Urothelial cancer can also arise in the lining of the kidney’s collecting system or the ureter. These cancers are uncommon but may be found on tests for worsening kidney function, or if a patient has blood in the urine or flank pain.
CONDITIONS
Upper Tract Urothelial Cancer
Common Risk Factors
• Smoking
• Male sex
• Previous bladder cancer
• Occupational exposure – chemical manufacturing, and the rubber, dye and petroleum industries
• Lynch syndrome
• Chronic inflammation from recurrent stones or infection
How We Diagnose Upper Tract Urothelial Cancer
• CT urogram
• Urine cytology
• Cystoscopic washings with retrograde pyelogram (dye tests)
• Ureteroscopy with biopsy
How We Treat Upper Tract Urothelial Cancer
• Kidney-sparing (endoscopic) laser ablation for low-risk, favourable tumours
• Radical nephroureterectomy (removal of the kidney and ureter) for higher-risk disease
• Surveillance cystoscopy and imaging to monitor for bladder recurrence
• Immunotherapy or chemotherapy for advanced disease
