What are ureter and renal pelvis cancers?

Ureter and renal pelvis cancers are cancers that start in the ureter or renal pelvis. They are uncommon and usually only one ureter or kidney is affected.

Of all kidney cancers, only about 7 out of 100 (7%) begin in the renal pelvis, and 5 out of 100 (5%) in the ureter.

About 9 in 10 cancers of the ureter and renal pelvis (90%) start in cells called transitional cells. The cancer is called urothelial carcinoma or transitional cell carcinoma (TCC). Transitional cells line the renal pelvis, ureters, bladder and urethra.

This information is about cancer that starts in the ureter and renal pelvis. We have separate information about kidney cancer (renal cell cancer).


Symptoms of ureter and renal pelvis cancers

Some people do not have symptoms but are diagnosed when having a test or scan done for another reason.

The symptoms of ureter and renal pelvis cancer are similar to kidney cancer (renal cell cancer). The most common symptoms of ureter and renal pelvis cancer are blood in the urine (pee), called haematuria, and pain in one side of the lower back.

Sometimes the ureter may become blocked, either by cancer cells or by a blood clot. This causes urine to stay in the kidney and ureter. This is called hydronephrosis. Symptoms, such as back pain, may develop more quickly and be more severe.

Causes of ureter and renal pelvis cancers

The causes of cancer of the ureter and renal pelvis are unknown, but research is going on to try to find out more. There are certain things that can affect the chances of developing ureter and renal pelvis cancer. These are called risk factors.

Diagnosis of ureter and renal pelvis cancers

If you have symptoms, you usually start by seeing your GP. They will examine you and arrange for you to have some tests. They may test your urine (pee). They may also do blood tests to check:
  • your general health
  • the number of cells in your blood (blood count)
  • how well your kidneys and liver are working.

If your GP is not sure what the problem is, or they think your symptoms could be caused by cancer, they will usually refer you to the hospital to see a specialist doctor. This doctor is called a urologist. They specialise in treating urinary, bladder and kidney problems.

If you have blood in your urine, you may be referred to a specialist clinic. This is called a haematuria clinic. Often these clinics can do tests on the same day.

At the hospital

The urologist or a specialist nurse will ask you about your symptoms and your general health. They will also examine you and arrange some of the following tests.

  • Blood tests

    Blood tests help your doctors check how well your kidneys and liver are working.

  • Urinary cytology

    During a urinary cytology, a sample of your urine (pee) will be checked for cancer cells.

  • CT urogram

    A CT urogram is a type of CT scan. It looks at the kidneys, ureters and bladder.

  • Cystoscopy and ureteroscopy

    Cystoscopy and ureteroscopy are tests that let the doctor look inside the bladder, ureter and renal pelvis.

  • Intravenous urogram (IVU/IVP)

    An intravenous urogram (IVU/IVP) is a type of x-ray that looks at the whole of your urinary system.

  • MRI (magnetic resonance imaging) scan

    An MRI scan uses magnetism to build up a detailed picture of areas of your body.

Waiting for test results can be a difficult time, we have more information that can help.

Staging and grading of ureter and renal pelvis cancers

The stage of a cancer describes its size and how far it has spread. Staging information comes from the tests you have had.

A doctor decides the grade of the cancer by looking at the cancer cells under a microscope. The grade gives an idea of how the cancer might grow or spread.

Knowing the stage and grade helps your doctors plan the best treatment for you.

Treatment for ureter and renal pelvis cancers

A team of specialists will discuss your treatment options. This is called a multidisciplinary team (MDT).

Treatment depends on a number of factors, including the position, type, stage and grade of the cancer. Your doctors will also take into account how well your kidneys work, your general health and your personal preferences.

Your doctor will explain the different treatments and their side effects. They will also talk to you about the things you should consider when making treatment decisions.

  • Surgery

    Surgery is the main treatment for cancer of the ureter and renal pelvis. After surgery, you may be offered other treatments to get rid of any remaining cancer cells and reduce the chance of the cancer coming back. This is known as adjuvant treatment.

  • Radiotherapy

    Radiotherapy uses high-energy rays to destroy cancer cells and shrink the tumour. It is not commonly used to treat this type of cancer. It may occasionally be given after surgery to treat any cancer cells that could not be removed, or if surgery is not possible.

  • Chemotherapy

    Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells.

  • Immunotherapy

    Immunotherapy drugs encourage the body’s immune system to fight cancer cells.

You may also have some treatments as part of a clinical trial.

After treatment for ureter and renal pelvis cancers


After your treatment has finished, you will have regular check-ups with your cancer doctor to monitor how you are recovering after treatment. These will usually include a physical examination. It may also involve taking some urine (pee) or blood samples.

You may have regular checks with a CT urogram or ureteroscopies. You will also have cystoscopies to detect any changes in the bladder. This is because people with cancer of the ureter or renal pelvis have an increased risk of developing a bladder cancer after a few years.

You can talk to your cancer doctor or specialist nurse about any problems or worries you have at these check-ups. If you have any problems or notice any new symptoms between your appointments, let your doctor know as soon as possible.

You may get anxious between appointments. This is natural. It may help to get support from family, friends or a support organisation.

Macmillan is also here to support you. If you would like to talk, you can:

Well-being and recovery

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes after treatment.

Making small changes to the way you live such as eating well and keeping active can improve your health and well-being and help your body recover.

Reviewed: 30 June 2018
Reviewed: 30/06/2018
Next review: 02 January 2021
Next review: 02/01/2021

This content is currently being reviewed. New information will be coming soon.