Last Modified : 2005-04-14
The renal pelvis is part of the kidney and the ureter connects the kidney to the bladder. There are 2 kidneys, one on each side of the backbone, above the waist. The kidneys of an adult are about 5 inches long and 3 inches wide and are shaped like a kidney bean. The kidneys clean the blood and produce urine to rid the body of waste. The urine collects in the middle of each kidney in a large cavity called the renal pelvis. Urine drains from each kidney through a long tube called the ureter, into the bladder, where it is stored until it is passed from the body through the urethra.
The renal pelvis and ureters are lined with transitional cells. These cells can change shape and stretch without breaking apart. Transitional cell cancer starts in these cells. Transitional cell cancer can form in the renal pelvis or the ureter or both.
Renal cell cancer is a more common type of kidney cancer. Refer to the PDQ summary on Renal Cell Cancer Treatment for more information.
Misuse of certain pain medicines can affect the risk of developing transitional cell cancer of the renal pelvis and ureter.Risk factors include the following:
These and other symptoms may be caused by transitional cell cancer of the renal pelvis and ureter. Other conditions may cause the same symptoms. There may be no symptoms in the early stages. Symptoms may appear as the tumor grows. A doctor should be consulted if any of the following problems occur:
The following tests and procedures may be used:
The prognosis (chance of recovery) depends on the stage and grade of the tumor.
The treatment options depend on the following:
Most transitional cell cancer of the renal pelvis and ureter can be cured if found early.
The process used to find out if cancer has spread within the renal pelvis and ureter or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:
In stage 0, the cancer is found only on tissue lining the inside of the renal pelvis or ureter. Stage 0 is divided into stage 0a and stage 0is, depending on the type of tumor:
In stage I, cancer has spread through the cells lining the renal pelvis and/or ureter, into the layer of connective tissue.
Stage IIIn stage II, cancer has spread through the layer of connective tissue to the muscle layer of the renal pelvis and/or ureter.
Stage IIIIn stage III, cancer has spread:
In stage IV, cancer has spread to at least one of the following:
The cancer is found only in the kidney.
RegionalThe cancer has spread to tissues around the kidney and to nearby lymph nodes and blood vessels in the pelvis.
MetastaticThe cancer has spread to other parts of the body.
Recurrent transitional cell cancer of the renal pelvis and ureter is cancer that has recurred (come back) after it has been treated. The cancer may come back in the renal pelvis, ureter, or other parts of the body.
Different types of treatments are available for patients with transitional cell cancer of the renal pelvis and ureter. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.
Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.
One type of standard treatment is used:One of the following surgical procedures may be used to treat transitional cell cancer of the renal pelvis and ureter:
Fulguration is a surgical procedure that destroys tissue using an electric current. A tool with a small wire loop on the end is used to remove the cancer or to burn away the tumor with electricity.
Segmental resection of the renal pelvisThis is a surgical procedure to remove localized cancer from the renal pelvis without removing the entire kidney. Segmental resection may be done to save kidney function when the other kidney is damaged or has already been removed.
Laser surgeryA laser beam (narrow beam of intense light) is used as a knife to remove the cancer. A laser beam can also be used to kill the cancer cells. This procedure may be called laser therapy or laser fulguration.
Regional chemotherapy and regional biologic therapyChemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. Biologic therapy is a treatment that uses the patient's immune system to fight cancer; substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. Regional treatment means the anticancer drugs or biologic substances are placed directly into an organ or a body cavity such as the abdomen, so the drugs will affect cancer cells in that area. Clinical trials are studying the effectiveness of chemotherapy or biologic therapy using drugs placed directly into the renal pelvis or the ureter.
This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.
Treatment of localized transitional cell cancer of the renal pelvis and ureter may include the following:
This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.
Treatment of regional transitional cell cancer of the renal pelvis and ureter is usually done in a clinical trial. Information about ongoing clinical trials is available from the NCI Web site.
Treatment of metastatic transitional cell cancer of the renal pelvis and ureter is usually done in a clinical trial, which may include chemotherapy. Information about ongoing clinical trials is available from the NCI site.
Treatment of recurrent transitional cell cancer of the renal pelvis and ureter is usually done in a clinical trial, which may include chemotherapy. Information about ongoing clinical trials is available from the NCI Web site.