What is Upper Urinary Tract Cancer?

The upper urinary tract consists of the renal pelvis (kidney pelvis), renal calyces and ureters. While it is somewhat rare, cancer can be found in any of these locations. Upper urinary tract cancers start in the urothelium, a thin layer of tissue that lines the renal pelvis, ureters, bladder and urethra. The urothelium layer is composed of urothelial cells (also known as transitional cells). Cancer diagnosed in this layer is called urothelial cell or transitional cell cancer.

As a lining, the urothelium is in direct contact with urine. As a filtered byproduct of the kidneys, urine can carry harmful waste that may expose the urothelial cells to carcinogens. Because the bladder holds urine over long periods of time, it is at a higher risk for developing transitional cell cancer. In comparison, the upper urinary tract has less exposure to urine which results in a lower risk of cancer development.

Causes of Upper Urinary Tract Cancer

There is not a definitive cause for Upper Urinary Tract Cancer. However, there are factors that may put individuals at risk.

• Chemical and Carcinogens – Because urine is a filtered byproduct of the blood (transported and held in the urinary system) people who consume or expose themselves to potential carcinogens may be at higher risk. These hazards include tobacco use (smoking) and being in contact with chemicals in the workplace.
• Gender and Age – Men and women are both at risk for developing Upper Urinary Tract Cancer. However, the diagnosis of this cancer is higher in men. At the same time, more women die from these cancers. Statistics also show that age plays a part. These cancers are generally diagnosed after 70.
• Race – Research shows that more Caucasians are diagnosed with Upper Urinary Tract Cancer. However, it appears to be more deadly among African-Americans.

Diagnosis

Diagnosing Upper Urinary Tract Cancers can be challenging based on the cancer’s location, and because early symptoms – such as pain and blood in the urine – can mimic other urological conditions. However, urologists do have several tools that can help them make a diagnosis, including:

• Blood tests
• Urine cytology – this analysis is performed to detect abnormal cells in the urine
• In-office physical examination and review of medical history
• Imaging – these may include a CT scan, MRI or X-ray
• Cystoscopy – an in-office procedure in which a thin, lighted scope is passed through the urethra into the bladder in order to detect abnormalities such as tumors or lesions

Ureteroscopy – This examination utilizes an endoscope to inspect the ureters and renal pelvis. Because the scope is fed through the upper urinary tract, it is performed under general anesthesia. A biopsy of these areas can also be taken during this procedure.

If you need to see a Urologist, contact Urology Austin to schedule an appointment with one of our providers.