Upper tract urothelial cancer (UTUC)

Upper tract urothelial cancer signs and symptoms

Upper tract urothelial cancer can be difficult to diagnose in its early stages and you may have no symptoms if the cancer is slow growing.

Symptoms that some people may experience include:

• blood in the urine (haematuria) — you may or may not be able to see this

• pain on one side of the back caused by a blockage in the kidney or ureter

• weight loss

• urinary tract infections

Causes of upper tract urothelial cancer

The cause of UTUC is not known in most cases. However, there are several risk factors:

• smoking tobacco

• a history of long-term inflammation of the ureter or kidney

• exposure to certain chemicals over time, such as those used to make plastics, textiles, rubber, paint and dyes

• exposure to arsenic

• prior chemotherapy or radiation therapy for another cancer

• long-term use of large quantities of painkillers

• family history of bladder cancer

• having Lynch syndrome (an inherited syndrome) or Balkan nephropathy (caused by exposure to toxins in the diet of people living in the Balkan region)

Diagnosis of upper tract urothelial cancer

If your doctor thinks you may have UTUC they will take your medical history, perform a physical examination and arrange for you to have a number of tests.

If the results of these tests suggest that you may have UTUC, your doctor will refer you to a specialist called a urologist, who will arrange further tests. These may include:

Treatment for upper tract urothelial cancer

Discussions with your health professionals will help you decide on the best treatment for your cancer depending on the type of cancer you have and its exact location; the grade and stage of your cancer; your age, fitness and general health; the health and function of your other kidney (if it is the kidney that is affected) and your preferences.

The main treatments for UTUC include surgery, chemotherapy and sometimes radiation therapy. These can be given alone or in combination. This is called multi-modality treatment.

Treatment Team

• Cancer nurse -

  assists with treatment and provides information and support throughout your treatment.

• Medical oncologist -

  prescribes and coordinates the course of chemotherapy.

• Physiotherapist/occupational therapist -

  help with physical and practical problems such as restoring movement and mobility after treatment.

• GP (General Practitioner) -

  looks after your general health and works with your specialists to coordinate treatment.

• Radiation oncologist -

  prescribes and coordinates radiation therapy treatment.

• Other allied health professionals -

  such as social workers, pharmacists, and counsellors

• Dietitian -

  recommends an eating plan to follow while you are in treatment and recovery.

• Pathologist -

  examines cells and tissues under a microscope

• Urologist -

  specialises in the treatment of diseases of the urinary system (male and female) and the male reproductive system

Screening for upper tract urothelial cancer

There is currently no national screening program for UTUC available in Australia.

Preventing upper tract urothelial cancer

As the causes of UTUC is not known in most cases it is not possible to prevent the disease. However, quitting smoking, limiting exposure to certain chemicals and not taking large quantities of painkillers can help reduce your risk of developing UTUC.

Prognosis for upper tract urothelial cancer

Prognosis refers to the expected outcome of a disease. It is not possible for any doctor to predict the exact course of the disease. An individual's prognosis depends on the type and stage of cancer, as well as their age and general health at the time of diagnosis. This information will also help your doctor to advise on the best treatment options.