What are the other Names for this Condition? (Also known as/Synonyms)

• Renal Pelvis and Ureter, Transitional Cell Cancer
• TCC of Renal Pelvis and Ureter

What is Transitional Cell Cancer of the Renal Pelvis and Ureter? (Definition/Background Information)

• Transitional Cell Cancer of the Renal Pelvis and Ureter is a term used to describe the transformation of normal cells to cancer cells in the renal pelvis (part of the kidney) and ureter. The ureters carry urine from the kidneys to the urinary bladder
• Transitional Cell Cancer of the Renal Pelvis and Ureter may be caused by smoking habit and long-term misuse of pain medication, as well as exposure to certain industrial chemicals and dyes
• Back pain, blood in urine, unintended weight loss and fatigue are some symptoms of Transitional Cell Cancer of the Renal Pelvis and Ureter
• The stage of tumor at the time of diagnosis and response to treatment determine the prognosis of Transitional Cell Cancer of the Renal Pelvis and Ureter

Who gets Transitional Cell Cancer of the Renal Pelvis and Ureter? (Age and Sex Distribution)

• Transitional Cell Cancer of the Renal Pelvis and Ureter is a rare condition that may affect individuals of all ages
• Both males and females may be affected
• Worldwide, individuals of all racial and ethnic groups may be affected

What are the Risk Factors for Transitional Cell Cancer of the Renal Pelvis and Ureter? (Predisposing Factors)

The risk factors for Transitional Cell Cancer of the Renal Pelvis and Ureter may include the following:

• Smoking habit
• Long-term misuse or abuse of pain medication
• Exposure to industrial chemicals and dyes (used for manufacturing leather goods, textiles, rubber and plastics)

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Transitional Cell Cancer of the Renal Pelvis and Ureter? (Etiology)

• Transitional Cell Cancer of the Renal Pelvis and Ureter is caused by conversion of normal cells to malignant cells in the renal pelvis (top part of the ureter) and ureter 
• The renal pelvis and ureter have a lining of cells known as “transitional” cells. The transformation of the transitional cells causes their uncontrolled growth. Thus the world “transitional” is used in the context of origin of malignant cells
• Smoking, exposure to industrial chemicals and misuse of drugs (such as pain medicines) can increase the transformation of transitional cells to malignant ones

What are the Signs and Symptoms of Transitional Cell Cancer of the Renal Pelvis and Ureter?

The signs and symptoms of Transitional Cell Cancer of the Renal Pelvis and Ureter may include:

• Persistent back pain
• Blood in urine
• Pain during urination
• Frequent urination
• Tiredness
• Unintended weight loss

How is Transitional Cell Cancer of the Renal Pelvis and Ureter Diagnosed?

Transitional Cell Cancer of the Renal Pelvis and Ureter is diagnosed on the basis of the following information:

• Complete physical examination
• Thorough medical history evaluation
• Assessment of signs and symptoms
• Laboratory tests, including:
  • Blood tests
  • Analysis of urine
  • Microscopic examination of urine (urine cytology) to check for presence of malignant cells
• Imaging tests, such as
  • Ultrasound scan of the affected region
  • MRI and CT scan of the affected region
  • Ureteroscopy
  • Intravenous pyelogram (IVP)
• Biopsy of renal pelvis and ureter tissue: A tissue biopsy of mass is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
  • Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
  • Sometimes, the pathologist may perform special studies, which may include immunohistochemical stains, molecular testing, and very rarely, electron microscopic studies, to assist in the diagnosis

Following a diagnosis of Transitional Cell Cancer of the Renal Pelvis and Ureter, tests are conducted to ascertain the size of tumor and extent of its spread, using the following guidelines:

• Stage 0 (Papillary Carcinoma and Carcinoma in Situ)
• Stage I
• Stage II
• Stage III
• Stage IV

Transitional Cell Cancer of the Renal Pelvis and Ureter is also described as:

• Localized
• Regional
• Metastatic

(Source: National Cancer Institute, May 2015)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Transitional Cell Cancer of the Renal Pelvis and Ureter?

The complications of Transitional Cell Cancer of the Renal Pelvis and Ureter may include:

• Spread of cancer to other organs in the pelvic region
• Spread of cancer to distant organs and tissues
• Recurrence of Transitional Cell Cancer of the Renal Pelvis and Ureter after treatment

Complications may occur with or without treatment, and in some cases, due to treatment also.

How is Transitional Cell Cancer of the Renal Pelvis and Ureter Treated?

The treatment for Transitional Cell Cancer of the Renal Pelvis and Ureter may include surgery that includes:

• Removal of kidney, ureter and bladder cuff (nephroureterectomy)
• Removal of parts of ureter that has cancer, and reconnecting healthy parts (segmental resection of the ureter)

How can Transitional Cell Cancer of the Renal Pelvis and Ureter be Prevented?

Transitional Cell Cancer of the Renal Pelvis and Ureter may be prevented by

• Smoking cessation
• Discontinue use/abuse of pain medication
• Minimize exposure to industrial chemicals known to cause cancers, by wearing protective gear

Due to the metastasizing potential and chances of recurrence of Transitional Cell Cancer of the Renal Pelvis and Ureter, regular medical screening at periodic intervals with blood tests, radiological scans, and physical examinations, once an individual is diagnosed with the cancer

What is the Prognosis of Transitional Cell Cancer of the Renal Pelvis and Ureter? (Outcomes/Resolutions)

• The prognosis of Transitional Cell Cancer of the Renal Pelvis and Ureter depends upon a set of several factors, which includes:
  • Stage of tumor: With lower-stage tumors, when the tumor is confined to site of origin, the prognosis is usually excellent with appropriate therapy. In higher-stage tumors, such as tumors with metastasis, the prognosis is poor
  • The surgical respectability of the tumor (meaning, if the tumor can be removed completely)
  • Overall health of the individual: Individuals with overall excellent health have better prognosis compared with those with poor health
  • Whether the unaffected kidney is healthy
  • Age of the individual: Older individuals generally have poorer prognosis than younger individuals
  • Whether the tumor is occurring for the first time, or is a recurrent tumor. Recurring tumors have worse prognosis 
  • Response to treatment: Tumors that respond to treatment have better prognosis compared to tumors that do not respond to treatment
• With an early diagnosis and prompt treatment, the prognosis is good for Transitional Cell Cancer of the Renal Pelvis and Ureter 
• Regular follow-up visits with the healthcare provider are important

Additional and Relevant Useful Information for Transitional Cell Cancer of the Renal Pelvis and Ureter:

In addition, affected individuals may inquire about clinical trials for novel methods of treatment at their medical facility or visit the following websites:

• www.clinicaltrials.gov 
• https://www.cancer.gov/about-cancer/treatment/clinical-trials 

The following DoveMed website link is a useful resource for additional information:

http://www.dovemed.com/diseases-conditions/rare-disorders/