Upper urinary tract urothelial cancer (UTUC)
On this page
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What is upper urinary tract urothelial cancer (UTUC)?
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Symptoms of upper urinary tract urothelial cancer (UTUC)
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Causes and risk factors of upper urinary tract urothelial cancer (UTUC)
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Diagnosis of upper urinary tract urothelial cancer (UTUC)
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Staging and grading of upper urinary tract urothelial cancer (UTUC)
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Treatment for upper urinary tract urothelial cancer (UTUC)
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After treatment for upper urinary tract urothelial cancer (UTUC)
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How we can help
What is 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
Diagnosis of upper urinary tract urothelial cancer (UTUC)
If you have symptoms, you usually start by seeing your GP. They will examine you and arrange for you to have some tests. They may test your pee (urine). They may also do blood tests to check:
- your general health
- the number of cells in your blood (full blood count)
- how well your kidneys and liver are working.
If your GP is not sure what the problem is, or they think your symptoms could be caused by cancer, they will usually refer you to the hospital to see a specialist doctor. This doctor is called a urologist.
If you have blood in your urine, you may be referred to a specialist clinic. This is called a haematuria clinic. Usually, these clinics can do tests on the same day.
At the hospital
The urologist or a specialist nurse will ask you about your symptoms and your general health. They will also examine you and arrange some of the following tests:
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Blood tests
Blood tests help your doctors check how well your kidneys and liver are working. They also show the number of blood cells in your blood. This is called a full blood count.
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Urinary cytology
During a urinary cytology, a sample of your urine is checked for cancer cells.
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CT scan
A CT scan takes a series of x-rays which create a three-dimensional (3D) picture of the inside of the body.
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CT urogram
A CT urogram is a type of CT scan to look at the kidneys, ureters and bladder.
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Flexible cystoscopy
A flexible cystoscopy is a test that looks for changes in the bladder.
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Cystoscopy and ureteroscopy
Cystoscopy and ureteroscopy are tests that let the doctor look inside the bladder, ureter and renal pelvis.
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MRI scan
An MRI scan uses magnetism to build up a detailed picture of areas of your body.
Waiting for test results can be a difficult time. We have more information that can help.
Treatment for upper urinary tract urothelial cancer (UTUC)
A team of specialists will discuss your treatment options. This is called a multidisciplinary team (MDT).
Treatment depends on a number of factors, including the position, type, stage and grade of the cancer. Your doctors will also consider:
- how well your kidneys work
- your general health
- your personal preferences.
Your cancer doctor will explain the different treatments and their side effects. They will also talk to you about the things you should consider when making treatment decisions.
You may also have some treatments as part of a clinical trial.
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Surgery
Surgery aims to remove the area affected by cancer. It is usually the main treatment for UTUC that has not spread to distant parts of the body. After surgery, you may be offered other treatments to try and get rid of any remaining cancer cells. This may reduce the chance of the cancer coming back. This is called adjuvant treatment.
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Chemotherapy
Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. You may have chemotherapy to reduce the risk of cancer coming back after surgery. Or you may have it as the main treatment for cancer that has spread to other parts of the body.
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Immunotherapy
Immunotherapy drugs encourage the body’s immune system to fight cancer cells. You may have a type of immunotherapy called BCG after surgery to reduce the risk of cancer coming back. If the cancer has spread to other parts of the body, you may have immunotherapy drugs called checkpoint inhibitors.
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Targeted therapy
Targeted therapy drugs affect the way that cancer cells grow. These are sometimes used after chemotherapy and immunotherapy to treat cancer that has spread to other parts of the body. Your cancer doctor or specialist nurse will tell you if they think a targeted therapy drug is suitable for you. Some drugs are not available on the NHS. But there may be ways you can still have them. Your doctor can discuss this with you.
Date reviewed
This content is currently being reviewed. New information will be coming soon.
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