Tests for Kidney Cancer | Kidney Cancer Diagnosis (2022)

Kidney cancer might be found because of signs or symptoms a person is having, or it might be found because of lab tests or imaging tests a person is getting for another reason. The actual diagnosis of kidney cancer is made by looking at a sample of kidney cells in the lab or sometimes by how the kidney looks on an imaging test. If you think you have possible signs or symptoms of kidney cancer, see your doctor.

Medical history and physical exam

If you have any signs or symptoms that suggest you might have kidney cancer, your doctor will want to take your complete medical history to check for risk factors and to learn more about your symptoms.

A physical exam can provide information about signs of kidney cancer and other health problems. For example, the doctor may be able to feel an abnormal mass (lump) when they examine your abdomen (belly).

If symptoms or the results of the physical exam suggest you might have kidney cancer, more tests will probably be done. These might include lab tests,imaging tests, or biopsies of the kidney.

Blood tests

Lab tests cannot show for sure if a person has kidney cancer, but they can sometimes give the first hint that there may be a kidney problem. If cancer has already been diagnosed, they are also done to get a sense of a person’s overall health and to help tell if the cancer might have spread to other areas. They also can help show if a person is healthy enough to have an operation.

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Special tests are done on a urine sample to look for small amounts of blood and other substances not seen with the naked eye. About half of all patients with renal cell cancer will have blood in their urine. If the patient has transitional cell carcinoma (in the renal pelvis, the ureter, or the bladder), sometimes a special test of the urine sample (called urine cytology) will show actual cancer cells in the urine.

Complete blood count (CBC): This is a test that measures the number of different cells in the blood. This test result is often abnormal in people with kidney cancer. Anemia (having too few red blood cells) is very common. Less often, a person may have too many red blood cells (called polycythemia) because the kidney cancer cells make a hormone (erythropoietin) that causes the bone marrow to make more red blood cells. Blood counts are also important to make sure a person is healthy enough for surgery.

Blood chemistry tests: These tests are usually done in people who might have kidney cancer, because the cancer can affect the levels of certain chemicals in the blood. For example, high levels of liver enzymes are sometimes found. High blood calcium levels may be found which might lead to more imaging tests. Blood chemistry tests also measure kidney function, which is especially important if certain imaging tests or if surgery is planned.

Urinalysis (urine testing)

This test of your urine may be done if your doctor suspects a kidney problem.

Imaging tests to look for kidney cancer

Imaging tests use x-rays, magnetic fields, sound waves, or radioactive substances to create pictures of the inside of your body. Imaging tests are done for a number of reasons, such as:

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  • To look at suspicious areas that might be cancer
  • To learn how far cancer might have spread
  • To help determine if treatment is working
  • To look for possible signs of cancer coming back after treatment

Unlike most other cancers, doctors can often diagnose kidney cancer with fair certainty based on imaging tests without doing a biopsy (removing a sample of the tumor). Some patients, however, may need a biopsy.

Computed tomography (CT) scan

The CT scan uses x-rays to make detailed cross-sectional images of your body. It can provide precise information about the size, shape, and location of a tumor. It is also useful in checking to see if a cancer has spread to nearby lymph nodes or to organs and tissues outside the kidney.

CT-guided needle biopsy:If a kidney biopsy is needed, this test can also be used to guide a biopsy needle into the mass (lump) to get a sample to check for cancer.

When a CT is done to look at the kidneys, an IV (intravenous) contrast dye is often needed to make certain areas stand out better on the scan. This CT contrast can damage the kidneys. This happens more often in patients whose kidneys are not working well in the first place. Because of this, your kidney function will be checked with a blood test before you get IV contrast.

Magnetic resonance imaging (MRI) scan

MRI scansmay be done when a person can’t have the CT contrast dye because they have an allergy to it or they don’t have good kidney function. MRI scans may also be done if there’s a chance that the cancer has grown into major blood vessels in the abdomen (like the inferior vena cava), because they provide a better picture of blood vessels than CT scans. Finally, they may be used to look at abnormal areas in the brain and spinal cord that might be due to cancer spread.

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Ultrasound

Ultrasound can help find a kidney mass and show if it is solid or filled with fluid (kidney tumors are more likely to be solid). Different ultrasound patterns can also help doctors tell the difference between some types of benign and malignant kidney tumors.

If a kidney biopsy is needed, this test can also be used to guide a biopsy needle into the mass to take a sample.

Angiography

Angiography is an x-ray test that looksat blood vessels. In traditional angiography, a contrast dye is injected into the renal artery, and the dye outlines the blood vessels. X-rays are taken to identify and map the blood vessels that feed a kidney tumor.

