What to expect from chemotherapy for upper tract urothelial cancer

Upper tract urothelial cancer begins in the lining of the renal pelvis or ureter. Chemotherapy may be considered before or after surgery, or when cancer needs treatment beyond the urinary tract. The choice of medicines depends on scan results, kidney function, hearing, nerve health, and general fitness. Treatment is commonly organised in cycles: an infusion or treatment period followed by time for the body to recover. Blood and urine tests help guide the next visit.

You may experience tiredness, nausea, appetite or taste changes, mouth soreness, constipation or diarrhoea, hair loss, or a temporary fall in blood cells. Some medicines can affect kidney function, hearing, or nerves. Hydration instructions are specific to your regimen, so follow your team’s advice rather than forcing extra fluids.

Bring a full list of medicines and tell the team about hearing changes, ringing in the ears, numbness, urinary changes, or previous kidney problems. Plan transport, rest, and help with household tasks. Eat what you can tolerate, use prescribed anti-sickness medicines as directed, and keep notes on urine output, temperature, bowel changes, and new symptoms. Check before using painkillers or supplements.

Contact the team urgently for fever or chills, very little urine, blood in the urine that is increasing, severe vomiting or diarrhoea, breathing difficulty, chest pain, confusion, or unusual bleeding. Report sudden hearing changes, worsening ringing, or new weakness or numbness. If you cannot keep fluids down or feel faint, seek same-day advice.

Ask how kidney function affects medicine choices, whether chemotherapy is before or after surgery, what hydration plan applies, which tests are needed before each cycle, how hearing and nerve symptoms will be monitored, and which after-hours number to use.