Transitional cell carcinoma (TCC) kidney cancer is a rare type of cancer that may have no symptoms at first. A person may be more at risk due to several factors, including exposure to certain substances.

Transitional cell carcinoma (TCC) kidney cancer is a type of cancer in the lining of the kidney or the ureters. The ureters are the tubes that carry urine from the kidneys to the bladder. The kidneys filter and clean the blood of waste products, which then collect in the bladder.

People may have no TCC kidney cancer symptoms until the tumor grows. Healthcare professionals may treat TCC kidney cancer using surgery or other treatments. A person’s outlook may be good, depending on the stage and spread of the cancer.

This article discusses what TCC kidney cancer, now known as upper urinary tract urothelial carcinoma, is, its symptoms, and its causes.

A note on TCC

TCC is now mainly known as upper urinary tract urothelial carcinoma (UUTUC), or upper tract urothelial carcinoma. A medical definition of TCC kidney cancer is cancer of the renal pelvis and ureter.

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Upper urinary tract urothelial carcinoma (UUTUC) is a type of cancer that forms in the transitional cells. Transitional cells are a type of cell that line the inside of the:

  • Renal pelvis: The area at the center of the kidneys. The urine collects here before it flows into the ureter.
  • Ureters: These are tubes that connect the kidneys to the bladder.

Transitional cells stretch and shrink with the level of urine in the renal pelvis or bladder.

UUTUC is rare. There are about 7,000 people with cases every year in the United States.

Learn about kidney cancer.

People with early stage UUTUC may have no symptoms.

However, as the tumor grows, they may develop symptoms, including:

  • blood in their urine
  • pain in their back that does not go away
  • extreme tiredness
  • unexplained weight loss
  • painful or frequent urination

Other conditions can also cause these symptoms. If a person experiences any of them, they should seek medical advice for diagnosis and treatment.

Changes to the way transitional cells in the renal pelvis and ureters work cause UUTUC. These changes especially include how they grow and divide into new cells.

Some risk factors increase the chance of DNA damage to a person’s cells, which may lead to cancer. These factors increase a person’s risk of UUTUC and include:

  • having a personal history of bladder cancer
  • smoking
  • having a family history of Lynch syndrome, a genetic condition that leads to several types of cancer
  • taking a lot of certain pain medications, such as phenacetin
  • exposure to aristolochic acid, a type of acid found in certain plants, as well as herbal remedies and agricultural products contaminated by aristolochic plants
  • exposure to some dyes and chemicals used in making:
    • leather goods
    • textiles
    • plastics
    • rubber

To diagnose UUTUC, healthcare professionals will generally ask a person about their personal and family medical health history. They also will typically perform a physical exam.

They may use tests and procedures as well, including:

  • urinalysis, checking the urine’s color and some of its contents, including:
    • sugar
    • protein
    • blood
    • bacteria
  • ureteroscopy, where a healthcare professional uses a thin tube instrument to look inside the ureter and renal pelvis
  • urine cytology, checking a sample of urine under a microscope for abnormal cells that may indicate cancer
  • CT or CAT scans, which use X-rays and computers to make detailed images of the inside of the body
  • ultrasound scans, using echoes from high energy sound waves to make images of bodily tissues
  • MRI scans, which use powerful magnets and radio waves to make computerized images of the inside of the body
  • biopsies, which involve checking cell or tissue samples under a microscope for signs of cancer

If a healthcare professional confirms a diagnosis of UUTUC, they will usually perform further tests. These determine if the cancer has spread within the renal pelvis and ureter or to other parts of the body. About 9% of people have UUTUC that spreads to other locations in their body.

The tests help healthcare professionals plan the best cancer treatment by helping them determine the cancer’s stage. The stage of cancer describes how big the tumor is and if it has spread from where it started.

These tests include:

  • chest X-rays
  • PET scans, which use injectable radioactive tracers and a scanner to make detailed pictures to check the activity of cells in the body
  • bone scans, which use injectable radioactive materials and scanners to check the bones for cancer cells

Treatment options for UUTUC depend on several factors, such as a person’s overall health, the stage of UUTUC, and the presence of other medical conditions.

Treatment options include:

  • Endoscopic ablation: A surgeon inserts a small, flexible tube into the ureter via the bladder. They then use a laser or heat source on the end of the tube to destroy cancer cells.
  • Chemotherapy: Healthcare professionals may prescribe a person anticancer cytotoxic drugs to destroy cancer cells. They may prescribe these drugs before, after, or during surgery to treat a person’s cancer.
  • Surgery: Surgeons may perform one of several surgeries, such as a nephroureterectomy. This removes the kidney, ureter, and a small portion of the bladder. The surgeon may perform a segmental ureterectomy, which preserves the kidney. Another option includes a lymph node dissection, which removes some glands near the kidney called lymph nodes.

Read more about surgery for kidney cancer.

What is the survival rate of TCC kidney cancer?

According to the National Cancer Institute (NCI), the survival rate of early stage TCC kidney cancer can be more than 90%. However, if the TCC has spread to other parts of the body or past the inner lining of the bladder, the survival rate can be 15% or lower.

Is TCC an aggressive cancer?

How aggressive TCC kidney cancer is can depend on several factors. More advanced TCC kidney cancers that have grown into or through the lining of the bladder are typically more aggressive.

Cancer resources

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Transitional cell carcinoma (TCC) kidney cancer, or upper urinary tract urothelial carcinoma, is a rare type of cancer that affects the kidneys or the tubes from the kidneys to the bladder.

Several risk factors can make a person more likely to develop TCC kidney cancer. These include smoking, a family history of TCC kidney cancer, and exposure to certain substances or chemicals.

Treatments include surgery, chemotherapy, or tumor elimination using endoscopic ablation. A person’s outlook for TCC kidney cancer can be generally good but depends on the stage and spread of the tumor.