What is Upper Tract Urothelial Carcinoma (UTUC)?

Most bladder cancers (approximately 90-95%) occur in the bladder itself. However, the urothelial cells that line the bladder are also found in other locations in the urinary system. Urothelial carcinoma is a cancer that can occur in those cells.

The kidneys and ureters make up the upper part of the urinary tract. Those parts of the urinary tract also have urothelial cells. Approximately 5-7 % of urothelial cancer can occur in the upper lining of the kidney, called the calyx and renal pelvis. It could also occur in one or both of the ureter(s), a tubes that leads from each of your kidneys to the bladder. Cancer in the renal pelvis or ureter(s) is called Upper Tract Urothelial Carcinoma, or UTUC

In addition to the other regular signs of bladder cancer, individuals with UTUC may also experience flank pain (discomfort, or severe pain in the part of the body below the rib). This can occur because the tumor or bleeding may obstruct or block the kidney.

Some people have no signs or symptoms of UTUC. Their doctor finds the tumors when looking for other health problems during radiology tests or scans.

There are two kinds of upper tract urothelial carcinoma:

  • Non-invasive: more than half the people have this type, where the cancer remains in the urothelial cells that line the renal pelvis or ureters.
  • Invasive: the rest have this type, where the cancer has grown beyond those urothelial cells. Or it may have spread to other parts of the body.

The grade of the tumor is determined by a pathologist who examines the cells under a microscope. Low grade UTUC is usually not very aggressive and is slow to spread. High grade UTUC can be more aggressive. It may spread to other parts of your urinary tract, or to other parts of your body. The grade of your UTUC is important to know as you and your doctor choose the best treatment for your cancer. Doctors may also use imaging studies to help them stage UTUC. Ask your doctor to explain the details about your diagnosis and pathology report.

This information and assessing your overall health, will help your doctor recommend the best treatment options for your cancer. Depending on the stage, grade and location of your tumor, UTUC can be treated with medications or surgery.

More information:

MD Anderson Cancer Center urologist Dr. Surena Matin, and medical oncologist Dr. Matthew Campbell and urologist Dr. Kate Murray from University of Missouri Medical Center, on Understanding Upper Tract Urothelial Carcinoma (UTUC) for a discussion of how UTUC is similar and different from other forms of bladder cancer in its diagnosis and treatment options. Register now to:
1) Increase your understanding of who is at risk for developing UTUC and how it is discovered.
2) Learn how UTUC is evaluated.
3) Understand how UTUC is treated.

In Treatment Talk | Upper Tract Urothelial Carcinoma Medical Oncologist Dr. Jeannie Hoffman-Censits and urologist Dr. Nirmish Singla from the Greenberg Bladder Cancer Institute at Johns Hopkins University, along with patient advocates  “Tony” and Christina discuss the ways high and low grade UTUC are treated.

For more information about upper tract urothelial carcinoma, we invite you to watch our webinar, “Exploring Upper Tract Urothelial Carcinoma.”

The webinar is moderated by Dr. Gary Steinberg from NYU Langone and the panelists include Dr. Ahmad Shabsigh from the Ohio State University, Dr. Alon Weizer from the University of Michigan, Dr. Seth Lerner from Baylor College of Medicine, Dr. Jennifer Linehan from the John Wayne Cancer Institute, Dr. Surena Matin from MD Anderson Cancer Center, and Dr. Monty Pal from City of Hope.