Man with UTUC

How UTUC can be treated

Finding out that you have any type of cancer is scary, but try not to worry. UTUC can be treated.

Silhouette of man with UTUC

Before treatment

Before choosing a treatment, your urologist probably did a biopsy. During the biopsy, there is a chance that your urologist was able to remove the entire tumor. If not, then it will be important to choose the right treatment for you.

When it comes to choosing a treatment, the most important thing to think about is the grade of your cancer. The grade of your cancer depends on how aggressive the cancer cells are. In UTUC, there are 2 different grades: low grade and high grade.

Scroll down to see what treatment options are available for low-grade and high-grade UTUC.

If you haven’t talked to your urologist about whether your cancer is low or high grade, be sure to ask. For help with how to talk to your urologist and the right questions to ask, be sure to visit the Talking to Your Urologist page.

Treatments for low-grade UTUC

Wait and watch

What is it?

If your urologist was able to remove all of your tumor during your biopsy or a minor surgery, he or she might want to wait and watch to see if the tumor comes back. You will probably be asked to come back for more appointments over the next few weeks or months so that your urologist can run more tests and keep an eye on it.

Why this treatment might be right for you

If your urologist wants to wait and watch, it means he or she is pretty sure that your whole tumor was removed. That’s great news! You might not need any more treatment at this time. However, your urologist will probably keep running tests to make sure that the tumor hasn't come back.

Why this treatment might NOT be right for you

If you still have a tumor or part of a tumor, it is important to get treated to try to prevent serious kidney damage or death. Even if your urologist already tried to remove your tumor, if he or she wasn’t able to remove all of it, you might need to get more treatment.


Minor surgery

What is it?

There are a few minor operations that you can get to remove low-grade UTUC tumors. Your urologist might use a laser, forceps, or another surgical tool to remove your tumor. No matter what tool your urologist uses, you will usually be put to sleep during the operation.

Your urologist might call these operations endoscopic resection or endoscopic management because they are done using a piece of equipment called an endoscope. An endoscope is a camera that lets a doctor see the inside of your body while he or she does an operation. The type of endoscope that urologists use is called a ureteroscope (ureter-o-scope).

Why this treatment might be right for you
  • With these operations, you will usually be able to go home the same day and won’t have to spend the night in the hospital.
  • These operations are relatively safe and do not require long recovery. Also, they usually do not cause any long-term damage to your kidney or ureter.
  • Since you will be put to sleep or take medicine to numb the pain, these operations usually aren’t too painful.
Why this treatment might NOT be right for you
  • These operations do not work all the time. You might have to go back for more than one operation if all of your tumor can’t be removed the first time.
  • Even if your operation works the first time, your cancer could come back. Then you would have to decide if you want another operation or if you want to try a different treatment.
  • The exact location of your tumor could make these operations more difficult. If the tumor is in the small parts of your kidney, it might be hard to reach. If it’s in a really tough spot, your urologist might not be able to reach it at all.

Major surgery

What is it?

If your urologist thinks that your low-grade UTUC is serious enough, he or she might recommend an operation to remove your kidney. This could mean removing your whole kidney, your ureter, and possibly a small part of your bladder. It could also mean removing just a part of your kidney or ureter.

Your urologist might call this operation an NU or an RNU, which stands for nephroureterectomy (nephro-ureter-ectomy) or radical nephroureterectomy.

Radical nephroureterectomy graphic

An NU or RNU for low-grade UTUC usually means removing the kidney, the ureter, and (possibly) a small part of the bladder.

This might seem like a scary option, but plenty of people live full and healthy lives with only one kidney. But, you should make sure to think about exactly what this operation would mean for you before you get it.

Why this treatment might be right for you

This option is the only way to guarantee that your cancer is fully removed. If your cancer is serious enough, this might be the best option to help you move on with your life cancer free.

