Rak moczowodu
Objawy

Rak moczowodu (UTUC) to rzadki nowotwór wywodzący się z komórek przejściowych wyścielających moczowody, występujący głównie u osób powyżej 65. roku życia, częściej u mężczyzn. Najczęstszym objawem jest krwiomocz (makro- lub mikrohematuria), który może pojawić się już we wczesnym stadium choroby. W miarę progresji nowotworu pojawiają się objawy bólowe w okolicy lędźwiowej, dysuria, częstomocz, nykturia, zmniejszenie strumienia moczu, utrata masy ciała i przewlekłe zmęczenie. Zaawansowane stadium może prowadzić do wodonercza z powodu zablokowania moczowodu, co skutkuje upośledzeniem funkcji nerki. Lokalizacja guza determinuje objawy kliniczne – guzy dystalne manifestują się objawami podobnymi do raka pęcherza, natomiast guzy proksymalne częściej powodują ból lędźwiowy i wodonercze. Diagnostyka powinna uwzględniać ryzyko współistnienia raka pęcherza moczowego, co wymaga regularnej kontroli obu lokalizacji.

Rak moczowodu – wprowadzenie

Rak moczowodu (ang. ureteral cancer) jest nowotworem wywodzącym się z komórek przejściowych wyścielających moczowody, czyli przewody łączące nerki z pęcherzem moczowym. Stanowi on rzadką postać nowotworu układu moczowego, występującą najczęściej u osób starszych, zwłaszcza po 65. roku życia, oraz u pacjentów, którzy wcześniej chorowali na raka pęcherza moczowego.123 Rak moczowodu jest klasyfikowany jako nowotwór górnych dróg moczowych i określany również jako rak urotelialny górnego odcinka dróg moczowych (UTUC – Upper Tract Urothelial Carcinoma).4

Nowotwór ten występuje częściej u mężczyzn niż u kobiet, przy czym zachorowalność wzrasta znacząco po 65. roku życia.56 Jest to schorzenie bliźniacze do raka pęcherza moczowego, gdyż wywodzi się z tego samego typu komórek nabłonkowych. Osoby z rakiem moczowodu mają zwiększone ryzyko rozwoju raka pęcherza, dlatego wymagają regularnej kontroli w kierunku obu tych nowotworów.7

Objawy wczesnego stadium raka moczowodu

We wczesnym stadium rak moczowodu często nie daje charakterystycznych objawów lub symptomy są subtelne i mogą być łatwo przeoczone. W wielu przypadkach nowotwór ten wykrywany jest przypadkowo podczas badań obrazowych wykonywanych z innych powodów.89 Jednakże, nawet we wczesnej fazie mogą wystąpić pewne symptomy, które powinny skłonić pacjenta do konsultacji lekarskiej:

  • Krwiomocz (hematuria) – krew w moczu jest najczęstszym pierwszym objawem, który może nadawać moczu zabarwienie od różowego do brunatnego przypominającego colę110
  • Ból pleców lub boku, zwłaszcza w okolicy między żebrami a biodrem (ból w okolicy lędźwiowej)1112
  • Dyskomfort lub ból podczas oddawania moczu (dyzuria)13

Krwiomocz jest szczególnie istotnym objawem, gdyż może wystąpić już we wczesnym stadium choroby. Może on być widoczny gołym okiem (makrohematuria) lub wykrywalny tylko w badaniu laboratoryjnym moczu (mikrohematuria).1415 Warto podkreślić, że etiologia krwiomoczu może być różna, jednak zawsze wymaga dokładnej diagnostyki, szczególnie u osób po 50. roku życia.

Objawy zaawansowanego raka moczowodu

W miarę progresji nowotworu, gdy guz rośnie i wnika głębiej w ścianę moczowodu lub rozprzestrzenia się na okoliczne struktury, objawy stają się bardziej nasilone i zróżnicowane:13

W zaawansowanym stadium choroby może dojść do zablokowania moczowodu przez guz lub skrzep krwi, co prowadzi do zastoju moczu w nerce (wodonercze, hydronephrosis). Stan ten powoduje nasilony ból w okolicy lędźwiowej i może prowadzić do pogorszenia czynności nerki po stronie zajętej.822

Objawy związane z umiejscowieniem guza

Objawy raka moczowodu mogą różnić się w zależności od lokalizacji guza w obrębie moczowodu. Guzy zlokalizowane w dystalnej (dolnej) części moczowodu mogą powodować objawy podobne do raka pęcherza moczowego, takie jak częstomocz i nagłe parcie na mocz. Natomiast guzy w proksymalnej (górnej) części moczowodu częściej powodują ból w okolicy lędźwiowej i objawy związane z wodonerczzem.23

W przypadku guzów bliższego odcinka moczowodu pacjenci mogą doświadczać także nudności, wymiotów oraz zaburzeń w oddawaniu moczu.23 Nowotwory dystalnego odcinka moczowodu mogą natomiast dawać objawy podobne do zapalenia pęcherza moczowego, powodując dyskomfort w podbrzuszu i częstomocz.

Powikłania i progresja choroby

Rak moczowodu, jeśli nie zostanie wcześnie wykryty i leczony, może prowadzić do poważnych powikłań i progresji choroby.17 Do najczęstszych powikłań należą:

Wodonercze i upośledzenie czynności nerki

Gdy guz blokuje światło moczowodu, mocz zatrzymuje się w miedniczce nerkowej i kielichach, powodując wodonercze (hydronephrosis). Stan ten prowadzi do zwiększonego ciśnienia wewnątrz nerki, jej rozszerzenia i stopniowego upośledzenia funkcji.2425 W przypadku długotrwałego zastoju moczu może dojść do nieodwracalnego uszkodzenia miąższu nerki i zaniku korowego.

