What Is Transitional Cell Carcinoma

Types Of Transitional Cell Carcinoma

Also known as urothelial carcinoma, transitional cell carcinoma affects the renal pelvis and ureter. All bladder cancers have two subtypes of tumors that are classified based on how they grow. Papillary carcinomas are slim, finger-shaped tumors that originate in the bladders inner surface and grow deeper into the hollow portion of the bladder. Flat carcinomas have a similar appearance but do not grow into the bladders hollow center.

Because both types of tumors can spread beyond the renal pelvis and ureter areas, specific cases of transitional cell carcinoma are referred to in numerous ways. These include:

• Invasive urothelial or transitional cell carcinoma
• Papillary urothelial neoplasm of low-malignant potential
• Non-invasive flat carcinoma or flat carcinoma in situ
• Primary transitional cell carcinoma of the prostate, colon, breast, or lung

Your oncologist will explain the details of your diagnosis to ensure you feel comfortable in your treatment plan and understand what to expect.

Causes And Risk Factors

People will often assume that cancer of the bladder or kidneys is caused by exposure to toxins we ingest, whether it be contaminated water or chemicals in our food. For the most part, this is not the case. While toxins are definitely linked to the development of TCC, they are most often the types we inhale over long periods of time.

Chief among these is cigarette smoke. In fact, over half of all TCC diagnoses in men and over a third in women are associated with heavy smoking. Moreover, the risk and stage of the disease appear directly linked to the number of years a person has smoked and the daily frequency of smoking.

According to research from the Memorial Sloan-Kettering Cancer Center in New York, bladder cancer in smokers is not only more prevalent but usually more invasive than in nonsmokers.

The cause for this association is not entirely clear, but some have hypothesized that long-term exposure to tobacco smoke causes chromosomal changes in epithelial tissues which give rise to lesions and cancers. The risk is seen to be highest in persons who smoke over 15 cigarettes a day.

Other risk factors to TCC include:

How Is Carcinoma Diagnosed

A history and physical is performed to see if your symptoms are consistent with carcinoma and to look for any signs of it on examination.

Skin lesions that might be cancer are looked at by your doctor who can tell if its likely to be a basal or squamous cell carcinoma based on its characteristics, such as:

• size
• texture
• growth rate

Carcinoma inside your body is evaluated with imaging tests that show its location and size. They can also show if it has spread locally or within your body.

These tests include:

• CT scans
• MRI scans

Once the cancer has been evaluated with imaging, a biopsy is performed. A part or all of the lesion is surgically removed and looked at under a microscope to determine if its cancer and what kind it is.

Special scopes which are lighted tubes with a camera and special tools designed for a specific organ are often used to look at the cancer and tissue around it, and biopsy or remove the cancer.

All carcinomas are treated with a combination of surgery, radiation therapy, and chemotherapy depending on its location, how advanced it is, and whether its spread locally or to a distant part of the body.

• Surgery is used to remove all of the cancer or as much of it as possible.
• Radiation therapy is usually used to treat a specific area with local cancer spread.
• Chemotherapy is usually used to treat cancer that may have spread distantly.

The outlook for any carcinoma depends on:

Information and support

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Types Of Bladder Cancer

The type of bladder cancer depends on how the tumors cells look under the microscope. The 3 main types of bladder cancer are:

• Urothelial carcinoma. Urothelial carcinoma accounts for about 90% of all bladder cancers. It also accounts for 10% to 15% of kidney cancers diagnosed in adults. It begins in the urothelial cells found in the urinary tract. Urothelial carcinoma is sometimes also called transitional cell carcinoma or TCC.

• Squamous cell carcinoma. Squamous cells develop in the bladder lining in response to irritation and inflammation. Over time, these cells may become cancerous. Squamous cell carcinoma accounts for about 4% of all bladder cancers.

• Adenocarcinoma. This type accounts for about 2% of all bladder cancers and develops from glandular cells.

There are other, less common types of bladder cancer, including sarcoma of the bladder and small cell bladder cancer, among others. Sarcomas of the bladder often begin in the fat or muscle layers of the bladder. Small cell bladder cancer is a rare type of bladder cancer that is likely to spread to other parts of the body.

What Is Transitional Cell Carcinoma

Transitional cell carcinoma originates in the very cells it is named for. Transitional epithelial cells are found in the lining of the ureter, the tube connecting the bladder to the kidneys. The ureter is responsible for transporting urine from the renal pelvis, or the middle of the kidneys, into the bladder. While transitional cell carcinoma originates along the ureter, high-grade cases allow it to spread into other organs and areas of the body. The prostate is the most commonly affected organ, as it is connected to the urinary system via ducts. Cancerous cells, however, may eventually spread to the breast, colon, or lungs.

