Ureteral carcinoma is the medical term for a cancer that is located in the ureter. Sometimes ureteral carcinoma is also called ureteral cancer. In many cases, however, the tumor affects not only the ureter, but also the renal pelvis or the kidneys themselves. The prognosis depends on the stage at which ureteral cancer is diagnosed.
What is ureteral carcinoma?
The ureter can be considered a classic tissue tube. Its function is to carry urine directly from the kidneys to the bladder. Ureteral carcinoma usually represents a malignant tumor, which, strictly speaking, has affected the ureteral epithelium. However, based on the number of new cases of ureteral cancer, it must be said that this type of tumor is rare. However, it is mainly men who are affected by the tumor; women rarely develop this rare type of cancer. Experts believe that this imbalance is influenced by the favoring factors of smoking and occupation.
Causes
Smoking is cited as the most common cause. Thus, the constant consumption of nicotine is said to cause carcinoma to form in the ureter. Based on that fact, it can also be assumed why men are more often affected by ureteral carcinoma; after all, studies say that there are more smokers among men. Furthermore, ureteral carcinoma is also considered a classic occupational disease. This is especially true for groups of people who work primarily with chemical substances (such as aromatic amines). Those are to promote and/or favor the cancer formation quite.
Symptoms, complaints and signs
In many cases, ureteral carcinoma goes unnoticed. Only at an advanced stage do patients notice that “something is wrong.” Those affected usually do not seek medical attention until symptoms such as hematuria (clearly visible blood in the urine) or even severe pain in the lower abdomen occur. Ureteral carcinoma is very rarely detected at an early stage. At most, ureteral carcinoma may be diagnosed incidentally during a screening examination. Other symptoms include blockages or even narrowing of the ureters; here, too, the affected person complains of severe pain.
Diagnosis and course of the disease
The ureter is examined as part of urological treatment. The urologist usually also makes the diagnosis that the patient has ureteral carcinoma. First, the physician investigates the symptoms – mainly the presence of blood in the urine. Sonographic examinations are performed, and the excretory urogram (AUG) also plays a role, so that it can be determined what causes blood to be visible in the urine. It is important that before the urologist makes the diagnosis of ureteral carcinoma, other diseases can be ruled out. Similar symptoms are caused by renal cell carcinoma, renal pelvic carcinoma or bladder carcinoma. These carcinomas must therefore be excluded, so that – after the exclusion procedure – only ureteral carcinoma remains. Above all, since there are different therapeutic approaches; only when the diagnosis is 100 percent confirmed can treatment be started. The course of the disease and the prognosis depend on the stage at which the ureteral carcinoma was discovered or whether other regions have already been affected by the tumor.
Complications
Because ureteral carcinoma is often not detected until it is in an advanced stage, complications are common. Typically, those affected suffer from severe pain in the lower abdomen, accompanied by constipation and narrowing of the ureters. As a result, complications such as bowel obstruction, urinary retention and serious kidney damage can occur. As the disease progresses, the symptoms also increase in intensity and frequency. The pain develops into a chronic condition that significantly limits sufferers and reduces their quality of life. A severe course of the disease can also lead to the development of mental illness. In the course of the disease, ureteral carcinoma can spread and affect other organs. In the worst case, the tumor disease takes a fatal course, associated with serious complications up to organ failure and ultimately the death of the patient.Surgery is problematic due to the location of the tumor and carries the risk of nerve, muscle and vascular injury. Chemotherapy or radiation therapy is always a great burden for those affected and can have late effects such as osteoporosis and memory disorders. Scars may remain after laser treatment.
When should you go to the doctor?
In the case of ureteral cancer, the affected person is dependent on medical examination and treatment, since it cannot heal on its own. In this case, in the worst case, the cancer can spread throughout the body and thus lead to the death of the affected person. A doctor should therefore be contacted at the very first symptoms and signs of this disease. A doctor should be contacted in case of ureteral carcinoma if the patient suffers from severe pain in the lower part of the abdomen. In most cases, this also very often results in constipation or various inflammations on the ureter itself. Pain during urination can also indicate ureteral carcinoma. Furthermore, bloody urine can also indicate this disease. The disease can be detected and treated by a general practitioner. Possibly there is a reduced life expectancy due to the disease. The further course depends strongly on the time of diagnosis, so that no general prediction can be made.
