What is Ureteral Cancer?

Medically Reviewed By: Guru P. Sonpavde, MD

Ureteral cancer is a type of cancer that grows in the ureter, or the two thin tubes that connect the kidneys to the bladder. It is uncommon compared with other cancers.

What are the ureters?

Kidneys make urine by filtering waste and extra water from blood. The urine travels from the kidneys to the bladder in two thin tubes, which are called ureters.

Are there any risk factors for ureteral cancer?

The causes of ureteral cancer remain unclear, but there are some factors that may increase risk. Risk factors for ureter cancer include the following:

  • Having a personal history of bladder cancer
  • Smoking cigarettes
  • Taking several certain pain medicines, such as phenacetin
  • Being exposed to certain dyes and chemicals used in making leather goods, textiles, plastics, and rubber
  • Inherited familial disorders, especially Lynch syndrome

Talk with your doctor if you think you may be at risk. Remember: Having a risk factor does not mean you will develop ureteral cancer.

What are the symptoms of ureteral cancer?

Signs and symptoms of ureteral cancer can vary, but can include the following:

  • Blood in the urine
  • A pain in the back that doesn’t go away
  • Extreme tiredness
  • Weight loss with no known reason
  • Painful or frequent urination

While these symptoms can be unrelated to ureteral cancer, be sure to check with your doctor to make sure they are addressed.

Signs and symptoms can appear in the early stages of ureteral cancer, but may also appear as the tumor grows.

How is ureteral cancer treated?

There are different types of treatment for patients with ureteral cancer. Treatments will depend on various factors including tumor size, tumor location, and tumor aggressiveness. Ureter cancer that is high-grade on pathology examination may require intravenous chemotherapy before or after surgery to improve the cure rate. In addition, intravenous immunotherapy using a drug called nivolumab is now approved for certain patients following surgery who are not eligible for chemotherapy.

Types of surgical options can include:

  • Nephroureterectomy: The majority of ureteral cancers are treated with this type of surgery to remove the kidney and the entire ureter.
  • Segmental resection of the ureter, a surgical procedure that involves removing the part of the ureter that contains cancer and some of the healthy tissue around it. The ends of the ureter are then reattached. This treatment is used when the cancer is superficial and in the lower third of the ureter only, near the bladder.

Clinical trials are also testing potential new treatments, including:

  • Fulguration, 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 pelvis
  • Laser surgery
  • Regional chemotherapy and regional biologic therapy for low grade ureter cancers
  • Targeted oral therapy following surgery to test the effectiveness of drugs that inhibit cancers with mutations in the FGFR3 gene

About the Medical Reviewer

Guru P. Sonpavde, MD

Guru P. Sonpavde, MD is the director of the bladder cancer program at Dana-Farber Cancer Institute and is on the faculty of Harvard Medical School. He completed his medical oncology fellowship at Indiana University. His primary focus is on clinical trials to develop new drugs and combinations to treat urologic cancers, particularly bladder cancer. He also has led translational projects and developed prognostic classifications and endpoints focused on bladder cancer. He is a meber of the Genitourinary Committee of Southwest Oncology Group and the Bladder Cancer Task Force of the National Cancer Institute Genitourinary Steering Committee.