While the diseases cause is unknown, several risk factors may increase ones likelihood of developing transitional cell carcinoma. These include obesity, smoking, exposure to job-site carcinogens, and consuming water with high arsenic levels. Symptoms may vary, and patients with early-stage or low-grade transitional cell carcinoma may show no initial symptoms. As the disease progresses, however, the following signs often appear:

• Fatigue
• New, persistent back pain
• Frequent or painful urination

Contact your physician immediately if you notice any of these symptoms, as early detection is your best chance to overcome a cancer diagnosis.

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Recovery Of Transitional Cell Carcinoma In Cats

With current technologies, all treatment of transitional cell carcinoma in cats is considered palliative. This means that treatment is meant to alleviate the physical pain and discomfort of the disease and lengthen the life of your cat. With a well-developed and consistent treatment, your cats lifespan may be extended by eight months to a year or more.

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Transitional Cell Carcinoma Average Cost

From 522 quotes ranging from $3,000 – $8,000

Average Cost

The Kidneys And Ureters

The kidneys are two bean shaped organs, each about the same size as a fist. They are near the middle of your back, one on either side of your spine.

The renal pelvis is in the middle of the kidney. Urine collects here and then drains through a tube called the ureter and into the bladder. When you empty your bladder, the urine leaves the body through a tube called the urethra.

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Treatment Of Metastatic Or Recurrent Transitional Cell Cancer Of The Renal Pelvis And Ureter

For information about the treatments listed below, see the Treatment Option Overview section.

Treatment of metastatic or recurrenttransitional cell cancer of the renal pelvis and ureter is usually done in a clinical trial, which may include chemotherapy.

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

Transitional Cell Carcinoma In The Kidney

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Most Common Subtypes Of Carcinoma

• Basal cell carcinoma. This type develops in cells in the deepest layer of the epithelium, called basal cells.
• Squamous cell carcinoma. This type develops in cells in the top layer of the epithelium, called squamous cells.
• Transitional cell carcinoma. This type develops in the stretchy cells in urinary tract epithelium, called transitional cells.
• Renal cell carcinoma. This type develops in the epithelial cells of the filtering system of the kidney.
• Adenocarcinoma. This type starts in specialized epithelial cells, called glandular cells.

Sarcoma is another type of cancer. Its different from carcinoma because, rather than the epithelium, it starts in cells in connective tissue, which is found in bone, cartilage, tendons, and muscle.

Sarcomas occur much less frequently than carcinomas.

Different types of carcinoma can develop in the same organ, so its sometimes better to categorize cancer by subtype instead of organ.

The most common carcinomas by subtype are:

What Is The Outlook For This Type Of Cancer

The outlook for someone diagnosed with cancer of the renal pelvis and ureter depends on a number of factors that your doctor will discuss with you. In particular, the chance of recovery is dependent on:

• Stage of the cancer. People with advanced stages of the disease will have a lower survival rate, even with treatment.
• Location of the tumor. If the tumor is located beyond the ureter and renal pelvis, the cancer may quickly metastasize to the kidney or other organs, reducing chances for survival.
• Overall kidney health. If there are underlying kidney disorders, the survival rate is lower, even with treatment.
• Cancer recurrence. Cancer recurrences have lower cure and survival rates than initial cancers.
• Metastasis. If the cancer has spread to other organs in the body, the survival rate is lower.

Its important to see your doctor for regular checkups and to let them know about any new symptoms youve developed. This helps your doctor catch potentially serious conditions in the earliest stages.

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What Is Bladder Cancer

Bladder cancer starts when cells that make up the urinary bladder start to grow out of control. As more cancer cells develop, they can form a tumor and, with time, spread to other parts of the body.

The bladder is a hollow organ in the lower pelvis. It has flexible, muscular walls that can stretch to hold urine and squeeze to send it out of the body. The bladder’s main job is to store urine. Urine is liquid waste made by the 2 kidneys and then carried to the bladder through 2 tubes called ureters. When you urinate, the muscles in the bladder contract, and urine is forced out of the bladder through a tube called the urethra.

Looking For More Of An Introduction

If you would like more of an introduction, explore these related items. Please note that these links will take you to other sections on Cancer.Net:

• ASCO Answers Fact Sheet:Read a 1-page fact sheet that offers an introduction to kidney cancer. This free fact sheet is available as a PDF, so it is easy to print.

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What Causes Transitional Cell Carcinoma

Researchers are still unsure about the exact cause of transitional cell carcinoma. There may be a connection between smoking, infection, exposure to chemicals, and exposure to radiation. The actual cancer starts when the cell in the urinary tract begin to change and grow more rapidly than usual. The cells do not shed, but continue to grow into tumors.

