What is urinary tract cancer?

Urinary tract cancer is a general term for tumors in the kidney, bladder, and the tubes that connect them. These life-threatening tumors occur mostly after age 65. Urinary tract cancer is three times more common in men than in women.

How does it occur?

There are a number of risk factor for cancers of the kidney and bladder.

Cigarette smoking is a known risk for both kidney and bladder tumors.

Another risk is on-the-job exposure to chemicals called aromatic amines used in the petroleum and aniline dye industries. People who have worked with the following materials have a greater than average risk of getting urinary tract cancer:

• dyes

• rubber

• leather

• paint, especially cadmium-containing paint

• other organic chemicals.

Repeated exposure to these materials for 2 years or more increases the risk of cancer, but the cancer may not appear until many years later.

One medication, phenacetin, has been associated with increased rates of bladder cancer. Phenacetin used to be present in nonprescription pain medications, but is no longer used.

What are the symptoms?

The symptoms of urinary tract cancer are often the same as the symptoms of an infection in the urinary tract. Symptoms depend on the size of the tumor and how advanced the cancer is. Common symptoms are:

• bloody urine, usually without pain

• the need to urinate frequently and with urgency

• irritation, discomfort or pain during urination.

How is it diagnosed?

The doctor will diagnose urinary tract cancer by taking a medical history, performing a physical exam, and also ordering laboratory and diagnostic tests.

The doctor may ask:

• if you smoke

• if you've had a tumor of any kind in the past

• if you have blood in your urine

• if you have problems urinating

• if you have frequent urinary tract infections.

Some of the tests that may be used are:

• examination of blood and urine samples under a microscope

• x-rays

• intravenous pyelogram (x-ray of the urinary tract that uses a special injected dye)

• computed tomography (CT) scan of the kidneys or bladder

• ultrasound scan

• bone scan

• cystoscopy (inspection of inside of the bladder)

• pelvic angiogram (x-ray of blood vessels in the pelvis after injection of dye).

How is it treated?

Treatment depends on where the tumor is, how large the tumor is, whether it has spread to other parts of the body, and your overall physical condition. Treatment options are immunotherapy, chemotherapy, radiation therapy, and surgery. These treatments may be used individually or in combination.

• Immunotherapy: Especially in kidney cancer, treatment with interleukins helps the body's own defenses kill the cancer.

• Chemotherapy: Anticancer drugs are used to try to kill the cancer cells.

• Radiation therapy: The cancerous area is exposed to high doses of radiation to:
  • shrink the size of a tumor

  • decrease pain if a tumor is pressing on a nerve

  • control bleeding

  • decrease swelling in the legs

  • decrease pain in the bones and joints.
• Surgery: The type of surgery depends on where the tumor is located in the urinary tract. The types of possible surgery are:
  • transurethral resection (only the tumor is removed): under anesthesia the tumor is removed from the bladder lining through a slim tube (cystoscope) inserted through the urethra

  • partial cystectomy (part of the bladder is removed)

  • radical cystectomy (all of the bladder is removed)

  • urethrectomy (the urethra is removed)

  • nephrectomy (the kidney is removed).

Your urinary tract doctor (urologist) and your cancer specialist (oncologist) will evaluate your situation and recommend a treatment plan.

After treatment the doctor will recommend regular checkups to see if the cancer has returned. It is important to follow the doctor's instructions so that any recurrence can be found early. Most recurrences of urinary tract cancer are diagnosed 1 to 5 years after treatment.

How long will the effects last?

The chance for cure depends on where the tumor is, how large it is, the type of cells the tumor is made of, and whether the tumor has spread to other parts of the body.

Most of the symptoms of urinary tract cancer appear after the cancer is fairly advanced. Because the chance for cure is improved if the cancer is found early, it is important to have regular checkups with a doctor.

It is very important to report symptoms (such as blood in the urine, pain, or trouble urinating) to a doctor right away.

How can I take care of myself?

If you have cancer you can help yourself feel better by eating nutritious foods, getting plenty of rest, and following your doctor's advice. In addition, try to have less stress in your life and take more time to relax.

Be sure to ask your doctor any questions you may have about the course of the disease, treatments, side effects of the treatments, support groups, and anything else that concerns you. Ask your doctor about some alternative methods for pain control (such as relaxation techniques, guided imagery, and hypnosis).

What can be done to help prevent urinary tract cancer?

Because the causes of urinary tract cancer vary and are not all known, methods of prevention are minimal, but one way to prevent the cancer is to stop smoking. Some cancers are caused by environmental and industrial chemicals, dyes, and processing materials. The best method of prevention of such cancers is to avoid these hazards or take proper precautions when working with them.