Kidney Cancer

If you have kidney cancer symptoms, your healthcare provider will perform a complete medical history and physical exam. They also may order certain tests that can help in diagnosing and assessing cancer. These tests may include:

• Urinalysis: A sample of your urine (pee) is tested to see if it contains blood. Even very small traces of blood, invisible to the naked eye, can be detected in tests of urine samples.
• Blood tests: These tests count the number of each of the different kinds of blood cells, as well as look at different electrolytes in your body. A blood test can show if there are too few red blood cells (anemia), or if your kidney function is impaired (by looking at the creatinine).
• CT scan: This is a special X-ray that uses a computer to create a series of images, or slices, of the inside of your body. This test is often done with intravenous contrast (dye). People with impaired kidney function may not be able to receive the dye.
• Magnetic resonance imaging (MRI): This is a test that produces images of the inside of your body using a large magnet, radio waves and a computer.
• Ultrasound: This test uses high-frequency sound waves that are transmitted through body tissues to create images that are displayed on a monitor. This test is helpful in detecting tumors, which have a different density from healthy tissues.
• Renal mass biopsy: During this procedure, a thin needle is inserted into the tumor, and a small sample of your tissue is removed (biopsy). A pathologist will look at the tissue under a microscope to see if there are any cancer cells. Because biopsies for kidney cancer aren’t always completely reliable, your healthcare provider may or may not recommend this test.

What are the kidney cancer stages?

Most cancers are grouped by stage, a description of cancer that aids in planning treatment. The stage of a cancer is based on:

• The location and size of the tumor.
• The extent to which your lymph nodes are affected.
• The degree to which the cancer spread, if at all, to other tissue and organs.

Your healthcare provider uses information from various tests, including CT, MRI and biopsy, to determine the stage of cancer.

• Stage I: The tumor is 7 centimeters (cm) across or smaller and is only in your kidney. It hasn’t spread to lymph nodes or other tissue. (Lymph nodes are small “filters” that trap germs and cancer cells and store infection-fighting cells.).
• Stage II: The tumor is larger than 7 cm across but is still only in your kidney. It hasn’t spread to lymph nodes or other tissue.
• Stage III: The tumor has spread to your major blood vessels — your renal vein and inferior vena cava — or into the tissue surrounding your kidney or to nearby lymph nodes.
• Stage IV: The tumor has spread outside of your kidney to your adrenal gland (the small gland that sits on top of your kidney), or to distant lymph nodes or other organs.

Tumors are also graded, which is a way of rating a tumor based on how abnormal its cells look. Tumor grading can also tell your healthcare provider how fast the tumor is likely to grow. Tumors whose cells don’t look like normal cells and divide rapidly are called high-grade tumors. High-grade tumors tend to grow and spread more quickly than low-grade tumors.