There are several things that might make your case serious enough for this surgery to be right for you:

  • If you have a large tumor and your urologist can’t remove all of it with minor surgery
  • If the location of your tumor is in the small parts of your kidney and your urologist can’t reach it with minor surgery
  • If you have more than one tumor and your urologist is not able to remove all of them with minor surgery
Why this treatment might NOT be right for you

If you have certain health conditions, this operation might not be right for you. You and your urologist should think very hard about this operation if

  • You have only one kidney
  • You have chronic kidney disease or another disease that affects your kidneys
  • You are generally in poor health

Even if you have both of your kidneys and your health is good enough, this operation is still very serious. There are many things to think about before you decide to get this surgery.

Here are both the short-term and long-term effects:

Short term

  • You could spend several days in the hospital.
  • You might have to have a catheter for 3 to 7 days to help you urinate.
  • You will have to miss time from work, sometimes 30 days or more.
  • A family member or caregiver might have to miss time from work.
  • You will not be able to drive for at least 1 to 2 weeks.
  • You will not be able to exercise or do any major activities for up to 6 weeks.
  • There is always a chance that something could go wrong during the operation, causing you to have to spend more time in the hospital or have to get more treatments.

Long term

  • Having only one kidney could have a serious impact on your life and overall health. With only one kidney, you have a higher chance of getting chronic kidney disease, which is a very serious disease. Having only one kidney could also mean that you will not be able to take certain medicines or get other treatments in the future.
  • Although removing your kidney means that your cancer will also be removed, it could still come back in your bladder or your other kidney.

Treatments for high-grade UTUC

Major surgery

What is it?

High-grade UTUC is very serious. To make sure that all of your tumor is removed, major surgery is the only option. Usually this means removing your whole kidney, your ureter, and a small part of your bladder.

Your urologist might call this operation an NU or an RNU, which stands for nephroureterectomy (nephro-ureter-ectomy) or radical nephroureterectomy.

Radical nephroureterectomy graphic

An NU or RNU for high-grade UTUC means removing the kidney, the ureter, and a small part of the bladder.

Before this surgery, your urologist might also recommend a round of chemotherapy treatment. This is something that is usually only done for high-grade UTUC, and it is an extra precaution to help make sure that the cancer doesn't spread to other parts of your urinary tract.

Getting an NU or RNU might seem like a scary option, but plenty of people live full and healthy lives with only one kidney. But, you should make sure to think about exactly what this operation would mean for you before you get it.

If you have only one kidney, you and your urologist will have to talk about what else you can do to fight your cancer. There might be other treatments that can help keep your cancer from spreading or getting worse.

Why this treatment is right for you

High-grade UTUC is very dangerous. If it’s not treated, it could cause serious kidney problems, spread to other parts of your body, or cause death. This option is the only way to guarantee that your cancer is fully removed. It is also the option that gives you the best chance to move on with your life cancer free.

What to think about before getting this treatment

This is a major operation, so there are many short-term and long-term effects that you should know about.

Short term

  • You could spend several days in the hospital.
  • You will have to have a catheter for 3 to 7 days to help you urinate.
  • You will have to miss time from work, sometimes 30 days or more.
  • A family member or caregiver might have to miss time from work.
  • You will not be able to drive for at least 1 to 2 weeks.
  • You will not be able to exercise or do any major activities for up to 6 weeks.
  • There is always a chance that something could go wrong during the operation, causing you to have to spend more time in the hospital or have to get more treatments.

Long term

  • Having only one kidney could have a serious impact on your life and overall health. With only one kidney, you have a higher chance of getting chronic kidney disease, which is a very serious disease. Having only one kidney could also mean that you will not be able to take certain medicines or get other treatments in the future.
  • Although removing your kidney means that your cancer will also be removed, it could still come back in your bladder or your other kidney.

Another option: Clinical studies

New treatments for cancer are always being studied. An organization called the Bladder Cancer Advocacy Network (BCAN) keeps a list of clinical studies in bladder cancer and urinary tract cancer on its website.

Another way to find a clinical study is to check the US National Library of Medicine's study registry.

Remember, clinical studies test new treatments that aren’t approved by the US Food & Drug Administration (FDA) yet. They aren’t a sure thing. Be sure to talk to your doctor about whether one of these studies might be right for you.

Before you choose a treatment, it’s important to ask your urologist the right questions.

Make sure you’re ready to talk to your doctor

Silhouette of UTUC patient talking to urologist