Cancer of the Proximal Ureter

The ureters are the tube-like structures that allow drainage of urine from the kidneys down to the urinary bladder.

Causes

Exposure to environmental chemicals, damage from overuse of medications, (even over the counter medications), and smoking are known to be causative for this type of cancer.

Symptoms

Among the symptoms a patient may experience with cancer of the ureter, flank pain, nausea, changes in urination may exist. Cancers are highly vascular, (contain many blood vessels), so blood in the urine is likely to be an early sign of disease in the urinary system.

Diagnostic Tests

The patient will have a urinalysis which can reveal cancer cells, but often will contain red blood cells. The urologist will proceed, once this finding has been noted, to have the patient tested for tumors in the urinary tract. One of the tests done is an intravenous pyelogram. This type of x-ray provides an image of the kidneys and ureters after a contrast medium has been injected intravenously enabling the organ to be seen on the xray.

The urologist may look directly into the ureter using a scope, (ureteroscopy) and can biopsy suspicious areas during the examination. Other diagnostic imaging tests used include ultrasound of the ureter, MRI

Treatment

Excision or removal of the cancer surgically can be accomplished by using a section of the ileum, removed from the intestines, and connected to the ureter as replacement for the excised section. This method enables the urological surgeon to spare the adjacent kidney. This will depend greatly on the stage of the tumor. (See cancer staging in glossary).

The surgeon may, instead, elect to remove the ureter and adjacent kidney if the staging indicates spread of the cancer cells prior to surgery to these structures is probable.