Last updated: 17-Oct-2026
Tapping Book on WhatsApp will likely open the WhatsApp app on your phone.
Dr Swati Shah
MS, DrNB (Surgical Oncology)
Urology Cancer Surgeon
Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad · 18 years of experience
★★★★★ 4.99 from 84 Google reviews (Gota clinic) · 5.0 from 35 (Apollo, Bhat)
IN SHORT
Each test before treatment answers one question. Where is the tumour, is the bladder clear, how aggressive is it, and can the other kidney cope?
A CT urogram and a camera check of the bladder come first, in every patient. A plan made without both of them is a guess.
Kidney function is written down as a number before any operation. That number decides whether stronger chemotherapy will still be possible afterwards.
This page is one part of a larger guide. For how ureter and renal pelvis cancer is treated and why the whole ureter is removed, start with our nephroureterectomy guide.
This cancer is treated in one of two ways. Either the kidney is kept, or the kidney and the whole ureter are removed. The right path depends on results gathered before treatment. If a needed test is skipped, the wrong path can be chosen. If a test changes nothing, it only adds risk. So each test has a job, and a place in the order.
| Question | Test that answers it | Who has it |
|---|---|---|
| Where is the tumour, how many are there, and how big? | CT urogram. | Every patient, first. |
| Is there a tumour in the bladder too? | Cystoscopy. | Every patient, before any treatment higher up. |
| How aggressive are the cells? | Urine cytology. Sometimes a biopsy by ureteroscopy. | Cytology for all. A biopsy only when it can change the plan. |
| Can the other kidney manage alone? | Creatinine and eGFR. A renogram if needed. | Blood tests for all. A renogram when the other kidney looks weak. |
| Has it reached the chest? | CT scan of the chest. | When the tumour looks high-risk. |
| Could it run in the family? | A Lynch syndrome test on the tumour, and three questions. | Every patient. |
A CT urogram is a contrast CT scan with a late phase. The dye fills the urine channels and outlines the tumour from inside.
It is the reference test for this cancer. Bring the images themselves, not only the printed report. A useful report answers these points:
The bladder has the same lining as the ureter. A tumour can grow in both places at the same time. So a cystoscopy is done in every patient, before any treatment higher up. A thin camera passes into the bladder through the urine passage. If a bladder tumour is found, it becomes part of the same plan. In men with abnormal urine cells, the part of the urine passage inside the prostate is also checked.
Urine cytology looks for cancer cells in the urine. High-grade cells with a normal bladder point to a high-risk tumour higher up.
Urine passed in the normal way is tested first. Sometimes urine is also collected straight from the affected ureter during a camera test. That sample shows what is happening on that side alone. Low-grade and high-grade cells lead to different plans.
In ureteroscopy, a thin telescope is passed up the ureter under anaesthesia. A small piece of the tumour can be taken for testing. This gives a surer grade and helps sort the risk. But it has a known downside. After it, a new tumour appears in the bladder more often. Doctors do not yet agree that the test itself causes this.
| Needed when | Skipped when |
|---|---|
| Keeping the kidney is being considered. | The CT urogram and high-grade urine cells already show a high-risk tumour. |
| The diagnosis is truly in doubt. | Removing the kidney and ureter is already the agreed plan. |
When it is done, it is kept short and the channels are not over-stretched. A single dose of chemotherapy medicine is then put into the bladder.
Blood tests check creatinine and eGFR, the kidney function number. It is written clearly in your file before treatment. If one kidney is removed, this number falls afterwards. Stronger chemotherapy, called cisplatin, needs enough kidney function. Some people can have it before the operation but not after. So the number is recorded now and shared with the cancer medicine doctor before surgery.
If the other kidney looks weak, or kidney function is already low, a nuclear renogram is done. It shows how much work each kidney does. Blood count, liver tests and how active you are day to day are also noted.
This cancer can be the first sign of an inherited condition called Lynch syndrome. So every tumour is tested for it.
The tumour tissue is tested for four repair proteins, called MMR proteins. You are also asked about your age and about bowel, womb, stomach, ovary or small bowel cancer in you or a close relative. An abnormal result leads to a genetics referral. It can change the check-ups for your whole family, not just for you.
Infection behind a blocked kidney comes before every cancer test. Fever with chills and side pain needs the kidney drained first. When a tumour is suspected, a tube through the back, called a nephrostomy, is preferred over a stent inside the ureter. Heavy bleeding with clots that stops urine also needs care the same day.
All results are reviewed together by the cancer team before the first treatment. The tumour is then placed in a low-risk or a high-risk group.
The tests should not drag on. A wait of more than about 12 weeks from diagnosis to the main operation is linked with worse results. What the groups mean for treatment is explained on the nephroureterectomy page. Bring these to your first visit:
An ultrasound can show a swollen kidney, but not the lining of the urine channels well. The CT urogram is the reference test for this cancer.
No. It is needed when keeping the kidney is planned or the diagnosis is unclear. If the scan and urine cells already show a high-risk tumour, it is skipped.
The bladder has the same lining and can carry a tumour at the same time. It is checked in every patient before any treatment.
Removing a kidney lowers kidney function. The number before surgery tells the team whether cisplatin chemotherapy may still be possible afterwards.
This cancer can be linked to Lynch syndrome. Finding it changes the check-ups for your relatives as well as for you.
Treatment choices are explained on the nephroureterectomy page. The early signs are covered on the ureter cancer signs page. For questions before you travel, call +91-63590-11009.
Shah’s Gastro, Cancer & Robotic Surgery Centre
Dr Swati Shah — MS, DrNB (Surgical Oncology) · Urology Cancer Surgeon
Consultation: Gota OPD, Gota, Ahmedabad. Surgery: Apollo Hospital, Bhat, Gandhinagar.
Gota OPD — Gota, Ahmedabad, Gujarat
Apollo Hospital, Bhat, Gandhinagar — Apollo Hospital International Limited, Plot No. 1 A, GIDC Bhat Industrial Estate, Bhat, Gandhinagar, Gujarat
Call: +91-63590-11009 · WhatsApp: +91-63590-11009
Told you have a growth in the ureter or the kidney's drainage space? Bring the CT urogram report and urine reports to the consultation. Which tests are still missing is decided at the consultation. Call +91-63590-11009 Bring your reports to the visit
Tapping Book on WhatsApp will likely open the WhatsApp app on your phone.
Swasth Parivar: every week, practical advice on recovery, diet and warning signs. No advertising. Stop any time.
Your number is used for these updates and for the clinic to reach you. It is never sold or passed on. To stop, reply STOP on WhatsApp.
