Kidney Cancer Diagnosis

Kidney cancer develops in the cells of the kidneys, two bean-shaped organs located just below the ribcage on either side of the spine. These vital organs filter waste from the blood and help maintain the body’s fluid and electrolyte balance.

The most common type of kidney cancer is renal cell carcinoma, which forms in the lining of the small tubes inside the kidneys (renal tubules). In most cases, the exact cause is unknown. Risk factors include smoking, obesity, high blood pressure, certain inherited conditions, such as von Hippel-Lindau disease, and prolonged exposure to harmful substances, such as asbestos and cadmium.

While renal cell carcinoma is relatively uncommon, it is one of the more frequently diagnosed cancers in older adults, especially in men. Possible symptoms include bloody urine, persistent pain on one side of the back or abdomen, unexplained weight loss, chronic fatigue and fever.

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Kidney cancer is usually diagnosed through a multi-step process. In addition to a clinical evaluation, this may include:

Laboratory tests used for diagnosing kidney cancer

Common lab tests used to diagnose kidney cancer include:

Blood work

A complete blood count (CBC) may reveal signs of kidney dysfunction, anemia or abnormal levels of certain substances, such as calcium, phosphorus, proteins and liver enzymes. An abnormal result may warrant follow-up testing.

A creatinine test measures the level of creatinine in the blood (or urine). Normally, the kidneys produce this chemical waste product at a consistent rate. An elevated creatinine level could mean the kidneys are not functioning properly, possibly due to cancer.

Glomerular filtration rate (GFR) is a blood test that measures kidney function. A low GFR means the kidneys are not filtering the blood well, which could suggest a problem with their function.

Urinalysis

A urine test can detect blood, bacteria and abnormal cells in the urine, suggesting possible kidney issues that may warrant follow-up testing. For example, albumin is a protein in the blood that healthy kidneys prevent from passing into the urine. A high level of albumin in the urine (albuminuria) is associated with an increased risk of kidney cancer.

Although a physician cannot confirm a diagnosis of kidney cancer based on lab testing alone, the results can provide valuable information that, alongside imaging, can guide further diagnostic steps.

Imaging tests used for diagnosing kidney cancer

Imaging plays a key role in helping a physician determine the presence and extent of kidney cancer. Common tests include:

Ultrasound

Also known as sonography, ultrasound imaging employs high-frequency sound waves to create real-time images of the kidneys and surrounding soft tissues. This noninvasive procedure can help a physician identify masses, cysts and other abnormalities in the kidney structures, providing initial insights into potential kidney cancer.

Computed tomography (CT)

CT involves taking multiple X-rays from different angles to produce detailed cross-sectional images. The results can help a physician visualize the size and location of any tumors and determine whether kidney cancer has spread to nearby lymph nodes or other tissues, guiding further treatment decisions.

Magnetic resonance imaging (MRI)

MRI uses strong magnetic fields and radio waves to create detailed images of soft tissues. The resulting images can help a physician assess the characteristics of kidney masses, differentiate between benign and malignant tumors and evaluate the involvement of surrounding structures, which can influence treatment planning.

Intravenous pyelogram (IVP)

An X-ray imaging test, IVP involves the injection of a contrast dye into a vein. X-rays are then captured as the dye passes through the urinary tract. The dye will collect in the kidneys, ureters and bladder, making these structures appear bright white on the X-rays. The images may reveal blockages or irregular outlines in the urinary tract, which could indicate cancer.

Procedures used for diagnosing kidney cancer

If a kidney tumor is identified, the final step in the diagnostic process is usually a tissue test (biopsy). Using a small needle, a physician will remove a portion of the suspicious growth. The removed cells will then be sent to a laboratory for microscopic examination by a pathologist, who can confirm the presence of cancerous cells. In some cases, a surgeon may remove part or all of the kidney tumor to allow for a more in-depth examination of the affected tissues.

Frequently asked questions (FAQs) about the diagnostic process for kidney cancer

The following FAQs-related articles provide additional information about the diagnostic process for kidney cancer:

• How is kidney cancer diagnosed?
• How can kidney cancer be detected early?

The next steps after a kidney cancer diagnosis

After a kidney cancer diagnosis is confirmed, the next steps may include:

• Staging the tumor – Additional imaging tests, such as CT scans or MRIs, may be performed to help the physician assess the size of the tumor, check for spread to nearby lymph nodes or other tissues and establish the cancer stage.
• Consulting with specialists – Typically, the patient will meet with a urologist or oncologist specializing in kidney cancer to discuss the diagnosis, staging results and treatment options, which may include surgery, chemotherapy, radiation therapy and/or immunotherapy.
• Planning treatment – Based on the stage of the tumor, the patient’s overall health and other factors, a tailored treatment plan will be developed, which may incorporate input from various healthcare professionals to fully address all aspects of care.
• Exploring support services – The patient may be introduced to supportive care specialists, who can recommend appropriate counseling and support groups to help the patient cope with the emotional and psychological impact of their diagnosis and treatment.

Benefit from world-class care at Moffitt Cancer Center

The multispecialty team in Moffitt’s high-volume Urologic Oncology Program has extensive experience in diagnosing and treating kidney cancer. We are also proud to be the only cancer center based in Florida to have earned the prestigious designation of Comprehensive Cancer Center from the National Cancer Institute, which is a nod to our trailblazing research and robust clinical trials.

If you would like to learn more about the diagnostic process for kidney cancer, you can request an appointment with a specialist in Moffitt’s Urologic Oncology Program by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.