Przewlekła niedrożność moczowodu powoduje narastające objawy kliniczne, takie jak nasilający się ból, osłabienie, a w przypadku niewydolności nerki – objawy mocznicy.8

Nawracające zakażenia układu moczowego

Zastój moczu sprzyja rozwojowi zakażeń układu moczowego, które mogą przybierać postać nawracających infekcji. Pacjenci często zgłaszają objawy dyzuryczne, bóle w podbrzuszu oraz stany podgorączkowe.226

Przerzuty odległe

W zaawansowanym stadium raka moczowodu może dojść do przerzutów do innych narządów. Najczęstszymi miejscami przerzutów są:

  • Węzły chłonne regionalne (pachwinowe, okołoaortalne)27
  • Płuca2822
  • Wątroba28
  • Kości2822

Objawy związane z przerzutami zależą od zajętego narządu:28

  • Przerzuty do kości mogą powodować ból kostny, złamania patologiczne lub hiperkalcemię, która objawia się nudnościami, splątaniem i zmęczeniem
  • Przerzuty do płuc mogą prowadzić do kaszlu, duszności lub odkrztuszania plwociny z domieszką krwi
  • Przerzuty do wątroby mogą powodować żółtaczkę (zażółcenie skóry i oczu), ból brzucha i niewyjaśnioną utratę masy ciała
  • Zajęcie węzłów chłonnych może powodować obrzęk kończyn dolnych (obrzęk limfatyczny), ból miednicy lub trudności w oddawaniu moczu

Progresja i rokowanie w raku moczowodu

Przebieg kliniczny raka moczowodu zależy od wielu czynników, w tym od stadium zaawansowania nowotworu w momencie rozpoznania, stopnia złośliwości histologicznej guza oraz ogólnego stanu zdrowia pacjenta.1317

Stadia zaawansowania raka moczowodu

Rak moczowodu, podobnie jak inne nowotwory, klasyfikowany jest według systemu TNM (Tumor, Nodes, Metastasis). Wyróżnia się następujące stadia zaawansowania:29

  • Stadium I: Guz wrasta przez nabłonek do warstwy łącznotkankowej moczowodu
  • Stadium II: Guz wrasta do warstwy mięśniowej moczowodu
  • Stadium III: Guz wrasta do tkanek okołomoczowodowych lub nerki
  • Stadium IV: Guz rozprzestrzenia się na narządy sąsiadujące, węzły chłonne lub odległe narządy

Prawdopodobieństwo nawrotu systemowego (poza układem moczowym) wzrasta wraz z wyższym stadium zaawansowania choroby.30 W stadium II (inwazja mięśniowa) ryzyko nawrotu wynosi około 50%. W stadium III, gdy nowotwór rozprzestrzenia się na tkanki tłuszczowe poza moczowód lub do węzłów chłonnych, ryzyko nawrotu wzrasta do około 70%. Stadium IV jest zazwyczaj nieuleczalne, choć poddaje się leczeniu paliatywnemu.

Rokowanie

Rokowanie w raku moczowodu zależy głównie od stadium zaawansowania w momencie rozpoznania.31 We wczesnych stadiach choroby, gdy nowotwór ograniczony jest do moczowodu lub nerki, szanse na wyleczenie są dobre, szczególnie gdy możliwe jest całkowite chirurgiczne usunięcie guza.1016

Gdy nowotwór rozprzestrzenia się poza moczowód, rokowanie znacząco się pogarsza. Rak moczowodu z przerzutami odległymi ma 5-letni wskaźnik przeżycia wynoszący około 5% lub mniej.6

Na rokowanie wpływają również następujące czynniki:31

  • Lokalizacja guza – guzy w dystalnej części moczowodu mają lepsze rokowanie niż guzy w proksymalnej części
  • Ogólny stan zdrowia nerek – współistniejące choroby nerek obniżają wskaźniki przeżycia
  • Nawroty choroby – nawroty nowotworu mają niższe wskaźniki wyleczenia i przeżycia niż rak pierwotny
  • Przerzuty – obecność przerzutów odległych znacząco pogarsza rokowanie

Nawroty choroby

Rak moczowodu charakteryzuje się stosunkowo wysokim ryzykiem nawrotu.14 Nawroty mogą wystąpić zarówno w obrębie układu moczowego (np. w pęcherzu moczowym), jak i poza nim. Około 20-25% pacjentów z rakiem pęcherza moczowego rozwinie raka górnych dróg moczowych, w tym moczowodu.2

W przypadku dystalnego guza moczowodu leczonego metodą dystalnej ureterektomii (DU), nawroty w górnym odcinku dróg moczowych występują u około 19,6% pacjentów, przy czym u 66,7% z nich wystąpił wcześniej rak pęcherza moczowego.32 Wszystkie takie przypadki wymagają ratunkowej nefroureterektomii (usunięcia nerki i moczowodu).

