Chapter 2
Diagnosis
Your doctor may use some combination of the following tests to diagnose your ureter cancer:
- Physical examination. Your doctor will complete a comprehensive physical exam, including asking you questions about your health history and about symptoms related to ureter cancer.
- Computerized tomography (CT) scan. This imaging test uses specialized X-rays to create detailed images of the inside of your body. Your doctor then closely reviews the images for signs of ureter cancer or other problems.
- Urine tests. You may need to undergo a urine test so that your doctor can rule out possible urinary tract infection (UTI) or check for blood in your urine.
- Ureteroscopy. During this test, your doctor passes a thin, lighted scope (ureteroscope) into your urethra (hole where urine exits your body), and into your bladder and ureters. Your doctor uses specialized viewing equipment to check for signs of cancer.
Your doctor may use other diagnostic tests to find out more about your cancer, where it’s located and which treatments are likely to be most effective. Your doctor may use some of these tests to find out how well your treatment is working.
Stages
If you’re diagnosed with ureter cancer, the next step will be for your oncologist (cancer doctor) to determine how advanced the cancer is. This is called “staging.” The earliest stage cancer is called stage I (1) and the most advanced cancer is stage IV (4).
The stages of ureter cancer are:
- Stage I. This is when the cancerous tumor has grown through the lining of the connective tissue layer of the ureter.
- Stage II. This is when the tumor has grown into the muscle layer of the ureter.
- Stage III. This is when the tumor has grown into the kidney or fat that’s around the ureter.
- Stage IV. This is when the tumor has spread into nearby organs, to nearby lymph nodes or to distant organs, such as the lungs, liver or bone.
In most cases, doctors also use the TNM system for staging ureter cancer:
- T describes how large the main tumor is, if it has gone through the ureter wall and if it has spread into nearby tissues.
- N indicates whether the cancer has spread to the lymph nodes near the ureter. Lymph nodes are small collections of immune system cells to which cancers commonly spread.
- M indicates if the cancer has metastasized (spread) to farther away body areas, such as the brain, lungs or bones.