Transitional cell carcinoma happens in the inside lining of the bladder, the urethra, and ureters. The cells mimic regular cells and open up when the bladder is full and squeeze back together when there is nothing in the bladder.

There are a few risk factors that raise the chances of TCC including:

Is There A Cure For Renal Pelvis Carcinoma

Transitional cell carcinoma of the renal pelvis, accounting for only 7% of all kidney tumors, and transitional cell cancer of the ureter, accounting for only 1 of every 25 upper urinary tract tumors, are curable in more than 90% of patients if they are superficial and confined to the renal pelvis or ureter.

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Infiltrating Urothelial Carcinoma Microcystic Variant

Urothelial carcinoma may occasionally show a striking cystic pattern, with cysts ranging from microscopic up to 1 to 2 mm in diameter . The cysts may contain necrotic material or pink, pale secretions . The cyst lining may be absent, flattened, or urothelial and may show differentiation toward mucinous cells . The differential diagnosis includes urothelial carcinoma with glandular differentiation and benign processes such as cystitis cystica, cystitis glandularis, and nephrogenic adenoma. Urothelial carcinoma with microcystic pattern often coexists with the nested variant of urothelial carcinoma and is unrelated to primary adenocarcinoma of the urinary bladder.

Marijn M. Speeckaert, … Joris R. Delanghe, in, 2013

Available Treatments At Rcca

Your treatment team at Regional Cancer Care Associates will determine whether you require surgery, nonsurgical treatment options, or a combination of both. If youre a candidate for bladder cancer surgery, nephroureterectomy is one of the most common procedures. During surgery, the affected kidney, ureter, and surrounding bladder tissue are removed to eliminate cancer cells. Segmental resection is also common, as it removes the portion of the ureter that contains cancer. If your cancer has spread outside the renal pelvis and ureter, your doctor will discuss additional surgical options specific to the site of your cancer.

Several nonsurgical treatment options are often used in conjunction with surgery or independently. These include chemotherapy, immunotherapy, targeted therapy, and more. You may also be eligible for clinical trials that test the efficacy of new treatment methods and medications for transitional cell carcinoma.

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Citation Doi And Article Data

Citation:DOI:Assoc Prof Frank GaillardRevisions:see full revision historySystems:

• TCC of the urinary tract
• Urinary tract TCC
• Urinary tract transitional cell carcinoma
• Urothelial cell carcinoma

Transitional cell carcinoma , also called urothelial cell carcinoma , is the most common primary malignancy of the urinary tract and may be found along its entire length, from the renal pelvis to the bladder.

As imaging findings and treatment vary according to where along the urinary tract the tumor arises, each location is discussed separately.

The remainder of this article concerns itself with a general discussion of transitional cell carcinomas.

Causes Of Transitional Cell Carcinoma

The exact cause of TCC is not known. Genetics likely plays a role as several breeds have a much higher risk of developing TCC than other dogs. Environmental factors such as exposure to lawn pesticides or herbicides and insecticides found in some flea control products are linked to the development of TCC. Also, the chemotherapy drug cyclophosphamide is known to cause TCC.

A link between second-hand smoke and the development of TCC in dogs may warrant further study as smoking is the greatest cause of TCC in humans. Female dogs have a tendency to develop TCC more than males and some vets speculate this is because females dont mark their territory like males do hence storing urinary toxins longer.

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Transitional Cell Carcinoma Diagnosis

Your oncologist may use one or more of the following tests to diagnose TCC:

• Physical exam – your doctor will perform a complete physical exam including asking questions about your health history and related risk factors.
• Biopsy – in this test, your doctor removes a biopsy from your renal pelvis or ureter. Lab specialists closely examine the tissue sample checking for abnormalities.
• Computerized tomography scan – your doctor may order a CT scan of your kidneys and bladder. This specialized imaging test uses a series of X-ray images to create detailed images of the inside of your body.
• Intravenous pyelogram – this test checks the flow of fluid from the kidneys to the bladder. Your doctor can use IVP results to determine if your body is handling urine correctly.
• Magnetic resonance imaging – this imaging test uses magnets and computer-generated radio waves to create detailed images of the inside of your body.
• Ultrasound – your doctor may order an ultrasound, an imaging test that uses sound waves to create detailed images of your abdomen.
• Ureteroscopy – this procedure examines the inside of the ureter and renal pelvis to check for abnormal areas. Your doctor will use a ureteroscope inserted through the urethra into the bladder, ureter and renal pelvis.
• Urinalysis – your doctor may order this test, which checks a sample of your urine for abnormal levels of blood, protein or bacteria within it. These can be signs of problems with your bladder, kidneys or ureters.

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