Najczęstszymi miejscami progresji choroby po leczeniu chirurgicznym są węzły chłonne, a następnie płuca, wątroba i kości.32

Szczególne przypadki i grupy ryzyka

Niektóre grupy pacjentów są bardziej narażone na rozwój raka moczowodu lub mogą doświadczać nietypowego przebiegu choroby.2

Związek z rakiem pęcherza moczowego

Pacjenci z rakiem pęcherza moczowego mają zwiększone ryzyko rozwoju raka moczowodu, i odwrotnie – osoby z rakiem moczowodu mają wyższe ryzyko zachorowania na raka pęcherza.733 Jest to związane z faktem, że oba nowotwory rozwijają się z tego samego typu komórek nabłonkowych wyścielających drogi moczowe.

U osób z rakiem moczowodu rak pęcherza może wystąpić jednocześnie z rakiem moczowodu lub rozwinąć się wkrótce po leczeniu. Z tego powodu pacjenci z rakiem moczowodu powinni być regularnie monitorowani pod kątem raka pęcherza.33

Narażenie zawodowe

Niektóre zawody i gałęzie przemysłu wiążą się ze zwiększonym ryzykiem ekspozycji na substancje kancerogenne, które mogą predysponować do rozwoju raka moczowodu. Do grup podwyższonego ryzyka należą osoby pracujące w następujących branżach:2

  • Pracownicy pralni chemicznych
  • Malarze
  • Pracownicy przemysłu motoryzacyjnego
  • Kierowcy ciężarówek
  • Pracownicy produkcji papieru
  • Metalurdzy
  • Hydraulicy
  • Fryzjerzy
  • Pracownicy przemysłu oponiarskiego i gumowego
  • Pracownicy przemysłu chemicznego
  • Pracownicy przemysłu naftowego

Osoby pracujące w tych branżach powinny być szczególnie wyczulone na wczesne objawy choroby i regularnie poddawać się badaniom przesiewowym.2

Rzadkie postacie i prezentacje kliniczne

W niektórych przypadkach rak moczowodu może objawiać się w nietypowy sposób lub współistnieć z innymi chorobami onkologicznymi. Odnotowano przypadki pacjentów, u których rak moczowodu rozwinął się po wcześniejszym leczeniu raka piersi.34 Opisywano również przypadki raka moczowodu w stadium IV z przerzutami, który manifestował się jako skrajne zmęczenie, nudności, problemy z pęcherzem (częstość, nagłe parcie, wolne oddawanie moczu), podwyższony poziom kreatyniny, sporadyczny ból dolnej części pleców oraz ból miednicy, szczególnie w lewym dolnym kwadrancie.

U pacjentów z wywiadem onkologicznym wystąpienie nawet niespecyficznych objawów ze strony układu moczowego powinno skłaniać do pogłębionej diagnostyki w kierunku raka moczowodu.34

Podsumowanie

Rak moczowodu, choć jest rzadkim nowotworem układu moczowego, może prowadzić do poważnych konsekwencji zdrowotnych, jeśli nie zostanie wcześnie wykryty i leczony. Najczęstszym objawem wskazującym na możliwość występowania tego nowotworu jest krwiomocz, który powinien zawsze skłaniać do konsultacji lekarskiej.1415

Wczesne stadium choroby może przebiegać bezobjawowo lub dawać subtelne objawy, które łatwo przeoczyć. W miarę progresji nowotworu pojawiają się bardziej wyraźne symptomy, takie jak ból w okolicy lędźwiowej, zaburzenia mikcji, utrata masy ciała i przewlekłe zmęczenie.913

Rokowanie w raku moczowodu zależy głównie od stadium zaawansowania choroby w momencie rozpoznania. Nowotwory wykryte we wczesnym stadium, ograniczone do moczowodu, mają dobre rokowanie, szczególnie gdy możliwa jest radykalna interwencja chirurgiczna.1016 Natomiast zaawansowane stadia z przerzutami odległymi wiążą się z niekorzystnym rokowaniem.

Pacjenci z rakiem moczowodu wymagają długotrwałego monitorowania ze względu na wysokie ryzyko nawrotu choroby oraz rozwoju raka pęcherza moczowego.33 Regularne badania kontrolne po zakończeniu leczenia są niezbędne dla wczesnego wykrycia ewentualnego nawrotu i podjęcia odpowiedniego postępowania terapeutycznego.

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  1. 13.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

