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Tests and diagnosis
By Mayo Clinic staffA kidney cancer diagnosis typically begins with a complete medical history and a physical exam. Your doctor may also recommend blood and urine tests. If your doctor suspects a problem or if you're at high risk of kidney cancer, you may also have one or more of the following tests to check your kidneys for growths or tumors:
- Ultrasound. An ultrasound uses high-frequency sound waves to generate images of your internal organs, such as your kidneys and bladder, on a computer screen.
- Computerized tomography (CT) or magnetic resonance imaging (MRI) scan. CT scans use computers to create more-detailed images than those produced by conventional X-rays. MRI scans use magnetic fields and radio waves to generate cross-sectional pictures of your body.
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Tissue sample (biopsy). In selected cases, your doctor may recommend a procedure to remove a small sample of cells (biopsy) from a suspicious area of your kidney. During a biopsy, a surgeon uses ultrasound or CT images to guide a long, thin needle into your kidney to remove the cells. The cells are then examined under a microscope to determine whether they are cancer.
Biopsy procedures have risks, such as infection, bleeding and a very small chance that cancer could spread to the area where the needle is inserted. Because surgery is usually the first line treatment for kidney cancer, your doctor may forgo biopsy if he or she believes your tumor is very likely to be cancerous. That way you avoid the additional risks of a biopsy. Kidney biopsy is typically reserved for cases that are most likely to be noncancerous or for people who can't undergo an operation.
Additional tests for transitional cell cancer
Tests and procedures used to diagnose transitional cell kidney cancer may include:
- X-ray imaging of your urinary system (excretory urogram). X-rays of your urinary system may show signs of cancer. Your health care team will inject a dye into a vein in your arm. The dye is processed by your kidneys and your urinary system, and the dye makes it possible to see your urinary system on an X-ray.
- Looking inside your bladder (cystoscopy). Your doctor may use a long, narrow tube called a cystoscope to see the inside of your bladder. The cystoscope, which carries a light source and a special lens, is inserted through your urethra into your bladder. A cystoscope can also be used to extract a small tissue sample (biopsy) from any suspicious areas.
Kidney cancer staging
Once your doctor diagnoses kidney cancer, the next step is to determine the extent, or stage, of the cancer. Staging tests for kidney cancer may include additional CT scans, a chest X-ray or other imaging scans your doctor feels are appropriate.
Then your doctor assigns a number, called a stage, to your cancer. Kidney cancer stages include:
- I. Tumor is small and confined to the kidney
- II. Tumor is larger than a stage I tumor, and is confined to the kidney
- III. Tumor extends beyond the kidney to the surrounding tissue or the adrenal glands, and may also spread to a nearby lymph node
- IV. Cancer spreads outside the kidney or to distant parts of the body
