The so called transitional cell carcinoma of the kidney (TCC), also referred to as renal urothelial carcinoma (UC), is the least common form of kidney cancer. It only accounts for approximately seven percent of all kidney cancer diagnoses.

The cure rates for transitional cell carcinoma are roughly 90% as long as the cancer is confined to the center of the kidney, also know as  renal pelvis. However, and like many other malignant diseases, the cure rates decrease drastically once the cancer has spread and in cases of TCC the numbers to down to 10 percent.



(Transitional Cell Carcinoma of the Kidney, Photo Credit pathconsultddx.com)


What are the causes of transitional cell carcinoma?

TCC is defined by different cell structures that are connected to each other. Transitional cell carcinoma originates in the renal pelvis lining, the bladder or the ureter. The causes of kidney cancer are not known. At this point there is simply not enough data available to conclusively link back the development of this diseases to concrete causes, however, there are a number of risk factors of transitional cell carcinoma which have been identified:
  • Age: The vast majority of new cases of transitional cell carcinoma is diagnosed in patients at the age of 60 to 70 years.
  • Ethnicity: Caucasians are more likely to develop TCC than any other ethnic group.Exposure to chemicals and toxins, including asbestos:
  • Exposure certain materials have been linked to an increased risk of developing TCC, such as asbestos fibers, textiles, rubbers, plastics.
  • Gender: Males are three times more likely to get TCC than women.
  • Medication Abuse: For instance, the abuse of medicines and over the counter drugs fro a prolonged time.
  • Smoking.
What are the symptoms Transitional Cell Carcinoma?

The symptoms of transitional cell carcinoma may lay dormant for years or even decades. This is yet again a typical aspect that the various forms of kidney cancers have in common. But as the mass grows they become more apparent. Those symptoms include:

  • Pain in the flanks, which occurs in 20 to 50 percent of all cases
  • Blood in the urine. This is also known as Hematuria.

How is the diagnosis of Transitional Cell Carcinoma done?

There are different test that an oncologist can use in order to diagnose TCC:

  • CT-Scans and Ultrasounds. These tests are used to get a better idea of the location of the tumor and create a visual image of the situation, in other words, the size of the mass and if there is anything else suspicious going on.
  • Urine Test. This is also called a urine cytology, which is essentially a lab test in order to detect cancer cells in the urine. However, it is important to understand that even if this test comes back clear - which was the case for me - that does not automatically mean that you don't have cancer. Further testing will be necessary, however, it is usually a good sign in general and an indication that most likely the cancer hasn't spread yet.
  • Ureteroscopy. A small tube is being inserted through the ureter to visually exam the bladder, ureter and pelvis. NO FUN, believe me. They knocked me out for that and I was very grateful that they did.

The Treatment of Transitional Cell Carcinoma

There is basically only one traditional treatment option for transitional cell carcinoma in its early stage and that is surgery.

Usually, a nephrectomy is being performed. A radical nephrectomy is the surgical removal of the kidney. If parts of the kidney can be saved, a partial nephrectomy is the preferred option. Nowadays, this procedure can be done with the help of a robot that is being controlled by a surgeon. This procedure is called laparoscopy significantly less invasive and allows the patients to recover quickly. I had a laparoscopic radical nephrectomy and done I was released from the hospital one day after the procedure.

New Treatment Options for Transitional Cell Carcinoma

Currently, there are numerous clinical trials undergoing to try out new treatments for TCC.

  • Laser Assisted Surgery: A laser device is being used to cut out or destroy cancerous cells.
  • Fulguration: A device that uses an electric current to burn out the tumor.
  • Regional Chemotherapy in combination with Biologic Therapy: A combination of certain drugs is being administered to reduce the growth of the tumor. Unlike conventional chemotherapy, these drugs are being directly placed into the affected area, and therefore have less of a negative effect on the patient;s immune system.