Invasive urothelial carcinoma (papillary)

Hello kakily,

Thanks for getting in touch. My name is Megan, I’m one of the Cancer Information Nurses on the Macmillan Support Line.

Welcome to the online community. I can see you have joined the ‘Carers only forum’ and hope you have been finding it supportive.

I was glad to read that your family members primary treatment had been successful in removing all the cancer and would like to wish them best for their continued recovery.

This is a good question and I hope I will be able to answer in a way that is understandable as it is a complex subject.

Urothelial cancer usually refers to and is the most common form of bladder cancer. This is because urothelial cells line the urinary tract which includes the urethra, bladder, ureters, and internal lining of the kidney, known as the renal pelvis.

But the kidney itself is different as it is made of renal cells. This is important because someone who has Upper urinary tract urothelial cancer will be on a different cancer care pathway to someone who has kidney cancer (renal cell cancer).  

This may offer reason as to why it has been difficult to come across information, as most information and resources available do highlight the bladder as the main organ affected by urothelial cancer.

When urothelial cancer is present further up the urinary tract there is always a concern that microscopic urothelial cancer cells, too small to be detected on any test or scan, could have potentially washed down from the renal pelvis and ureters and imbedded themselves into the urothelial lining of the bladder, possibly causing a recurrence in time. This is why adjuvant chemotherapy is often offered after surgery.

Surgery is often acknowledged to be a localised treatment, whereas theoretically chemotherapy treats the whole body. The hope is that if there would be any errant urothelial cancer cells remaining anywhere in the urinary tract these would be treated by the chemotherapy.

Invasive urothelial carcinoma (papillary) may also be referred to as high grade papillary urothelial carcinoma. This is referring to the grade of cancer which is how the cancer cells look under the microscope and are likely to behave.

In answer to your question yes you can have an invasive cancer that is localised.

In urothelial cancer care the word invasive can be used in different ways. Both referring to whether a urothelial cancer has invaded the muscle (usually a term used in bladder cancer). But also, in how the cells appear under the microscope, referring to their grade.

From the information you provided I believe the word invasive is referring to the grade of the urothelial cancer cells. However, as we are a charity and do not have access to healthcare records or systems, it would be best for your family member to clarify this with their clinical team.

You may also be interested in joining our ‘Bladder cancer forum’ and also exploring the resources and support available from Fight Bladder Cancer and Action Bladder Cancer UK.

I hope this information is useful. Please don’t hesitate to get back in contact by email, webchat or phone, if you need further information or support.

The Macmillan Support Line offers practical, clinical, financial and emotional support. You can call us free from landlines and from most mobile phone networks on 0808 808 00 00, 7 days a week, 8am – 8pm.

Best wishes, Megan

Cancer Information Nurse Specialist 

Ref MD/GHi