This test can help in planning surgery for some patients. Angiography can also help diagnose renal cancers since the blood vessels usually have a special appearance with this test.

Nowadays, angiography is done as a part of a CT or MRI scan , instead of as a separate x-ray test. This means less contrast dye is used, which is helpful since the dye can damage kidney function.

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Chest x-ray

An x-ray may be done after kidney cancer has been diagnosed to see if cancer has spread to the lungs. More often though, a CT chest is done because it can see abnormal areas better.

Bone scan

A bone scan can help show if a cancer has spread to your bones. A small amount of low-level radioactive material is injected into the blood and collects mainly in abnormal areas of bone.It might be done if there is reason to think the cancer might have spread to the bones such as bone pain or blood test results showing an increased calcium level.

Kidney biopsy

Unlike with most other types of cancer, biopsies are sometimes not needed to diagnose kidney tumors. In certain cases, imaging tests can provide enough information for a surgeon to decide if an operation is needed. The diagnosis is then confirmed when part of the kidney that was removed is looked at in the lab.

Abiopsy might be done to get a small sample of tissue from an area that may be cancer when the imaging tests are not clear enough to permit surgery. Biopsy may also be done to confirm cancer if a person might not be treated with surgery, such as with small tumors that will be watched and not treated, or when other treatments are being considered.

Fine needle aspiration (FNA) and needle core biopsyare 2 types of kidney biopsies that may be done.

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In cases where the doctors think kidney cancer might have spread to other sites, they may take a biopsy of the metastatic site instead of the kidney.

Biopsy results

The biopsy samples are sent to a lab, where they are looked at by a pathologist, a doctor who specializes in diagnosing diseases with lab tests. If kidney cancer is found, an important feature that is evaluated is the grade, specifically called the Fuhrman grade.

The Fuhrman grade is found by looking at kidney cancer cells in the lab. Many doctors use it to describe how quickly the cancer is likely to grow and spread. The grade is based on how closely the cancer cells look like those of normal kidney cells. Renal cell cancers are usually graded on a scale of 1 through 4. Grade 1 renal cell cancers have cells that look a lot like normal kidney cells. These cancers usually grow and spread slowly and tend to have a good prognosis (outlook). At the other extreme, grade 4 renal cell cancer looks quite different from normal kidney cells. These cancers tend to have a worse prognosis.

FAQs

What is the best test to detect kidney cancer? ›

Percutaneous Biopsy

CT and MRI scans are usually the only tests doctors need to diagnose kidney cancer. Sometimes, though, doctors perform what's known as a percutaneous biopsy if they need more information about a tumor before making a treatment recommendation.

How does kidney cancer get diagnosed? ›

The actual diagnosis of kidney cancer is made by looking at a sample of kidney cells in the lab or sometimes by how the kidney looks on an imaging test. If you think you have possible signs or symptoms of kidney cancer, see your doctor.

What blood tests indicate kidney cancer? ›

CBC. It's common for people with kidney cancer to have fewer red blood cells than is considered to be healthy (anemia) or, rarely, more red blood cells than is considered to be healthy (polycythemia) due to abnormal kidney function. Either of these results indicates the need for further testing. Blood chemistry test.

Can a urinalysis detect kidney cancer? ›

A urine test may be recommended to look for blood, bacteria, or cancer cells. These tests may suggest that kidney cancer is present, but they cannot be used to make a definite diagnosis.

What are the early signs of kidney cancer? ›

Kidney Cancer Signs and Symptoms
  • Blood in the urine (hematuria)
  • Low back pain on one side (not caused by injury)
  • A mass (lump) on the side or lower back.
  • Fatigue (tiredness)
  • Loss of appetite.
  • Weight loss not caused by dieting.
  • Fever that is not caused by an infection and that doesn't go away.

Does kidney cancer show up on CT scan? ›

Unlike other forms of cancer, kidney cancer may be reliably diagnosed by using a computed tomography (CT) scan without necessarily having to do a biopsy first. A CT scan for kidney cancer is a potentially lifesaving measure that may detect cancer as early as possible so you can begin treatment.

Can you see kidney cancer on an xray? ›

Computed tomography (CT) scans help us diagnose kidney cancer, especially if we notice a mass, either by physical examination or on an X-ray.

Can an ultrasound detect cancer in kidney? ›

Imaging tests such as computed tomography (CT) scans and magnetic resonance imaging (MRI) scans can often find small kidney cancers, but these tests are expensive. Ultrasound is less expensive and can also detect some early kidney cancers.

Does kidney cancer spread fast? ›

“Low grades of kidney cancer tend to be slow-growing, while high grades can multiply fast. The other types that are found to be more aggressive are papillary (types 1 & 2), chromophobe, medullary and oncocytic.”

