Upper urinary tract urothelial cancer (UTUC)

Upper urinary tract urothelial cancer (UTUC) is cancer that starts in the upper urinary tract. This is made up of the ureters and an area of the kidneys called the renal pelvis.

UTUC is uncommon. Usually, only one ureter or renal pelvis is affected.

UTUC is sometimes called transitional cell carcinoma (TCC). This is because around 9 in 10 cancers of the ureter or renal pelvis (90%) start in cells called transitional cells. Transitional cells line the renal pelvis, ureters, bladder and urethra.

This information is about cancer that starts in the ureter or renal pelvis. We have separate information about kidney cancer (renal cell cancer) and bladder cancer.

See also

• What is cancer?

Some people do not have symptoms but are diagnosed when having a test or scan for another reason.

The most common symptoms of UTUC are:

• blood in the urine (haematuria)
• pain in one side of the lower back.

Sometimes the ureter becomes blocked, either by cancer cells or by a blood clot. This causes urine to stay in the kidney and ureter. This is called hydronephrosis. If this happens, symptoms such as back pain may develop more quickly and be more severe.

See also:

• Do I have cancer?

There are certain things that can affect the chances of developing UTUC. These are called risk factors.

Having a risk factor does not mean you will definitely get UTUC. And if you do not have any risk factors, you may still develop cancer.

Your cancer doctor needs certain information about the stage and the grade of the cancer to advise you on the best treatment for you.

The stage of the cancer describes its size and whether it has spread. The grade of the cancer gives an idea of how quickly the cancer might grow and spread.

Staging and grading information comes from the tests you have had.

Follow-up

After your treatment has finished, you will have regular check-ups with your cancer doctor to monitor how you are recovering after treatment. These will usually include a physical examination. They may also involve taking some urine (pee) or blood samples.

You may have regular checks with a CT urogram, or a regular ureteroscopy. You may also have a cystoscopy to detect any changes in the bladder. This is because people with cancer of the ureter or renal pelvis have an increased risk of Bladder cancer after a few years.

If the cancer is advanced, you may continue having treatment while it is working for you. You may have regular CT scans to see how the cancer is responding.

You can talk to your cancer doctor or specialist nurse about any problems or worries you have at these check-ups. If you have any problems or notice any new symptoms between your appointments, tell your doctor as soon as possible.

You may feel anxious between appointments. This is natural. It may help to get support from family, friends or a support organisation. You may want to join a local support group. Your nurse may be able to give you details.

Macmillan is also here to support you. If you would like to talk, you can:

• Call the Macmillan Support Line on 0808 808 00 00.
• Chat to our specialists online.

Well-being and recovery

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.

Making small changes to the way you live, such as eating well and keeping active, can improve your health and well-being and help your body recover.