureter’s surface, this procedure can destroy the tumor and adjacent tissue with an electric current.

Laser Therapy

If the cancer is detected at an early stage or only appears on the ureter’s surface, a ureteroscope can be inserted into the ureter and a beam of laser light sent through to destroy the tumor.

Radiation therapy

After surgery, or if cancer has spread elsewhere in the body, high-energy radiation is used to kill cancer cells. The radiation is directed specifically to the ureter and other affected tissues or organs. 

Surgery

Surgery can include removal of a portion of the ureter, the whole ureter or the ureter and kidney. Sometimes a portion of the bladder is also removed. Surgical procedures may include:

• Nephrectomy: In this procedure, part or all of the kidney is removed.
• Nephro-ureterectomy: This procedure involves removal of the kidney, ureter and upper bladder (and sometimes adjacent lymph glands, tissue and fat).
• Segmental ureterectomy resection: If the tumor is small and localized, this procedure removes only the part of the ureter that contains cancer cells.
• Ureterectomy: The procedure involves removal of the entire ureter.
• Ureteroneocystomy (reimplantation): If cancer cells are only in the lower part of the ureter, this procedure removes only the lower part. The remaining section of the ureter is reconnected to the bladder.

Complications

Ureter cancer sometimes recurs, or puts you at a greater risk of other urinary tract cancers, so follow-up care for years after successful treatment is important. Certain complications may occur, including:

Kidney failure: This is a rapid loss of a kidney’s ability to remove waste and help balance fluids and electrolytes. Treatment depends on what is causing the kidney failure.

Localized spread of the tumor with increasing pain: If the tumor spreads, a patient may require additional treatments like surgery, chemotherapy and/or radiation, as well as medications to control pain.

Spread of the cancer: If ureter cancer spreads, or reappears in other areas of the body, additional treatments – like chemotherapy and radiation – may be required.