Does kidney cancer show protein in urine? ›

Morrissey, PhD, have developed a noninvasive method to screen for kidney cancer by measuring the presence of proteins in the urine. If kidney cancer is diagnosed early — before it spreads — 80 percent of patients survive. However, finding it early has been among the disease's greatest challenges.

Can a full blood count detect cancer? ›

A complete blood count (CBC) is a common blood test that your doctor may recommend to: Help diagnose some blood cancers, such as leukemia and lymphoma. Find out if cancer has spread to the bone marrow. See how a person's body is handling cancer treatment.

Can blood tests show signs of cancer? ›

Samples taken for cancer blood tests are tested in a lab for signs of cancer. When viewed under a microscope, the samples may show the actual cancer cells. Other blood tests might find proteins or other substances made by the cancer. Blood tests can also tell your provider how well your organs are working.

What can be mistaken for kidney cancer? ›

Half of all patients with kidney cancer are initially misdiagnosed, data from Kidney Cancer UK's patient survey has revealed. In 45% of patients surveyed the disease was first mistaken for less serious conditions such as a urine infection, kidney stones or respiratory problems, the charity said.

Where does kidney cancer usually start? ›

Renal cell carcinoma

RCC usually starts in the lining of tiny tubes in the kidney called renal tubules. RCC often stays in the kidney, but it can spread to other parts of the body, most often the bones, lungs, or brain.

What is the most common cause of kidney cancer? ›

The exact causes of kidney cancer, like many other cancers, are not known. However, we do know that certain things can increase your chances of developing kidney cancer. Older age, smoking, obesity, high blood pressure, long-term dialysis, and a family history of kidney cancer can all increase your risk.

What is life expectancy with kidney cancer? ›

5-year relative survival rates for kidney cancer
SEER stage5-year relative survival rate
Localized93%
Regional71%
Distant14%
All SEER stages combined76%
1 Mar 2022

How fast does a kidney cancer tumor grow? ›

The average growth rate in most studies has been observed at 0.3 cm/year.

Do you get pain with kidney cancer? ›

Symptoms of kidney cancer

If there are symptoms, they can include: blood in your pee – you may notice your pee is darker than usual or reddish in colour. a persistent pain in your lower back or side, just below your ribs. a lump or swelling in your side (although kidney cancer is often too small to feel)

What is kidney cancer pain like? ›

It can feel like pressure, a dull ache or a sharp pain. See a doctor if you have any kind of sudden, persistent pain lasting more than a few days.

Can cancer be diagnosed without a biopsy? ›

The doctor also may order lab tests, imaging tests (scans), or other tests or procedures. You may also need a biopsy, which is often the only way to tell for sure if you have cancer. This page covers tests that are often used to help diagnose cancer. Depending on the symptoms you have, you may have other tests, too.

Is kidney cancer curable? ›

Renal cell cancer, also called renal adenocarcinoma or hypernephroma, can often be cured if it is diagnosed and treated when still localized to the kidney and the immediately surrounding tissue. The probability of cure is directly related to the stage or degree of tumor dissemination.

How common is cancer of the kidney? ›

Kidney cancer is among the 10 most common cancers in both men and women. Overall, the lifetime risk for developing kidney cancer in men is about 1 in 46 (2.02%). The lifetime risk for women is about 1 in 80 (1.03%). A number of factors (described in Risk Factors for Kidney Cancer) also affect a person's risk.

What percentage of renal masses are cancerous? ›

About 20-30% of "suspicious" kidney tumors when removed prove to be benign! These benign growths include cysts, oncocytomas, angiomyolipomas, and mixed epithelial stromal tumors. Thus, 70-80% of these "small" kidney tumors are cancers and fortunately the majority are "well behaved" (low grade) cancers.

Does kidney cancer affect creatinine levels? ›

Blood urea nitrogen (BUN) and creatinine may be measured to check how well the kidneys are working. Higher levels could mean that the kidneys are not working well, which could be because of cancer.

Is kidney cancer a terminal? ›

Unfortunately, sometimes kidney cancer can't be cured. But specialists are getting better at helping patients to live longer after their diagnosis. Cancer can be life threatening because it can spread.

What are the signs kidney cancer has spread? ›

Symptoms of metastatic renal cell carcinoma

blood in the urine. pain on one side of the lower back. lump in the back or side. weight loss.

Can you live a long life after kidney cancer? ›

Survival for all stages of kidney cancer

around 65 out of every 100 (around 65%) survive their cancer for 5 years or more after they are diagnosed. more than 50 out of every 100 (more than 50%) survive their cancer for 10 years or more after they are diagnosed.