  • #1 Ureteral cancer – Symptoms and causes – Mayo Clinic
    https://www.mayoclinic.org/diseases-conditions/ureteral-cancer/symptoms-causes/syc-20360721
    Ureteral cancer is a growth of cells that starts in the ureters. The ureters are tubes that connect the kidneys to the bladder. The ureters are part of the urinary tract. They carry urine produced by the kidneys to the bladder. […] Signs and symptoms of ureteral cancer include: Blood in the urine, which may make the urine look red, pink or cola colored. Back pain. Pain when urinating. Losing weight without trying. Feeling very tired. […] Ureteral cancer is not common. When it happens, it occurs most often in older adults and in people who have had bladder cancer.
  • #2 Ureteral Cancer and Ureteral Urothelial Carcinoma | Saint John’s Cancer Institute – Santa Monica, CA
    https://www.saintjohnscancer.org/urology/conditions/ureteral-cancer/
    Upper tract urothelial carcinoma is a cancer that can occur anywhere from the inner linings of the kidney, down the ureter, in the bladder, and down the urethra. […] Ureteral cancer is uncommon and occurs mostly in older adults and in those who previously treated for bladder cancer. […] The following industries/careers are at a higher risk of carcinogenic chemical exposure: Dry Cleaners, Painters, Autoworkers, Truck drivers, Paper manufactures, Metal workers, Plumbers, Hairdressers, Tire and rubber workers, Chemical workers, Petroleum workers. […] What are the Symptoms of UTUC? Blood in the urine (may be microscopic, found using a urine test), Urinary tract infections, Flank pain (the right or left side of the lower torso), Back pain, Kidney pain. […] 44% of patients with UTUC have invasive, or more locally advanced, or metastatic, upper tract urothelial carcinoma. […] 20-25% of patients with carcinoma in the bladder will develop upper tract urothelial carcinoma.
  • #3
    https://www.amerikanhastanesi.org/mayo-clinic-care-network/mayo-clinic-health-information-library/diseases-conditions/ureteral-cancer
    Ureteral cancer Last Updated on July 23, 2024 Overview […] Ureteral cancer is uncommon. It occurs most often in older adults and in people who have previously been treated for bladder cancer. […] Signs and symptoms of ureteral cancer include: Blood in urine, Back pain, Pain when urinating, Losing weight without trying, Fatigue. […] Make an appointment with your doctor if you have any persistent signs and symptoms that worry you. […] Ureteral cancer treatment typically involves surgery. Your treatment options for cancer of the ureter will vary depending on the size and location of your cancer, how aggressive the cells are, and your own goals and preferences. […] After your treatment, your doctor will create a schedule of follow-up exams to look for signs that your cancer has returned. These exams also look for signs of bladder cancer, since people diagnosed with ureteral cancer have an increased risk of bladder cancer.
  • #4 Transitional Cell Cancer of the Renal Pelvis and Ureter > Fact Sheets > Yale Medicine
    https://www.yalemedicine.org/conditions/transitional-cell-cancer-of-the-renal-pelvis-and-ureter
    Symptoms of this type of cancer include: […] Blood in the urine […] Back pain […] Cramps in the side or back […] Fatigue […] Unexplained weight loss […] Pain or burning with urination […] Frequent urination. […] The good news is that when transitional cell cancer of the renal pelvis and ureter is caught early, its very treatable. When the cancer spreads, however, long-term survival rates taper off, depending on how far the cancer has traveled within the body. […] The outlook for people with transitional cell cancer of the renal pelvis and ureter depends on several factors, including patient age and overall health, as well as the stage and grade of the tumor. In general, lower-stage and lower-grade cancers have a better prognosis than high-stage and high-grade cancers. Its helpful to get an early diagnosis of transitional cell cancer of the renal pelvis and ureter because the disease is highly curable when its treated before it spreads. After treatment, patients should continue to see their doctor regularly to monitor the possible recurrence of the cancer.
  • #5 Ureter cancer treatment and diagnosis
    https://www.genesiscare.com/uk/condition/cancer/genitourinary-cancer/ureter-cancer
    Cancer of the renal pelvis (small area in the centre of the kidney that the ureter arises from) and ureter are very rare. They are considered bladder cancers rather than kidney cancers. Higher incidence in men than women. The incidence rises from the age of 65 years and is even rarer under this age. […] What are the symptoms of ureter cancer? Blood/blood clots in the urine (haematuria) Pain in the side of lower back Pain or burning sensation on passing urine Difficulty in passing urine. […] Some of these symptoms can be caused by other conditions such as infection.
  • #6 SSA – POMS: DI 23022.345 – Ureter Cancer – with Metastases or Inoperable, Unresectable or Recurrent – 10/05/2023
    https://secure.ssa.gov/poms.nsf/lnx/0423022345
    Ureter Cancer forms in transitional cells in the lining of the bladder, ureter, or renal pelvis. […] Symptoms may include: Blood in the urine; Persistent back pain; Extreme fatigue; Unintentional weight loss; and/or Painful or frequent urination. […] Ureter Cancer usually affects men more often than women and is more common in people older than 65. The 5-year survival rate is 5% or less.
  • #7 Ureteral cancer | Beacon Health System
    https://www.beaconhealthsystem.org/library/diseases-and-conditions/ureteral-cancer?content_id=CON-20314003
