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Transitional Cell Cancer of the Renal Pelvis and Ureter Treatment (PDQ®)

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Stages of Transitional Cell Cancer of the Renal Pelvis and Ureter

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 process used to find out if cancer has spread within the renal pelvis and ureter or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:

  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • Ureteroscopy : A procedure to look inside the ureter and renal pelvis to check for abnormal areas. A ureteroscope is a thin, tube-like instrument with a light and a lens for viewing. The ureteroscope is inserted through the urethra into the bladder, ureter, and renal pelvis. A tool may be inserted through the ureteroscope to take tissue samples to be checked under a microscope for signs of disease.
    Ureteroscopy; drawing shows the lower pelvis containing the right and left kidneys, ureter, bladder, and urethra. The flexible tube of a ureterscope (a thin, tube-like instrument with a light and a lens for viewing) is shown passing through the urethra into the bladder and ureter. An inset shows a woman lying on an examination table with her knees bent and legs apart. She is covered by a drape. The doctor looks at a an image of the inside of the ureter on a computer monitor.
    Ureteroscopy. A ureteroscope (a thin, tube-like instrument with a light and a lens for viewing) is inserted through the urethra into the ureter. The doctor looks at an image of the inside of the ureter on a computer monitor.

There are three ways that cancer spreads in the body.

Cancer can spread through tissue, the lymph system, and the blood:

  • Tissue. The cancer spreads from where it began by growing into nearby areas.
  • Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
  • Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

Cancer may spread from where it began to other parts of the body.

When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.

  • Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
  • Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.

The metastatic tumor is the same type of cancer as the primary tumor. For example, if transitional cell cancer of the ureter spreads to the lung, the cancer cells in the lung are actually ureter cancer cells. The disease is metastatic cancer of the ureter, not lung cancer.

The following stages are used for transitional cell cancer of the renal pelvis and/or ureter:

Stage 0 (Papillary Carcinoma and Carcinoma in Situ)

In stage 0, abnormal cells are found in tissue lining the inside of the renal pelvis or ureter. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is divided into stage 0a and stage 0is, depending on the type of tumor:

Stage I

In stage I, cancer has formed and spread through the lining of the renal pelvis and/or ureter, into the layer of connective tissue.

Stage II

In stage II, cancer has spread through the layer of connective tissue to the muscle layer of the renal pelvis and/or ureter.

Stage III

In stage III, cancer has spread:

Stage IV

In stage IV, cancer has spread to at least one of the following:

Transitional cell cancer of the renal pelvis and ureter is also described as localized, regional, or metastatic:

Localized

The cancer is found only in the kidney.

Regional

The cancer has spread to tissues around the kidney and to nearby lymph nodes and blood vessels in the pelvis.

Metastatic

The cancer has spread to other parts of the body.

  • Updated: October 22, 2014