Transitional cells are in your urinary system. It’s the part of your body that includes the kidneys, the bladder and the tubes that connect them. These cells are able to change shape and stretch without breaking and are found throughout your urinary tract. This lets the system expand to store urine and allow it to move through your body.
Transitional cell cancer (TCC) affects these cells. It can be found in the:
- Renal pelvis (located in the middle of your kidney)
- Top part of the ureter -- the long tube that connects your kidneys to your bladder.
The kidneys collect urine in the renal pelvis and then drain it through the ureter into the bladder. From there, it exits your body through your urethra (where you pee).
Types of Transitional Cell Cancer
Transitional cell carcinoma can be either low grade or high grade. If it’s low grade, it isn’t likely to spread into deeper layers of your bladder or anywhere else in your body. It’s also less likely to come back after treatment.
If it’s high grade, it’s more likely to spread to deeper layers of your bladder, other areas of your body, and your lymph nodes. It’s also likely to come back after treatment. High-grade TCC is the type of bladder cancer that is more likely to be life-threatening.
Because transitional cells line many different parts of your urinary tract system, you can sometimes develop tumors in more than one place. If you have TCC in your bladder, you should also be checked for tumors in other parts of your urinary tract system.
It’s not certain what causes most transitional cell cancers, but there are certain things that can increase your risk:
If you have TCC, you might not experience signs or symptoms in the early stages. But they’ll develop as the cancer grows. It’s important to see your doctor if you experience:
Tests and Diagnosis
To determine your condition, your doctor may use a number of tests:
- Physical exam to look for any signs of disease
- Detailed health history to learn about any past illnesses and your health habits
- Urinalysis to look for things like sugar, protein, bacteria, or blood
- Urine cytology test to check your urine sample under a microscope for cancer cells
Procedures for diagnosing TCC include:
- Ureteroscopy. This is how a doctor can look inside your ureter and renal pelvis for anything that doesn’t look right. He’ll use a ureteroscope -- a long, thin tube with a light on the end -- to look through your urinary system. Tissue samples can be taken during this procedure and checked for signs of disease.
- Intravenous pyelogram (IVP). This is a series of X-rays that check the kidneys, ureters, and bladder for cancer using a dye that’s injected into your vein. As the dye moves through your urinary system, it allows your doctor to see if there are any blockages.
- CT scan, ultrasound, or MRI. These can provide a detailed picture of what’s happening inside your body and help your doctor diagnose TCC.
- Biopsy. Your doctor may remove a sample of cells or tissue during surgery to look at it under a microscope.
Your treatment depends on your overall health and age, as well as how far your cancer has spread and how fast it’s growing. The earlier your cancer is diagnosed, the easier it will be for your doctors to get it under control and potentially cure it. Most cases of TCC in the renal pelvis and ureter can be cured if they’re found and diagnosed early enough.
Surgery is the standard treatment for this type of cancer. If you need surgery, you may require a nephroureterectomy. That’s the removal of your entire kidney, ureter, and the tissue connecting the ureter to the bladder (the bladder cuff).
If your cancer is superficial, your doctor might be able to do a type of surgery called a segmental resection of the ureter. This means your doctor will remove the part of your ureter where the cancer is, as well as some surrounding healthy tissue too. They will then reattach the ends of your ureter.
There are other types of treatments for TCC of the renal pelvis and ureter that are currently being studied in clinical trials:
- Fulguration: A tool is used to destroy the cancer with electricity.
- Segmental resection of the renal pelvis: This removes the renal pelvis where the cancer is but leaves the rest of the kidney in place.
- Laser surgery: A laser is used to either kill the cancer cells or remove them.
- Regional chemotherapy and regional biologic therapy: This directly targets the part of the body where the cancer is to either stop the growth of the cells or to boost your body’s natural defenses against them.