    Ureteral cancer is a growth of cells that starts in the ureters. The ureters are tubes that connect the kidneys to the bladder. Ureteral cancer is not common. When it happens, it occurs most often in older adults and in people who have had bladder cancer. Ureteral cancer is closely related to bladder cancer. The cells that line the ureters are the same type of cells that line the inside of the bladder. People diagnosed with ureteral cancer have an increased risk of bladder cancer. So people with ureteral cancer are usually tested for signs of bladder cancer. […] Signs and symptoms of ureteral cancer include: Blood in the urine, which may make the urine look red, pink or cola colored. Back pain. Pain when urinating. Losing weight without trying. Feeling very tired. […] Ureteral cancer happens when cells in a ureter develop changes in their DNA. A cell’s DNA holds the instructions that tell the cell what to do. In healthy cells, the DNA tells the cells to grow and multiply at a set rate. The DNA also tells the cells to die at a set time. In cancer cells, the DNA changes give other instructions. The changes tell the cancer cells to grow and multiply quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells. The cancer cells might form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it’s called metastatic cancer.
  • #8 Upper urinary tract urothelial cancer | Macmillan Cancer Support
    https://www.macmillan.org.uk/cancer-information-and-support/upper-urinary-tract-urothelial-cancer-UTUC
    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) and 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.
  • #9 Ureteral cancer – Wikipedia
    https://en.wikipedia.org/wiki/Ureteral_cancer
    Ureteral cancer oftentimes doesn’t present with any unusual symptoms until the cancer has progressed. […] Once the cancer has progressed it often causes hematuria, frequent urination, nocturia, and many other urination problems, as well as unusual weight loss and fatigue. […] Ureter cancer rarely causes problems in the early stages, but as the cancer progresses, there are often side effects. Symptoms of ureteral cancer may include „blood in the urine (hematuria); diminished urine stream and straining to void (caused by urethral stricture); frequent urination and increased nighttime urination (nocturia); hardening of tissue in the perineum, labia, or penis; itching; incontinence; pain during or after sexual intercourse (dyspareunia); painful urination (dysuria); recurrent urinary tract infection; urethral discharge and swelling”. […] Other common symptoms associated with ureteral cancer may include back pain, unexplained weight loss, and unusual fatigue.
  • #10 Renal Pelvis and Ureter Cancers – Kidney and Urinary Tract Disorders – Merck Manual Consumer Version
    https://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/cancers-of-the-kidney-and-genitourinary-tract/renal-pelvis-and-ureter-cancers
    Cancers may cause blood in the urine or crampy pain in the side. […] Blood in the urine is usually the first symptom. People may also have pain and burning during urination and an urgent, frequent need to urinate. Crampy pain in the flank (the space between the ribs and hip) or lower abdomen may occur if the flow of urine is obstructed (for example, because a blood clot blocks the ureter). […] If the cancer has not spread and if it can be completely removed surgically, cure is likely. However, if the cancer has spread into the wall of the renal pelvis or ureter or to distant sites, cure is unlikely.
  • #11 Symptoms of cancer of the renal pelvis or ureter | Canadian Cancer Society
    https://cancer.ca/en/cancer-information/cancer-types/renal-pelvis-and-ureter/signs-and-symptoms
    Cancer of the renal pelvis or ureter may not cause any signs or symptoms in its early stages. Signs and symptoms often appear as the tumour gets bigger or grows deeper into the wall of the renal pelvis or ureter. […] See your doctor if you have these signs or symptoms: blood in the urine (pee), which is called hematuria; back pain; pain on your side just below the ribs (flank pain); burning or pain while urinating; a need to urinate more often than usual (frequent urination); fatigue; loss of appetite; unexplained weight loss.
  • #12 Upper urinary tract urothelial cancer | Cancer Research UK
    https://www.cancerresearchuk.org/about-cancer/upper-urinary-tract-urothelial-cancer
    The symptoms of upper urinary tract urothelial cancer include: blood in your urine, pain in your side between the ribs and the hip (flank). […] They are similar to the symptoms of kidney cancer. […] Sometimes upper urinary tract urothelial cancer is found when you’re having a scan for something else.
  • #13 Transitional Cell Cancer (Kidney/Ureter) Treatment – NCI
    https://www.cancer.gov/types/kidney/patient/transitional-cell-treatment-pdq
    Transitional cell cancer of the renal pelvis and ureter is a type of cancer that forms in the transitional cells of the renal pelvis and ureter. […] Signs and symptoms of transitional cell cancer of the renal pelvis and ureter include blood in the urine and back pain. […] In the early stages, there may be no signs and symptoms of transitional cell cancer of the renal pelvis and ureter. Symptoms may appear as the tumor grows and may include: blood in the urine, a pain in the back that doesn’t go away, extreme tiredness, weight loss with no known reason, painful or frequent urination. […] After transitional cell cancer of the renal pelvis and ureter has been diagnosed, tests are done to find out if cancer cells have spread within the renal pelvis and ureter or to other parts of the body. […] The prognosis depends on the stage and grade of the tumor. […] Most transitional cell cancer of the renal pelvis and ureter can be cured if found early.
  • #14 Urothelial carcinoma: 8 insights about this common bladder cancer | MD Anderson Cancer Center
    https://www.mdanderson.org/cancerwise/urothelial-carcinoma–8-insights-about-this-common-bladder-cancer.h00-159697545.html
    The most common symptom is blood in the urine, also known as hematuria. It can be either something you can see with your eyes, or it might only show up during a urinalysis. […] Other symptoms of urothelial carcinoma can include frequent urination and painful urination. These are also symptoms of urinary tract infections. We’ve seen many patients who were treated by their primary care doctor for recurring UTIs when they actually had early-stage bladder cancer. […] Waking up frequently at night to urinate is another symptom of urothelial carcinoma. This symptom is almost always associated with one or more other symptoms. […] Urothelial carcinoma has a relatively high risk for systemic recurrence, which is recurrence outside of the urinary tract, that increases with a higher disease stage.
  • #15 Bladder and Ureteral Cancer
    https://www.froedtert.com/prostate-cancer/bladder-ureteral-cancer
