Ureteric Cancer

Diagnosis

Diagnosis of ureteral cancer is made through the following tests:

• Physical examination and medical history: The individuals are inquired about the symptoms, their duration and progression. They are also asked about their history of smoking, any kidney infections or chronic kidney stones, or chronic exposure to toxic chemicals (occupational exposure). Besides, the family history of the individual is also evaluated to identify the presence of urinary tract cancer in the immediate family members.
• Blood tests: Sometimes based on the symptoms, your doctor may advise you to undergo a comprehensive blood examination. A complete blood count helps determine anemia that may occur due to persistent blood loss in urine. Blood tests may also include kidney function tests to determine the functioning of the kidney, alkaline phosphatase levels as the higher level indicates the spread of cancer to bones and liver, and liver function tests to determine cancer metastasis to the liver.
• Urine analysis: It determines the presence of blood, pus cells, or bacteria in the urine. Blood in urine indicates bleeding in the urinary tract, while bacteria and nitrites indicate urinary tract infection. The urine culture test may also be conducted to determine the type of pathogen causing the infection. Urine cytology is also done to detect the presence of cancer cells.
• Cystoscopy: Cystoscopy is the technique performed to examine the health of lower urinary tract organs, such as the urethra and bladder. It is performed with the help of a cystoscope, a thin tube with a video camera at the end.
• Ureteroscopy: It is a procedure similar to the cystoscopy with the only difference that through ureteroscope, the health of the upper urinary tract organs, such as the renal pelvis and ureters, are examined. Ureteroscopy is usually conducted when the urinary analysis reports the presence of abnormal cells or blood.
• CT scan: CT scan provides high-quality 3D images of the urinary system to detect the presence of any tumor or blockage. It also detects the spread of the tumor to the nearby lymph nodes or other organs near the urinary system. The chest CT scans also diagnose metastatic ureteral cancer in the lungs. CT urography is also performed by injecting a dye into the vein and concentrating it into the urine to detect tumors.
• Retrograde pyelography: Retrograde pyelography involves injecting the dye directly into the ureters through cystoscopy and creating images of the dye movement through x-ray. It allows the cancer specialist to detect if a blockage interferes with the urine flow.
• Ultrasound: Ultrasound involves using high-frequency sound waves to create images of body parts. The technique detects the spread of ureteral cancer to the surrounding organs in the pelvis and abdomen. It is also used to evaluate kidney health.
• MRI: This technique uses radiofrequency waves and powerful magnetic forces to develop high-quality cross-sectional images of the tissues, organs, blood vessels, and bones. The technique is performed to detect if cancer has spread to the organs outside the urinary tract.
• Biopsy: During a biopsy, the samples from the abnormal tissues in the ureter or other body parts are obtained and sent to a laboratory for further examination. A biopsy can be performed through either ureteroscopy or surgery.
• Chest X-ray: Chest x-ray may also be performed in patients who experience pulmonary symptoms along with the symptoms of urinary tract disorders. The technique is used to diagnose the spread of cancer to the lungs.
• Bone scan: A bone scan is done with the help of radiopharmaceuticals and a scanning system to detect if ureteral cancer has spread to the bones.