Ureter or Renal Pelvis Cancer Treatment
Ureter or renal pelvis cancer is a rare form of cancer of the urinary tract that starts in the ureter lining (the pipe between the kidney and the bladder) or the renal pelvis (the area of the kidney where urine accumulates before it enters the ureter). Ureter or renal pelvis cancer is commonly classified as upper tract urothelial carcinoma (UTUC) and is treated with specialized care. Early detection and high-tech treatments, such as surgery, chemotherapy, immunotherapy, and targeted therapy, can greatly enhance outcomes.
This article explores the disease, treatment options, effectiveness, costs, and patient experiences, with a focus on treatment availability in India and China.
About the Disease
Ureter and renal pelvis cancers are also urothelial carcinomas, as in bladder cancer. Risk factors are smoking, exposure to some chemicals, chronic kidney disease, and genetic susceptibility. Symptoms can be hematuria (blood in urine), flank pain, urinary frequency, and weight loss. Diagnosis is done with imaging (CT scans, MRIs), urine cytology, and ureteroscopy with biopsy.
Indications for Treatment
Treatment depends on the cancer stage, patient health, and tumor characteristics. Indications include:
- Localized tumors (surgery is the primary option)
- Advanced or metastatic cancer (chemotherapy, immunotherapy, or targeted therapy)
- High-risk cases (adjuvant therapy post-surgery)
Procedure Details
Surgical Options
- Nephroureterectomy – Removal of the kidney, ureter, and part of the bladder.
- Segmental Ureterectomy – Removal of only the affected ureter segment (for localized tumors).
- Endoscopic Ablation – Laser or electrocautery to remove small tumors (for low-grade cancers).
Minimally Invasive Techniques
- Laparoscopic/Robotic Surgery – Offers faster recovery with smaller incisions.
Treatment Details: Chemotherapy, Immunotherapy, and Targeted Therapy
Chemotherapy
Used before (neoadjuvant) or after (adjuvant) surgery, or for metastatic cases. Common drugs:
- Cisplatin + Gemcitabine (first-line for advanced UTUC)
- MVAC (Methotrexate, Vinblastine, Doxorubicin, Cisplatin) – for aggressive tumors
Immunotherapy
Immune checkpoint inhibitors help the body attack cancer cells. Approved drugs:
- Pembrolizumab (Keytruda)
- Atezolizumab (Tecentriq)
- Nivolumab (Opdivo)
Targeted Therapy
For cancers with specific genetic mutations (e.g., FGFR3 alterations):
- Erdafitinib (Balversa) – Approved for FGFR-altered urothelial cancers
Effectiveness of Treatment
- Surgery has a high success rate for localized cancers (5-year survival ~70-90%).
- Chemotherapy improves survival in metastatic cases but has side effects.
- Immunotherapy shows durable responses in PD-L1-positive tumors.
- Targeted therapy benefits patients with specific mutations.
Risks and Side Effects
- Surgery Risks: Infection, bleeding, kidney function loss.
- Chemotherapy Side Effects: Nausea, fatigue, low blood counts.
- Immunotherapy Side Effects: Autoimmune reactions (rash, colitis, lung inflammation).
- Targeted Therapy Side Effects: High phosphate levels, vision changes.
Recovery and Aftercare
- Post-Surgery: Hospital stay (3-7 days), gradual return to normal activities in 4-6 weeks.
- Follow-Up: Regular imaging and urine tests to monitor recurrence.
- Lifestyle Changes: Hydration, smoking cessation, kidney-friendly diet.
Cost and Availability
Treatment costs vary by country and facility. India and China offer cost-effective options with high-quality care.
Cost Comparison (USD Approx.)
| Country | Surgery Cost | Chemotherapy (per cycle) | Immunotherapy (per dose) |
|---|---|---|---|
| USA | 30,000−50,000 | 3,000−6,000 | 8,000−12,000 |
| India | 6,000−10,000 | 500−1,500 | 2,500−4,500 |
| China | 8,000−15,000 | 800−2,000 | 3,000−5,000 |
| Turkey | 10,000−20,000 | 1,000−3,000 | 4,000−7,000 |
| Thailand | 12,000−18,000 | 1,200−2,500 | 3,500−6,000 |
| Israel | 20,000−35,000 | 2,500−5,000 | 6,000−10,000 |
| Malaysia | 10,000−16,000 | 1,000−2,500 | 3,000−6,000 |
| Korea | 15,000−25,000 | 1,500−3,000 | 4,000−8,000 |
Patient Experiences
Many patients report positive outcomes with surgery and immunotherapy. Some face challenges with chemotherapy side effects but appreciate newer targeted therapies. India and China’s affordable care attracts international patients.
List of Ongoing Clinical Trials in China
- Study on PD-1 Inhibitors for UTUC – Shanghai Cancer Center
- FGFR3-Targeted Therapy Trials – Peking University Hospital
- Combination Immunotherapy + Chemotherapy – Zhongshan Hospital
FAQ
Q: What is the best treatment for early-stage ureter cancer?
A: Surgery (nephroureterectomy or segmental resection) is the gold standard.
Q: Can immunotherapy cure advanced renal pelvis cancer?
A: It can control the disease long-term but is rarely curative alone.
Q: How much does treatment cost in India?
A: Surgery costs 6,000−10,000; immunotherapy is 2,500−4,500 per dose.
Q: Are there new treatments being tested?
A: Yes, clinical trials in China and globally are testing novel immunotherapies and targeted drugs.