    Ureteral cancer is a cancer that arises in the ducts that transport urine from the kidneys to the bladder (the ureters). It is essentially the same kind of malignancy as bladder cancer. […] The most common symptom of bladder or ureteral cancer is visible (or microscopic) blood in the urine. Occasionally, bladder irritability and frequent urination can be symptoms of these malignancies. People who notice blood in the urine or other symptoms should be evaluated by a physician immediately, because outcomes are correlated with the length of time between symptom onset and treatment. […] For appropriate patients, Froedtert the Medical College of Wisconsin offer several investigational therapies for bladder and ureteral cancers. These rigorously controlled clinical trials focus on finding new ways to prevent the return of cancer after surgery and slow down the progression of advanced disease.
  • #16 Ureter Cancer | Baptist Health
    https://www.baptisthealth.com/care-services/conditions-treatments/ureter-cancer
    Symptoms of ureter cancer may include: Blood or blood clots in the urine […] Cramps or back pain […] Dark urine […] Discomfort or burning during urination […] Fatigue […] Frequent or urgent urination […] Pain in the back at the juncture of the ribs and spine […] Unintentional weight loss. […] Prognosis depends upon how early the cancer is diagnosed, the size and location of the tumor, and if it has spread. Cancer present only in the ureter, or ureter and kidney, is typically curable. […] Ureter cancer treatment depends upon how far the condition has progressed. The goal is to eliminate the cancer.
  • #17 Transitional Cell Cancer of the Renal Pelvis and Ureter > Fact Sheets > Yale Medicine
    https://www.yalemedicine.org/conditions/transitional-cell-cancer-of-the-renal-pelvis-and-ureter
    Symptoms of this type of cancer include: […] Blood in the urine […] Back pain […] Cramps in the side or back […] Fatigue […] Unexplained weight loss […] Pain or burning with urination […] Frequent urination. […] The good news is that when transitional cell cancer of the renal pelvis and ureter is caught early, its very treatable. When the cancer spreads, however, long-term survival rates taper off, depending on how far the cancer has traveled within the body. […] The outlook for people with transitional cell cancer of the renal pelvis and ureter depends on several factors, including patient age and overall health, as well as the stage and grade of the tumor. In general, lower-stage and lower-grade cancers have a better prognosis than high-stage and high-grade cancers. Its helpful to get an early diagnosis of transitional cell cancer of the renal pelvis and ureter because the disease is highly curable when its treated before it spreads. After treatment, patients should continue to see their doctor regularly to monitor the possible recurrence of the cancer.
  • #18 Urethral Cancer: Causes, Symptoms, Diagnosis & Treatment
    https://my.clevelandclinic.org/health/diseases/6223-urethral-cancer
    Many people dont notice any signs of urethral cancer in its earliest stages. If you have symptoms, they usually include: […] Blood in your pee (hematuria). […] Weak or interrupted (stop-and-go) pee stream. […] Pain when peeing. […] Peeing more than usual. […] A lump or thickness in your penis or the space between your genitals and rectum (perineum). […] Clear, white or off-white fluid that comes out of your urethra (urethral discharge). […] Enlarged lymph nodes in your groin area. […] In some instances, urethral cancer can be fatal. It may grow and spread to other areas of your body, which is challenging to treat and more likely to be life-threatening. […] Urethral cancer is rare, which makes it difficult to establish survival rates. Recent studies show that the average survival rate for urethral cancer is about four years. The likelihood of surviving five years after diagnosis is 46%, and the likelihood of surviving 10 years after diagnosis is 31%. […] Typically, urethral cancer first spreads to the tissues around your urethra. It may spread to lymph nodes in your groin area. As a result, you may occasionally see swelling in your leg.
  • #19 Ureteral cancer | Health Library | Memorial Health System
    https://www.mhsystem.org/health-library/con-20314003/
    Signs and symptoms of ureteral cancer include: […] Blood in the urine, which may make the urine look red, pink or cola colored. […] Back pain. […] Pain when urinating. […] Losing weight without trying. […] Feeling very tired.
  • #20 Renal pelvis or ureter cancer Information | Mount Sinai – New York
    https://www.mountsinai.org/health-library/diseases-conditions/renal-pelvis-or-ureter-cancer
    Cancer of the renal pelvis or ureter is cancer that forms in the renal pelvis (center of the kidney) or ureter (tube that carries urine from the kidney to the bladder). […] Symptoms may include any of the following: Constant back pain, Blood in the urine, Burning, pain, or discomfort with urination, Fatigue, Flank pain, Unexplained weight loss, Loss of appetite, Anemia, Urinary frequency or urgency. […] Outcome varies, depending on the location of the tumor and whether the cancer has spread. Cancer that is only in the kidney or ureter may be cured with surgery. Cancer that has spread to other organs is usually not curable. […] Contact your provider if you have any of the symptoms listed above.
  • #21 Ureteral and Renal Pelvic Cancer Symptoms | Atlanta, GA
    https://ugatl.com/services/ureteral-renal-pelvis-cancer/
    Some signs and symptoms of ureteral and renal pelvic cancer are listed below. […] Dark urine […] Urinary frequency and urgency […] Pain or burning sensations when urinating […] Urinary hesitancy […] Blood or blood clots in urine […] Unintended weight loss […] Fatigue […] Abdominal or back pain […] Pain at the junction of your spine and ribs. […] If you are experiencing any of these signs and symptoms, you should seek the assistance of a skilled urologist. Since renal pelvis and ureter cancer have some symptoms that are similar to other kidney cancers, you should seek an accurate diagnosis from an experienced urologist.
  • #22
    https://bladdercancercanada.org/en/bladder-cancer/types-of-bladder-cancer/upper-tract/
