Ureteral Cancer Treatment
Surgery is the Primary Treatment for Cancer of the Ureter
Surgery is the primary treatment option for ureteral cancer. Treatment depends on the type, size, stage and location of the lesion. Removal of the entire kidney and ureter is the most common procedure. Surgeons may use nephron-sparing procedures to save kidney function. These include the use of delicate telescopes to target the ureteral cancer tumors without removing the kidney. If the ureteral cancer tumor is larger, it may be possible to remove the affected portion of the ureter without removing the kidney itself.
When the middle of the ureter is affected by the cancer, surgeons remove the tumor and rebuild the ureter. This is called segmental ureterectomy resection. When the tumor is located in the bottom third of the ureter, surgeons may remove that section of the ureter, while the rest is reconnected to the bladder. This procedure is called a ureteroneocystomy, or reimplantation.
If the entire kidney and ureter need to be removed, surgeons often can do this procedure laparascopically, with better results. If the tumor is located in the upper third of the ureter, a nephroureterectomy is often performed, removing the entire kidney and remainder of the ureter.
Laser Therapy, Electrosurgery, Radiation and Chemotherapy
Occasionally, a tumor may affect just the surface of the ureter. The cancer may be removed either by laser treatment or electrosurgery. These two surgical treatments can only work in the early stages of ureteral cancer. Laser therapy is defined by an ureteroscope being passed through the bladder and into the ureter. A narrow beam of intense laser is then passed through the tube to destroy the tumor. An electric current to remove the cancer defines electrosurgery.
Radiation therapy may be used in conjunction with surgery in advanced ureteral cancer or as a primary treatment for ureteral cancer that is noninvasive. Radiation therapy utilizes high-energy rays from a machine outside the body called external beam radiation. Surgically, implanted radioactive seeds or pellets called brachytherapy to destroy cancer cells can also be an option. External radiation and brachytherapy are sometimes used together. External radiation often involves a routine of five days a week for six weeks of treatment. Chemptherapy, of course is another recommended method of treatment.
Regular Cystoscopies and Healing
After treatment, you will have regular follow-up appointments to monitor how you are recovering. Follow-up will usually include a physical examination. It may also involve taking some urine or blood samples. You will also have regular cystoscopies to detect any changes in the ureter. If you have any problems, or notice any new symptoms between these times, contact Dr. Scherr's office immediately.