Your doctor may order some or all of a variety of tests that are available to determine the extent of your kidney cancer and to develop your treatment plan.
Your doctor may use different approaches to diagnose RCC (kidney cancer), depending on your symptoms, beginning with a physical examination and discussion of past and present medical problems.
In addition to a physical exam and medical history, your doctor will order some lab tests to complete your evaluation.
Blood samples will be collected as a part of a routine physical exam to evaluate kidney function and overall health.
Urinalysis will be done to collect and test urine. Microscopic tests can detect small amounts of blood or infection in the urine.
A plain x-ray of the chest may be done to see if the cancer has spread to the lungs. If something notable is seen on the x-ray, the doctor may order a CT scan of the chest to help determine what it is.
A CT scan is a highly specialized x-ray that can visualize internal organs and provides a very accurate cross section picture of specific areas of the body. It is one of the primary imaging tools for assessing RCC. To enhance the image of the abdominal organs, dye may be given orally (by mouth) or intravenously (IV) before the scan. The IV dye (also called IV contrast) may cause a hot flushing sensation or an allergic reaction, especially in individuals who are allergic to iodine.
An MRI is a specialized scan, similar to a CT scan, but may be used if patient’s kidney function is elevated – a sign the kidneys are not functioning properly. Because MRI machines use a powerful magnet, people with metal within their body, such as prosthetic hip replacements or pacemakers, should discuss the use of an MRI with their physician before the scan is performed. MRI scans require a person to lie still for a long time in an enclosed space, which may be difficult for those who don’t like to be in confined spaces.
A bone scan is used to check for the spread of cancer to the bones. It is done by injecting small amounts of a special radioactive material through a vein into your bloodstream. The test can identify both cancerous and non-cancerous diseases.
If the diagnostic test results are not clear, a biopsy may be performed. During a biopsy procedure a small sample of tissue is removed from the mass and examined to determine whether it is benign (non-cancerous) or malignant (cancerous). Using ultrasound or a CT scanner for guidance, the doctor will insert a long thin needle through the skin, directly into the mass, and remove the sample tissue. A pathologist will evaluate the biopsy tissue under a microscope to determine the histology and make a diagnosis.
If there is clear evidence of widespread metastasis when the kidney mass is discovered, a biopsy may be taken from an area of metastasis instead of from the kidney.
A pathologist may also receive a tissue sample taken during a surgery to remove a mass/tumor to study the tumor type and make a diagnosis, but this is not considered a biopsy.