    So, what are upper tract urothelial cancer symptoms? In addition to the signs of bladder cancer, individuals with UTUC may also experience pain in the upper abdomen or mid-back in the region of the kidney. UTUCs can block the ureter or kidney, causing blockage of the kidney (known as hydronephrosis), and they can even affect kidney function in some patients. […] High-grade UTUC has the potential to spread from the kidney or ureter to lymph nodes, lung and bone.
  • #23 Cancer of the Proximal Ureter – Clinical Urology
    https://clinicalurology.com/conditions-and-treatments/cancer-of-the-proximal-ureter/
    Among the symptoms a patient may experience with cancer of the ureter, flank pain, nausea, changes in urination may exist. […] Cancers are highly vascular (contain many blood vessels), so blood in the urine is likely to be an early sign of disease in the urinary system. […] The surgeon may instead, elect to remove the ureter and adjacent kidney if the staging indicates spread of the cancer cells prior to surgery to these structures is probable.
  • #24 Complications Resulting from Primary Cancer Progression – Holland-Frei Cancer Medicine – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK13537/
    Ureteral obstruction most commonly occurs because of large periaortic nodal metastases in the retroperitoneal space adjacent to the ureters. […] Such obstructive uropathy is most frequently the result of either primary nodal diseases (lymphomas) or of urologic neoplasms metastasizing to the periaortic nodes, particularly prostate cancer and germ cell tumors. […] Advanced retroperitoneal germ cell tumors and lymphomas are a unique subset of chemotherapy-sensitive tumors that frequently result in obstructive uropathy. […] When the cancer has the typical pathologic and serologic markers of a seminoma, obstructive uropathy is frequently observed with regionally advanced disease, in the absence of distant metastases. […] The rapidity of the anticipated response and the degree of compromise in renal function often govern whether percutaneous nephrostomy is necessary or whether a reasonable expectation exists that relief of obstruction can be achieved with cytotoxic chemotherapy.
  • #25 Complications Resulting from Primary Cancer Progression – Holland-Frei Cancer Medicine – NCBI Bookshelf
    https://www.ncbi.nlm.nih.gov/books/NBK13537/
    Ureteral obstruction caused by retroperitoneal metastases from cervical or breast cancer, or from retroperitoneal radiation fibrosis, is often treated by stenting. […] The neoplasm causing the retroperitoneal ureteral obstruction often invades the lumbar or sacral nerve roots, leading to excruciating pain. […] Pathologically, acute urinary tract obstruction results in increased central renal pressure and dilation of the ureter. […] With persistent and progressive obstructive uropathy, irreversible injury finally manifests itself with renal cortical atrophy. […] Following relief of obstructive uropathy, metabolic problems may occur.
  • #26 Ureteric tumours – Sandhurst Urology
    https://sandhursturology.com.au/conditions/ureteric-tumours/
    Ureteric tumours and cancers are rare, being most common in adults aged over 70. They can cause ureteric obstruction, and many people who develop them will also develop bladder cancer. […] Symptoms of ureteric tumours may include: Bladder irritation, Blood stained urine (haematuria), Pain in the lower back or side, Difficulty urinating, Urinary incontinence, Pain during or after sex, Recurrent urinary tract infections, Frequent urination, Fatigue, Unexplained weight loss. […] Remember that your own experience with a ureteric tumour is individual you may not experience every symptom and may experience slightly different symptoms to those specified.
  • #27 Urethral Cancer – Genitourinary Disorders – Merck Manual Professional Edition
    https://www.merckmanuals.com/professional/genitourinary-disorders/genitourinary-cancers/urethral-cancer
    Most women present with hematuria and obstructive voiding symptoms or urinary retention. Most have a history of urinary frequency or urethral syndrome (hypersensitivity of the pelvic floor muscles). Most men present with symptoms of urethral stricture; only a few present with hematuria or a bloody discharge. Sometimes if the tumor is advanced, a mass is felt. […] Urethral tumors invade adjacent structures early and thus tend to be advanced when diagnosed. External groin or pelvic (obturator) lymph nodes are usually the first sites of metastasis. […] Prognosis depends on the precise location in the urethra and extent of the cancer, particularly depth of invasion. The 5-year survival rates are 60% for patients with distal tumors and 10 to 20% for patients with proximal tumors. Recurrence rate is 50%.
  • #28 How can I track and understand my metastatic urothelial cancer?
    https://www.icliniq.com/qa/urothelial-carcinoma/what-are-the-signs-that-urothelial-carcinoma-has-spread
    Metastatic urothelial carcinoma is a more advanced form of cancer that begins in the urothelial cells lining the bladder, and in its metastatic stage, it spreads to other parts of the body. This cancer can also arise from the urethra, ureters, or renal pelvis. Once the cancer becomes metastatic, it can affect other organs such as the bones, lungs, liver, or lymph nodes, leading to more widespread symptoms. […] Bone metastasis may present with bone pain, fractures, or high calcium levels (hypercalcemia), which can cause nausea, confusion, and fatigue. […] Lung metastasis may lead to coughing, shortness of breath, or even blood-tinged sputum. […] Liver metastasis can result in jaundice (yellowing of the skin and eyes), abdominal pain, and unexplained weight loss. […] Lymph node involvement may cause swelling in the legs (edema) or in other parts of the body, blood in the urine (hematuria), pelvic pain, or difficulty urinating. […] Treatment at this stage is typically aimed at controlling the disease and improving quality of life, rather than curing it. Treatment options may include chemotherapy, immunotherapy, or targeted therapy.
  • #29 Ureter Cancer | Diagnosis and Treatment
    https://www.genesiscareus.com/en/condition/cancer/ureter-cancer