Treatment and therapy
In the context of ureteral carcinoma, all therapeutic concepts are considered, which on the one hand include organ-preserving resection or also bring the desired success by means of laser therapy; on the other hand, radical treatments must also be carried out if the ureteral carcinoma was discovered in the middle or late stage. During ureteral carcinoma treatment, the physician also pays attention to the renal pelvis; the therapy, no matter whether it is ureteral carcinoma or sometimes renal pelvis cancer, is almost identical. In many cases, when there is a risk of the ureteral carcinoma spreading, the renal pelvis is also treated. As a rule, surgical treatments are proposed. Conservative treatments, purely involving chemotherapy or radiotherapy, are not used for such a tumor. This is because without surgery the desired success of recovery is completely absent. However, before surgery is performed, the patient must undergo chemotherapy. Chemotherapy is often administered a few hours before surgery; chemotherapy is also administered after surgery. This is because studies have shown that chemotherapies applied immediately before and after the surgical procedure have a good chance of success in helping to combat the tumor. In many cases, however, the mere removal of the tumor may not bring the desired success. Probably also because in many cases one of the two kidneys is already affected as well. If this is the case, the ureter and also the kidney must be removed. In this case, the physician speaks of a “radical removal”. Due to the fact that ureteral carcinoma has a relatively high probability of recurrence, the patient should attend check-ups at regular intervals – even after successful treatment. It is important to check at regular intervals, especially during the first three years, to see if the tumor returns or stays away for good and if a 100 percent cure has occurred.
Prevention
Ureteral carcinoma can be prevented if any favoring factors are avoided. Thus, cigarette consumption should be avoided completely. Those who deal with chemical or carcinogenic substances that promote ureteral carcinoma should consider all possible protective measures so that the body is not directly exposed to carcinogenic substances.
Follow-up
In most cases, the person affected by ureteral carcinoma has only a few and usually very limited measures of direct aftercare available to him. For this reason, the affected person should see a doctor at an early stage so that further complications or discomfort from this disease can be prevented. Self-cure cannot occur, so a doctor should be contacted at the first signs or symptoms. Most sufferers are dependent on taking various medications, whereby attention must be paid to the correct dosage and also to regular intake.If there are any questions or uncertainties, a doctor should always be contacted first, and the doctor should also be consulted in the event of side effects. Many of those affected are dependent on the help and support of their own family due to the ureteral carcinoma. Support in everyday life is very important, and psychological support can also prevent depression and other psychological complaints. Whether ureteral carcinoma will result in a reduced life expectancy for the affected person cannot be universally predicted in this regard. Early detection of the disease is therefore paramount.
What you can do yourself
The treatment of ureteral carcinoma can be supported by various measures. First and foremost, rest and sparing are important. Therapy places a great strain on the body and psyche. This makes it all the more important to adopt a lifestyle that helps to reduce stress and optimally supports conservative treatment. In the case of carcinomas, the body needs a balanced diet. Vitamins, minerals and nutrients are particularly important, as these are depleted more quickly by malnutrition and by physical stress. To counteract the loss of appetite, appetite-increasing foods such as chocolate or fruit help. In case of doubt, the doctor prescribes appetite-stimulating drugs. During chemotherapy, inflammation of the mucous membranes can occur. These can be treated by the patient by taking a light diet. In addition, gentle toothpastes and mouth rinses should be used to prevent further irritation of the mouth and throat. The psychological complaints associated with cancer require talk therapy with an oncologist. Accompanying this, many conversations with friends, family and other people suffering from ureteral cancer are recommended. The condition is readily treatable, and accordingly, self-help should be oriented toward long-term improvement in health.
