Ureteral cancer is cancer of the ureters, muscular tubes that propel urine from the kidneys to the urinary bladder. It is also known as ureter cancer, renal pelvic cancer, and rarely ureteric cancer or uretal cancer. Cancer in this location is rare. Ureteral cancer becomes more likely in older adults, usually ages 70–80, who have previously been diagnosed with bladder cancer. Ureteral cancer is usually a transitional cell carcinoma. Transitional cell carcinoma is "a common cause of ureter cancer and other urinary (renal pelvic) tract cancers." Because the inside of the ureters and the inside of the bladder contain the same cell type, people who have been diagnosed with ureteral cancer are more likely to also be diagnosed with bladder cancer, and vice versa. Ureteral cancer oftentimes doesn't present with any unusual symptoms until the cancer has progressed. Once the cancer has progressed it often causes hematuria, frequent urination, nocturia, and many other urination problems, as well as unusual weight loss and fatigue. It has not become clear to doctors what specifically causes this disease but there are many well known risk factors, many of which are common to a variety of cancers. A diagnosis can be made in different ways, but some of the most common diagnostic tools are intravenous pyelography and computed tomography urography. Once a diagnosis is made, there are many different treatment methods, which will be dependent upon the nature of the cancer and the patient's wishes. Symptoms Ureter cancer rarely causes problems in the early stages, but as the cancer progresses, there are often side effects. Symptoms of ureteral cancer may include "blood in the urine (hematuria); diminished urine stream and straining to void (caused by urethral stricture); frequent urination and increased nighttime urination (nocturia); hardening of tissue in the perineum, labia, or penis; itching; incontinence; pain during or after sexual intercourse (dyspareunia); painful urination (dysuria); recurrent urinary tract infection; urethral discharge and swelling". Other common symptoms associated with ureteral cancer may include back pain, unexplained weight loss, and unusual fatigue. Causes and risk factors The exact causes of ureteral cancer are not clear. However, it is known that patients with a history of bladder cancer are more likely to develop ureteral cancer because both cancers contain the same cell type. As with other cancers, the cells lining the ureter undergo a DNA mutation resulting in abnormal growth of cells without programmed cell death; this