In the past, kidney cancers were diagnosed only after they have become quite large or symptoms of flank pain, blood in the urine or palpable mass in the abdomen developed. But fortunately, most renal cell carcinoma (RCC) are now found incidentally (during evaluation of unrelated medical problems) by imaging studies such as an ultrasound, computerized axial tomography (CAT) scan or magnetic resonance imaging (MRI).
In addition to taking a complete medical history and performing a physical exam, your doctor will likely recommend blood and urine tests. If your doctor suspects a problem, or if you are at high risk of kidney cancer (see Risk Factors), you may also have one or more of the following tests to check for growths or tumors:
- Ultrasound Examination. An ultrasound isn't an X-ray. Instead, it uses high-frequency sound waves to generate images of your internal organs, such as your kidneys and bladder, onto 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.
- Intravenous Pyelogram (IVP). In this older test, a contrast dye is injected into a vein in your arm. A series of X-rays is taken as the dye moves through your kidneys, ureters and bladder.
- Fine Needle Aspiration (FNA). Involves the insertion of a long, thin needle into the kidney in order to take a tiny sample of tissue (biopsy) for examination under a microscope. FNA is generally used if other tests have failed to prove the presence of a tumor. Biopsies are commonly performed on tumors that develop in a ureter or in the kidney pelvis—the area at the center of the kidneys where urine collects. FNAs are not routinely used when kidney cancer is suspected due to their high rate of false negatives.
Tests to Determine Whether Cancer has Spread (Metastasized)
If signs of kidney cancer are confirmed, the next step is to determine whether the cancer has spread outside of the kidneys (metastasized). This usually means more tests, including additional blood tests, an ultrasound of your liver, a CT scan, a chest X-ray or a bone scan. A bone scan is a test in which you are given a small amount of a radioactive material that is then taken up by your bones. Tumors absorb even more of this material and show up as a black area when a special camera scans your body.