    Signs and symptoms of ureter cancer may include: […] Blood/blood clots in the urine (hematuria) […] Fatigue […] Pain in the lower back on one side […] Pain or burning sensation while urinating […] Trouble urinating […] Unintentional weight loss. […] If you’re diagnosed with ureter cancer, the next step will be for your oncologist (cancer doctor) to determine how advanced the cancer is. This is called staging. The earliest stage cancer is called stage I (1) and the most advanced cancer is stage IV (4). […] The stages of ureter cancer are: […] Stage I. This is when the cancerous tumor has grown through the lining of the connective tissue layer of the ureter. […] Stage II. This is when the tumor has grown into the muscle layer of the ureter. […] Stage III. This is when the tumor has grown into the kidney or fat that’s around the ureter. […] Stage IV. This is when the tumor has spread into nearby organs, to nearby lymph nodes or to distant organs, such as the lungs, liver or bone.
  • #30 Urothelial carcinoma: 8 insights about this common bladder cancer | MD Anderson Cancer Center
    https://www.mdanderson.org/cancerwise/urothelial-carcinoma–8-insights-about-this-common-bladder-cancer.h00-159697545.html
    The risk for systemic recurrence in stage 0 (carcinoma in situ) or stage I urothelial carcinoma of the bladder is relatively low. However, the risk becomes higher when the cancer doesn’t respond to intravesical BCG treatment. […] Stage II urothelial carcinoma is muscle-invasive. Cancer at this stage has up to a 50% chance of relapse. […] Stage III urothelial carcinoma occurs when cancer spreads to the fatty layers outside of the bladder or the lymph nodes. These patients have up to a 70% chance of relapse. […] Stage IV cancer is typically not curable, but it is treatable. More than 90% of patients with stage IV urothelial carcinoma will always have the disease.
  • #31 Transitional Cell Cancer: Causes, Signs, and Treatment
    https://www.healthline.com/health/cancer-renal-pelvis-or-ureter
    In the early stages of the disease, cancer of the ureter may not have symptoms. However, as the cancer grows, symptoms may appear. These include: blood in the urine, persistent back pain, fatigue, unexplained weight loss, painful or frequent urination. […] These symptoms are associated with malignant cancer of the ureter, but they are also associated with other health conditions. It’s important to see your doctor if you are experiencing any of these symptoms so that you can get a proper diagnosis. […] The outlook for someone diagnosed with cancer of the renal pelvis and ureter depends on a number of factors that your doctor will discuss with you. In particular, the chance of recovery is dependent on: Stage of the cancer. People with advanced stages of the disease will have a lower survival rate, even with treatment. Location of the tumor. If the tumor is located beyond the ureter and renal pelvis, the cancer may quickly metastasize to the kidney or other organs, reducing chances for survival. Overall kidney health. If there are underlying kidney disorders, the survival rate is lower, even with treatment. Cancer recurrence. Cancer recurrences have lower cure and survival rates than initial cancers. Metastasis. If the cancer has spread to other organs in the body, the survival rate is lower.
  • #32 Analysis of progression after elective distal ureterectomy and effects of salvage radical nephroureterectomy in patients with distal ureteral urothelial carcinoma | Scientific Reports
    https://www.nature.com/articles/s41598-024-54232-4
    The probability of disease progression after RNU is reported to be 20-30% and the distribution of metastases after RNU is reported to be mostly in the lungs, liver, bone, and lymph node. […] The 3-year PFS rates in the RNU and DU groups were 73.5% and 79.8%, respectively (p=0.736). There were also no statistically significant differences in the 3-year OS and CSS rates between patients treated with RNU and DU (83.1% vs. 88.8%, p=0.457; 93.6% vs. 91.2%, p=0.169, respectively). […] Among 46 patients treated with DU, nine (19.6%) had recurred ipsilateral ureter or renal pelvis tumor during F/U duration of mean 18.3±12.7 months. Of the nine patients, six (66.7%) had a prior history of bladder tumor. All patients underwent salvage RNU. […] Upper tract recurrence is one of the most important and worrisome issues that must be taken into account during patient counseling prior to performing DU.
  • #33 Ureteral cancer – Hancock Health
    https://www.hancockhealth.org/de/mayo-health-library/ureteral-cancer/
    Signs and symptoms of ureteral cancer include: Blood in the urine, which may make the urine look red, pink or cola colored. Back pain. Pain when urinating. Losing weight without trying. Feeling very tired. […] People diagnosed with ureteral cancer have a high risk of bladder cancer. Bladder cancer may occur at the same time as the ureteral cancer or grow soon after treatment. […] Treatment options for ureteral cancer include surgery, chemotherapy, immunotherapy and targeted therapy. Treatment depends on many factors. These factors include the size and location of the cancer, how aggressive the cells are, and your own goals and preferences. […] Surgery is often recommended to remove ureteral cancer. The kind of surgery used for your ureteral cancer will depend on your cancer. […] For advanced ureteral cancer, chemotherapy may be used to control symptoms of the cancer. […] Immunotherapy might be an option for treating advanced ureteral cancer that spreads to nearby lymph nodes or other parts of the body. […] Targeted therapy may be used for treating advanced ureteral cancer.
  • #34 ureter cancer — Cancer Survivors Network
    https://csn.cancer.org/discussion/253704/ureter-cancer
    Wonder if any of you survivors have had ureter cancer? […] I also started with breast cancer..mastectomy in January 2009…then, this past May 2013 was told I had ureter cancer. […] I have this ureter cancer too. Mine was stage 3 with metastasis. […] I too started with breast cancer in 2004; and now facing ureter and bladder cancer (Stage 4) in 2014. […] What symptoms were you all having leading up to your diagnosis? […] For 3 months I have been having extreme fatigue, nausea off and on, bladder problems (frequency, urgency, slow peeing), elevated Creatinine, sporadic lower back pain, left and some right flank pain, and for the past 2.5 weeks bad pelvic pain, especially LLQ.