How Is Kidney (Renal Cell) Cancer Diagnosed?

This content has been reviewed and approved by

Robert J. Motzer, MD
Attending Physician

Memorial Sloan-Kettering Cancer Center

In addition to taking a complete medical history and giving you a physical examination, your doctor may also conduct various diagnostic tests. These tests help doctors confirm that a suspicious growth is present in the kidney. Once this is confirmed, nephrectomy (surgical removal of the kidney) can be performed. The suspicious tissue can then be examined under the microscope. Most cases of kidney cancer receive a definite diagnosis at the time of nephrectomy.

Diagnostic tests your doctor may give you include:

• Complete blood and urine laboratory tests
• Computed tomography scan (CT or CAT scan) - an imaging technique that takes cross-sectional x-ray scans (which may look like "slices") of internal organs to detect abnormalities that may not show up on an ordinary x-ray
• Magnetic resonance imaging (MRI) - an imaging technique that uses strong magnetic fields to take scans of an internal organ or structure, especially the brain and spinal cord
• Ultrasound (sonography) - an imaging technique that uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs to view internal organs as they function and to assess blood flow through various vessels
• Intravenous pyelogram - an imaging technique that takes a series of x-rays of the kidneys, ureters, and bladder after dye is injected into a vein; this test is done to detect tumors, abnormalities, kidney stones, or any blockages, and to see how well blood is flowing in the kidneys
  

Also, if you have bone pain, recent bone fractures, or certain abnormalities on your blood tests, your doctor may order a bone scan (x-ray pictures of your bones).

Based on results of other tests and procedures, your doctor may recommend a biopsy or nephrectomy containing the suspicious growth. Removal of the diseased tissue and examination under the microscope is the only sure way to diagnose cancer and let your doctor know the stage (extent) of the disease.

During a biopsy, your doctor removes a sample of tissue from the suspicious area. In nephrectomy, the entire kidney is removed. Nearby lymph nodes may also be removed to see if the cancer has spread.

Your doctor then sends the tissue samples to the laboratory so that a pathologist (a doctor who diagnosis diseases using laboratory tests) can examine the samples under a microscope. The examination reveals what cell type of kidney cancer is present.