Former Secretary of State Warren Christopher succumbs to cancer

Alt Warren Christopher

Former Secretary of State Warren Christopher has died. The 85-year-old Medal of Freedom honoree was Secretary of State for the Clinton administration from 1993 to 1997, and is credited for helping to bring about peace in Bosnia, and in negotiation the release of hostages in Iran. According to his family, Christopher died from “complications of kidney and bladder cancer”.

None of the news reports about his death give any specifics about his cancer. Saying he had kidney and bladder cancer means one of three of options: 1. He had a bladder cancer that spread to his kidney, 2. He had a kidney cancer that spread to his bladder, 3. He had a cancer that can form in the tissues of both the bladder and kidney. This kind of cancer is called a transitional cell cancer. As we have already done stories about bladder cancer and kidney cancer, let’s spend a little time talking about transitional cell cancer.

What is transitional cell cancer?

Transitional cell cancer is a disease in which malignant (cancer) cells form in the renal pelvis and ureter.

The renal pelvis is part of the kidney and the ureter connects the kidney to the bladder. There are 2 kidneys, one on each side of the backbone, above the waist. The kidneys of an adult are about 5 inches long and 3 inches wide and are shaped like a kidney bean. The kidneys clean the blood and produce urine to rid the body of waste. The urine collects in the middle of each kidney in a large cavity called the renal pelvis. Urine drains from each kidney through a long tube called the ureter, into the bladder, where it is stored until it is passed from the body through the urethra.

The renal pelvis and ureters are lined with transitional cells. These cells can change shape and stretch without breaking apart. Transitional cell cancer starts in these cells. Transitional cell cancer can form in the renal pelvis or the ureter or both.

In the past, misuse of a certain pain medicine, called phenacetin, could affect the risk of developing transitional cell cancer of the renal pelvis and ureter. Phenacetin was removed from the U.S. market in 1983, and phenacetin-related urinary cancer has become vanishingly rare.

Risk factors include the following:

  • Misusing certain pain medicines, including over-the-counter pain medicines, for a long time.
  • Being exposed to certain dyes and chemicals used in making leather goods, textiles, plastics, and rubber.
  • Smoking cigarettes.

Possible signs of transitional cell cancer of the renal pelvis and ureter include blood in the urine and back pain.

These and other symptoms may be caused by transitional cell cancer of the renal pelvis and ureter. Other conditions may cause the same symptoms. There may be no symptoms in the early stages. Symptoms may appear as the tumor grows. A doctor should be consulted if any of the following problems occur:

  • Blood in the urine.
  • A pain in the back that doesn’t go away.
  • Extreme tiredness.
  • Weight loss with no known reason.
  • Painful or frequent urination.

Certain factors affect the chance of recovery and treatment options, most notably the stage and grade of the tumor.

The treatment options depend on the following:

  • The stage and grade of the tumor.
  • Where the tumor is.
  • Whether the patient’s other kidney is healthy.
  • Whether the cancer has recurred.

Most transitional cell cancer of the renal pelvis and ureter can be cured if found early.

For more information about transitional cell tumors, click here to go to the Resounding Health Casebook on the topic.

For the casebook on Bladder Cancer, click here.

For the casebook on Kidney Cancer, click here.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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