Will cancer show up on blood tests? ›

Samples taken for cancer blood tests are tested in a lab for signs of cancer. When viewed under a microscope, the samples may show the actual cancer cells. Other blood tests might find proteins or other substances made by the cancer. Blood tests can also tell your provider how well your organs are working.

What is kidney cancer pain like? ›

It can feel like pressure, a dull ache or a sharp pain. See a doctor if you have any kind of sudden, persistent pain lasting more than a few days.

Can ultrasound detect Bladdercancer? ›

How do ultrasounds help detect and monitor bladder cancer? An ultrasound of the urinary tract can help assess the size of a bladder tumor and whether a bladder cancer has spread. Ultrasound is able to differentiate between fluid-filled cysts and solid tumors, however, it cannot determine if a tumor is cancerous.

Does kidney cancer spread fast? ›

“Low grades of kidney cancer tend to be slow-growing, while high grades can multiply fast. The other types that are found to be more aggressive are papillary (types 1 & 2), chromophobe, medullary and oncocytic.”

What is the 2 week rule? ›

The Two-Week Wait appointment system was introduced so that anyone with symptoms that might indicate cancer could be seen by a specialist as quickly as possible. Attending this appointment within two weeks is vitally important and will allow you to benefit from: Early reassurance that cancer has not been diagnosed or.

What cancer Cannot be detected by blood tests? ›

Aside from leukemia, most cancers cannot be detected in routine blood work, such as a CBC test. However, specific blood tests are designed to identify tumor markers, which are chemicals and proteins that may be found in the blood in higher quantities than normal when cancer is present.

Can a CBC indicate cancer? ›

However, there are more suspicious diseases that can be detected using a complete count CBC. This may include cancers of the breast, stomach, ovaries, and several other types. Meanwhile, this must be kept in mind that CBC is not the complete test to diagnose the specific type of cancer.

Where does kidney cancer usually start? ›

Renal cell carcinoma

RCC usually starts in the lining of tiny tubes in the kidney called renal tubules. RCC often stays in the kidney, but it can spread to other parts of the body, most often the bones, lungs, or brain.

Where does your back hurt with kidney cancer? ›

Where is back pain if it is due to kidney cancer? If a person has back pain caused by kidney cancer, they will usually feel it in the lower back, on one side, between the ribs and hips. A person will feel persistent pain that does not go away and is not due to an injury.

What is the most common cause of kidney cancer? ›

The exact causes of kidney cancer, like many other cancers, are not known. However, we do know that certain things can increase your chances of developing kidney cancer. Older age, smoking, obesity, high blood pressure, long-term dialysis, and a family history of kidney cancer can all increase your risk.

How painful is a cystoscopy? ›

People often worry that a cystoscopy will be painful, but it does not usually hurt. Tell your doctor or nurse if you feel any pain during it. It can be a bit uncomfortable and you may feel like you need to pee during the procedure, but this will only last a few minutes.

Is a CT scan better than a cystoscopy? ›

Diagnostic performance of CTU was compared with cystoscopy in 177 patients. CTU performed better with 96.3% sensitivity, 86.4% specificity, 92.8% diagnostic accuracy, 92.9% PPV, and 92.7% NPV.

Why would a urologist order a CT scan? ›

A CT urogram is used to examine the kidneys, ureters and bladder. It lets your doctor see the size and shape of these structures to determine if they're working properly and to look for any signs of disease that may affect your urinary system.

What is the life expectancy of someone with kidney cancer? ›

5-year relative survival rates for kidney cancer
SEER stage5-year relative survival rate
Localized93%
Regional71%
Distant14%
All SEER stages combined76%
1 Mar 2022

Is kidney cancer a terminal? ›

Unfortunately, sometimes kidney cancer can't be cured. But specialists are getting better at helping patients to live longer after their diagnosis. Cancer can be life threatening because it can spread.

Is kidney cancer curable? ›

Renal cell cancer, also called renal adenocarcinoma or hypernephroma, can often be cured if it is diagnosed and treated when still localized to the kidney and the immediately surrounding tissue. The probability of cure is directly related to the stage or degree of tumor dissemination.

Videos

1. Kidney Cancer Symptoms and Treatment
(Keck Medicine of USC)
2. Should I get genetic testing for kidney cancer?
(Kidney Cancer Association)
3. Understanding a Diagnosis of Kidney Cancer
(KidneyCAN)
4. What Are Some Symptoms of Kidney Cancer?
(Roswell Park Comprehensive Cancer Center)
5. New kidney biopsy technique changes cancer diagnosis
(UCI Health)
6. The Kidney and Kidney Cancers | UCLA Urology
(UCLA Health)

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