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What Can I Expect after Treatment?

When an upper urinary tract cancer is caught early, the chances of surgical cure are good. Overall the outlook depends on 2 factors:

  1. How aggressive the cancer cells are. Low-grade disease is less aggressive and has a lower chance of spreading to other organs. High-grade disease is more aggressive with a higher chance of spreading.
  2. How far the tumor has spread. If the tumor does not involve nearby lymph nodes or other tissue, there is a high likelihood of cure. Additional treatments would not be needed. But if the cancer has spread to nearby lymph nodes, your doctor will probably recommend additional systemic chemotherapy.

Recovery and Followup

Your recovery depends on your treatment. A minimally invasive approach will lead to a quicker recovery than traditional open surgery. The best treatment option is often the one that offers the best long-term outcome. If your surgeon has removed 1 kidney and the remaining kidney works well, your quality of life and future health should not be seriously affected. One good kidney can usually do the work of 2.

After treatment you will need continued check-ups to watch for regrowth of cancer. Upper urinary tract cancer is more likely to occur in multiple places than other cancers. For the first few years after treatment, your doctor will perform cystoscopy and other exams. These visits should continue at least yearly throughout your life.

Recurrence

Urothelial tumors often come back in new places in the urinary tract, even if the initial growth was on the surface of the urinary tract. New tumors develop lower in the ureter or the bladder in about 30 out of every 100 patients who have had upper tract tumors removed. If the lower ureter on the side of the cancer was not removed, it should be checked regularly with retrograde X-rays or a scope. For patients with upper tract tumors, it is rare for cancer to come back in the opposite upper urinary tract (less than 3 to 5 out of 100 patients).

Protecting Your Kidney after Surgery

If the surgery leaves you with only 1 kidney, you should avoid a few things, for example, major contact sports (e.g., football, karate or boxing), or NSAIDs (nonsteroidal anti-inflammatory drugs, e.g., aspirin and ibuprofen). In rare cases these drugs can cause kidney damage. Depending on how well the remaining kidney functions, you may need to avoid the dyes used in some imaging tests. You may also want to limit the salt and protein in your diet.

Treating problems like high blood pressure, diabetes, high cholesterol, and obesity can help prevent future kidney damage.