Kidney Cancer Diagnosis

To diagnosis kidney cancer after discussing your medical history, symptoms, risk factors, and family history, your doctor will perform one or more of these tests.

A kidney cancer diagnosis starts with a discussion of your medical history, your symptoms, risk factors, and family history of disease. You will give blood and urine and have a physical exam, checking for lumps in your abdomen, side, and back.

Because the kidneys are deep inside your body, however, small tumors won’t be apparent in that exam. Kidney cancers can grow large without causing any pain or other symptoms.

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Unlike most types of cancer, kidney cancer can often be diagnosed from imaging tests without a biopsy. A biopsy is when small pieces of tissue are taken from the tumor and looked at with a microscope. The diagnostic process may begin with one or more of the tests described below.

Urine tests

About half of all people with kidney cancer have blood in their urine, which is apparent in a urinalysis. But many conditions, including kidney stones, can cause blood in your urine.

Another test, a urine cytology, checks for cancer cells.

Blood tests

No blood test can diagnose kidney cancer. But a complete blood count (or CBC) and blood chemistry test can show signs in your blood that are linked with kidney cancer.

For example:             

• Too few red blood cells. This condition is called anemia. It is common in many kinds of cancer. 
• Too many red blood cells. This condition is called erythrocytosis or polycythemia. Some types of kidney cancer cells make a hormone called erythropoietin. This causes bone marrow to make too many blood cells.
• A high blood calcium level. This may show that the cancer has begun to affect your bones.  
• A high level of liver enzymes. This may be a sign that the cancer has spread to your liver.

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Imaging tests take pictures of the inside of your body to see what areas may have cancerous cells.  

CT scan

A CT scan is the most common type of imaging for investigating kidney cancer. It uses a series of x-rays and a computer to create detailed images of the inside of your body. This test can confirm a diagnosis of kidney cancer.

During the test, you lie still on a table as it slides into a CT scanner. A CT scan is painless. You may be asked to hold your breath one or more times during the scan.

In some cases, you will be asked to drink a contrast dye 4 to 6 hours before the scan. Then you may be asked to avoid eating until a second set of pictures is taken. The dye will pass through your body and exit through your bowel movements.

The dye may be injected into your vein as well. When the dye is injected, you may have a warm feeling from your chest to your groin.

Speak up if you have ever had a reaction to contrast dye, including hives, trouble breathing, or becoming suddenly hot. You can take special medicines before the test to help prevent those reactions. 

Angiography

Angiography also uses dye and x-rays to look at kidneys. In an angiogram, a catheter is inserted into an artery that goes to your kidney to inject the dye to that area.  

The test helps show the blood vessels and reveals which blood vessels are sending blood to tumors. This test can also help determine whether the tumor can be removed with surgery.

MRI

An MRI uses radio waves, large magnets, and a computer to create detailed images of your body. An MRI can show whether cancer has spread to your spine or brain.

During the test, you lie still on a table as it passes into a scanner tube. If you are claustrophobic, you may receive a sedative before the test. The scanner takes up to 15 minutes to create an image. You may need more than one set of images. The test may last an hour or more.

An MRI test is painless but noisy. You can wear earphones and an MP3 device, or you can ask for earplugs.

Ultrasound

An ultrasound uses sound waves to create images on a computer screen. A gel is put on the skin of your lower back. A technician uses a wand called a transducer to press on the skin above your kidneys. This test can help show if a kidney tumor is a fluid-filled sac (cyst) or a solid tumor. A solid tumor is more likely to be cancer.

Intravenous pyelogram (or IVP) is less commonly used today, but it is still sometimes helpful. It involves contrast dye and x-rays.

Sometimes, your healthcare team may decide to do a biopsy, to study a piece of tissue from a growth in your kidney.

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