Is it a case for chemoablation?
These potential Jelmyto candidates present with a range of characteristics and histories.
Ted, 55 years old, reported hematuria and flank pain. Urinalysis ruled out urinary tract infection. Cystoscopy ruled out bladder cancer.
Retrograde urography showed a large filling defect, and CT scan showed 2 endoscopically unresectable papillary tumors in the lower pole of the left renal pelvis. Ureteropyeloscopy and biopsy confirmed low-grade UTUC.
Father of 2 school-aged children, Ted is scared to lose a kidney. He prefers a noninvasive procedure that will not require extensive recovery.
- Key treatment considerations:
- 2 kidneys
- Diameter of largest tumor: 15 mm
- 2 unresectable papillary tumors
- Comorbidities: Hypertension
- Treatment site: ASC
Sidney, a 71-year-old veteran, was treated with laser ablation for a low-grade papillary tumor in her left renal pelvis last year.
Four months ago, she reported flank pain on her left side. CT urogram showed a 12 mm and 5 mm papillary lesion in the mid-pole calyx of her left renal pelvis and a 0.5 mm ureteral tumor. A diagnostic ureteroscopy was performed and biopsy confirmed recurrence of low-grade UTUC.
Sidney has tried laser ablation before but has asked what else can be done to provide a durable treatment response.
- Key treatment considerations:
- 2 kidneys
- 3 resectable papillary tumors
- Diameter of largest tumor: 15 mm
- Comorbidities: Hyperlipidemia, obesity
- Treatment site: Clinic
Mia is a 76-year-old grandmother with chronic kidney disease and a history of bladder cancer.
One year after endoscopic treatment, Mia had a recurrence in the upper tract with a low-grade papillary tumor of 3 mm in the upper pole calyx of her left kidney. She was treated with ablation but developed postoperative vomiting from general anesthesia and a painful urinary tract infection.
Within 8 months, Mia’s CT scan showed a new, low-grade, resectable papillary tumor in the mid-portion of her right kidney.
With her age and comorbid conditions, RNU could put her future health at risk.2
- Key treatment considerations:
- 2 kidneys
- 1 resectable papillary tumor
- Diameter of tumor: 12 mm
- Comorbidities: CKD, hyperlipidemia
- Treatment site: Hospital
Jonathan is 67 years old and newly retired. Two years ago, he was treated with endoscopic ablation for low-grade UTUC in his right kidney.
A recent MRI urogram demonstrated an enhancing soft tissue lesion in the right upper pole calyx and 3 smaller tumors throughout the renal pelvis of his left kidney. Two of these low-grade tumors were endoscopically unresectable.
Jonathan’s right kidney is currently being treated with ablation. He needs a treatment that can effectively address the unresectable tumors in his left kidney while taking both renal risk and upcoming travel plans into account.2
- Key treatment considerations:
- 2 kidneys
- > 3 papillary tumors, 2 unresectable
- Diameter of tumor: 12 mm
- Comorbidities: Hypertension
- Treatment site: Clinic

Does RNU have to be the next step for Ted’s unresectable primary disease?
Not an actual patient.Ted, 55 years old, reported hematuria and flank pain. Urinalysis ruled out urinary tract infection. Cystoscopy ruled out bladder cancer.
Retrograde urography showed a large filling defect, and CT scan showed 2 endoscopically unresectable papillary tumors in the lower pole of the left renal pelvis. Ureteropyeloscopy and biopsy confirmed low-grade UTUC.
Father of 2 school-aged children, Ted is scared to lose a kidney. He prefers a noninvasive procedure that will not require extensive recovery.
- Key treatment considerations:
- 2 kidneys
- Diameter of largest tumor: 15 mm
- 2 unresectable papillary tumors
- Comorbidities: Hypertension
- Treatment site: ASC