Diagnosis of Transitional Cell Cancer: Renal Pelvis & Ureter

Diagnosis of Transitional Cell Cancer of the Renal Pelvis & Ureter

The following tests and procedures may be used to diagnose transitional cell cancer of renal pelvis and ureter:
  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
  • Urinalysis: A test to check the color of urine and its contents, such as sugar, protein, blood, and bacteria.
  • Ureteroscopy: A procedure to look inside the ureter and renal pelvis to check for abnormal areas. Ureteroscope (a thin, lighted tube) is inserted through the urethra into the bladder, ureter, and renal pelvis. Tissue samples may be taken for biopsy.
  • Urine cytology: Examination of urine under a microscope to check for abnormal cells. Cancer in the kidney, bladder, or ureter may shed cancer cells into the urine.
  • Intravenous pyelogram (IVP): A series of x-rays of the kidneys, ureters, and bladder to check for cancer. A contrast dye is injected into a vein. As the contrast dye moves through the kidneys, ureters, and bladder, x-rays are taken to see if there are any blockages.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • Ultrasound: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram. An ultrasound of the abdomen may be done to help diagnose cancer of the renal pelvis and ureter.
Factors Affecting Prognosis and Treatment Options The prognosis (chance of recovery) depends on the stage and grade of the tumor. The treatment options depend on the following:
  • The stage and grade of the tumor.
  • Where the tumor is.
  • Whether the patient’s other kidney is healthy.
  • Whether the cancer has recurred.
 

Stages

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:
  • Intravenous pyelogram (IVP): A series of x-rays of the kidneys, ureters, and bladder to find out if cancer has spread within these organs. A contrast dye is injected into a vein. As the contrast dye moves through the kidneys, ureters, and bladder, x-rays are taken to see if there are any blockages.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • Ultrasound: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
  • Ureteroscopy: A procedure to look inside the ureter and renal pelvis to check for abnormal areas. Ureteroscope (a thin, lighted tube) is inserted through the urethra into the bladder, ureter, and renal pelvis. Tissue samples may be taken for biopsy.
  • Surgery: Tissues removed during surgery to treat the transitional cell cancer will be examined by a pathologist.
Cancer spreads in the body through tissue, blood or the lymph system. When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. The following stages are used for transitional cell cancer of the renal pelvis and/or ureter:

Stage 0 (Papillary Carcinoma and Carcinoma in Situ)

In stage 0, abnormal cells are found in tissue lining the inside of the renal pelvis or ureter. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is divided into stage 0a and stage 0is, depending on the type of tumor:
  • Stage 0a may look like tiny mushrooms growing from the lining. Stage 0a is also called noninvasive papillary carcinoma.
  • Stage 0is is a flat tumor on the tissue lining the inside of the renal pelvis or ureter. Stage 0is is also called carcinoma in situ.
 

Stage I

In stage I, cancer has formed and spread through the lining of the renal pelvis and/or ureter, into the layer of connective tissue.

Stage II

In stage II, cancer has spread through the layer of connective tissue to the muscle layer of the renal pelvis and/or ureter.

Stage III

In stage III, cancer has spread:
  • to the layer of fat outside the renal pelvis and/or ureter; or
  • into the wall of the kidney.
 

Stage IV

In stage IV, cancer has spread to at least one of the following:
  • A nearby organ.
  • The layer of fat surrounding the kidney.
  • One or more lymph nodes.
  • Other parts of the body.
Transitional cell cancer of the renal pelvis and ureter is also described as localized, regional, or metastatic: Localized The cancer is found only in the kidney. Regional The cancer has spread to tissues around the kidney and to nearby lymph nodes and blood vessels in the pelvis. Metastatic The cancer has spread to other parts of the body.

Recurrent Transitional Cell Cancer of the Renal Pelvis and Ureter

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