This information has been reviewed by:
Assoc. Prof. Ian Davis, MB BS (Hons) PhD FRACP FAChPM
Medical Oncologist, Austin Health, Associate Member, Ludwig Institute for Cancer Research
Doctors and other health professionals who treat kidney cancer
How kidney cancer is diagnosed
Computerised tomography (CT) scan
Magnetic resonance imaging (MRI)
Most kidney cancers are found when a doctor is checking for something else, because in its early stages kidney cancer often does not produce symptoms.
When they occur, symptoms of kidney cancer can include:
Most of these symptoms can be caused by other illnesses. However, if you have any of these symptoms, you must see your doctor.
Your doctor will examine you and refer you for tests to see if you have cancer. This can be a worrying and tiring time, especially if you need to have several tests.
If the tests show you have or may have cancer, your doctor will refer you to a specialist, who will advise you about treatment options. You should expect to be cared for by a team of health professionals from the relevant major fields listed below. Ideally, all your tests and treatment should be available at your hospital. This may not be possible in some non-metropolitan areas.
Specialists and other health professionals who care for people with kidney cancer include:
This section lists common tests for kidney cancer. You may have had some of them already.
In this test, sound waves are used to create a picture of your kidneys and organs nearby.
Before your test you may be asked to drink plenty of fluids so that your bladder is full and a clear picture can be seen. Once you are lying comfortably on your back, a gel is spread over your abdomen.
A small device, like a microphone, is passed over the area. It makes sound waves and receives echoes. A computer makes a picture of the echoes produced when the sound waves meet something dense, like an organ or tumour.
This test is painless and takes about 15 to 20 minutes.
This type of x-ray shows up abnormalities in the kidneys, bladder and the rest of the urinary system. An IVP can be done in a hospital x-ray unit or at a special clinic.
A dye is injected into a vein, usually in your arm. It goes through the bloodstream to the kidneys. The doctor can watch the dye move through the urinary system on an x-ray screen. The test can detect anything that isn't normal, like a tumour or kidney damage caused by a tumour.
The dye will probably make you feel hot and flushed for a few minutes, but this feeling will disappear. You may feel some discomfort in your abdomen, but this will only be for a short time. A belt is usually placed over your lower abdomen and tightened towards the end of the test. This is done to show if there are any problems with the way your bladder empties. There is a small chance of the injected dye causing an allergic reaction.
You should be able to go home as soon as the test is over. An IVP usually takes about an hour.
A chest x-ray uses low doses of radiation to check for abnormal areas in the chest. It takes only a few minutes and is painless and safe. If cancer has been diagnosed, a chest x-ray can show whether cancer has spread to your lungs or to the bones in your chest.
A CT scan is a type of x-ray that gives a picture of the organs and other structures (including any tumours) in your body.
CT scans are usually done at a hospital or a radiology clinic. It takes about 30 to 40 minutes to complete this painless test. You may be asked to not eat or drink for four hours before the scan.
You will have a liquid ‘contrast' dye before the scan, in a drink and in an injection. This helps outline the kidneys, ureters and bladder. You will be asked to lie on a table that slowly moves through the CT scanner, which is large and round like a doughnut. Most people are able to go home as soon as their scan is over.
There is a small possibility of the injected dye causing an allergic reaction. You should tell your doctor if you are allergic to iodine or to contrast dyes, or if you are diabetic or have abnormal kidney function.
This test is similar to a CT scan, but it uses magnetism instead of x-rays to build up pictures of your body. It may be able to provide more details than a CT scan. Like a CT scan, MRI is painless, and the magnetism is harmless.
You will be asked to lie still on a table inside a large metal tube, which is open at both ends. The test may take up to an hour.
The tube makes some people feel claustrophobic (afraid of being in a small space). If you think you are likely to feel this way, please tell the treatment centre in advance: you may be able to take someone into the room with you for support. The machine can be quite noisy. As the MRI scanner uses a powerful magnet, people with certain types of metal in their bodies should not have MRI scans. You should tell your doctor if you have any metal objects in your body (like a pacemaker), or clips from past operations, or (for example) if you have had injuries to the eyes or elsewhere caused by metal.
A radioisotope scan may be done to see if any cancer cells have spread beyond the kidney and into other places such as the bones. You will have a small amount of a radioactive substance injected into a vein, usually in your arm.
It is normal to wait for the dye to move through the body for a while before the images are taken. For a bone scan, this can take three to four hours. You will be scanned by a machine which detects tiny amounts of radioactivity.
The doctor can tell if the cancer has spread, as a larger amount of radioactivity is found in areas of bone affected by cancer cells. This causes a dark spot to appear on the bone scan. The scan is also used to see if your other kidney is healthy.
The amount of radiation used is small, and the radiation disappears from your body within a few hours. You will be advised to avoid contact with pregnant women and young children for the rest of the day, and drink plenty of fluids.
This procedure is not recommended for pregnant or breastfeeding women.
You may have a urine test to look for blood and signs of infection in your urine. A urine test can also sometimes find cancer cells from the kidney, ureter or bladder.
The doctor will ask for a blood sample to check your general health and blood count (the number of different blood cells in your blood). Too few or too many red blood cells can be a sign of kidney cancer. High levels of liver enzymes and changes in the chemicals and salts in the blood (such as calcium levels) can also be found in people with kidney cancer.
If you have blood in your urine, the doctor may recommend a cystoscopy.
The cystoscopy is done by a urologist. In many cases, it is done under local anaesthetic. The test is carried out using a small telescope called a cystoscope. This is gently passed through the urethra and into the bladder. Through the cystoscope, the doctor can examine the urethra and bladder. It may be possible to see where the bleeding is coming from.
The tests described on previous pages show whether you have cancer. They will also show where the primary cancer is and whether the cancer cells have spread to other parts of your body. This helps your doctors ‘stage' the disease so they can work out the best treatment for you.
The staging system used for kidney cancer is known as the ‘TNM system' (T=tumour, N=nodes, M=metastases).
Doctors combine this information to work out the stage of the cancer, from Stage 1 to Stage 4. For example, a cancer assessed as T1, N0, M0 (tumour contained within the kidney, lymph nodes not affected and no metastasis) would be called a Stage 1 cancer.
Your doctor may mention the ‘grade' of your cancer. This refers to its appearance under the microscope. A lower grade (for example, a Grade 1 cancer) is slower growing and less likely to spread. However, the grade of the cancer is not necessarily a very good predictor of how it will behave.
