Ureteral & Upper Tract Cancer, from the CureRays guide library.

Ureteral cancer is a rare cancer of the thin tubes that carry urine from the kidneys to the bladder; surgery is the main treatment, with radiation and medicine added in selected cases.

What it is.

Ureteral cancer, often grouped with kidney-lining cancer as 'upper tract urothelial cancer,' begins in the lining of the ureters — the two thin tubes that carry urine from each kidney down to the bladder. The same kind of cells line the kidney's collecting system, the ureters, and the bladder, which is why these cancers are closely related to bladder cancer and are treated by the same urology and cancer specialists. The most common warning sign is blood in the urine, which may be visible or found only on a test. Some people also have back or side pain if the tumor blocks the flow of urine. Because these tubes are narrow and deep in the body, treatment usually centers on surgery, and the team carefully checks the bladder as well, since these cancers can appear in more than one spot along the urinary tract. Risk factors include smoking and certain workplace chemical exposures. With early detection and the right treatment, outcomes can be very good.

How radiation treats it.

Radiation uses focused high-energy x-rays to damage the DNA inside cancer cells so they can no longer grow and divide. The ureters run deep in the back of the abdomen, close to the bowel, the remaining kidney, and the spine, so modern image-guided radiation is carefully shaped to concentrate the dose on the tumor area while protecting these neighbors. In ureteral cancer, radiation is not usually the first treatment — surgery and medicine lead — but it has an important supporting role. It can lower the chance of return after surgery when the cancer has grown beyond the wall, and it can relieve symptoms such as pain, bleeding, or blockage from tumors that cannot be removed. Treatments are painless and brief, given over a number of short sessions. Side effects depend on the area treated and are usually temporary, such as fatigue, mild nausea, or loose stools.

The ways we can treat it.

Adjuvant (post-surgery) radiation. Targeted radiation to the tumor area after surgery can lower the chance of the cancer returning locally in higher-risk cases, planned to protect the bowel and remaining kidney.

Palliative radiation. Precise radiation can relieve pain, bleeding, or blockage caused by a tumor that cannot be removed.

Stereotactic body radiation (SBRT). Highly focused, high-dose radiation in a few sessions can control a limited number of metastatic spots while sparing nearby organs.

Questions we hear often.

Will I lose a kidney? Sometimes the standard surgery removes the affected kidney and ureter together. But for small, low-grade tumors, kidney-sparing approaches through a tiny scope may be possible. Most people live well with one healthy kidney. Your team will explain what fits your case.

Why does my bladder need checking too? The ureter, kidney drainage system, and bladder share the same lining, so these cancers can show up in more than one spot. Regular bladder checks help catch and treat any new tumors early.

Do I need radiation? Not everyone does. Surgery and medicine are the main treatments. Radiation is added in selected cases — for example when the cancer grew beyond the ureter wall, or to relieve symptoms from tumors that cannot be removed.

This guide is informational only. It is not medical advice — please confirm anything here with your care team.