How is kidney cancer diagnosed?

Currently, there are no screening programmes for kidney cancer in the UK. Doctors use their clinical experience, scans and various tests to diagnose kidney cancer. Your doctor may use different tests and investigations, depending on which signs and symptoms you have.

If you have blood in your urine (haematuria), your family doctor or GP will usually test your urine to rule out infection. If there is no evidence of infection, or the haematuria continues, you will usually be referred to hospital for further tests and scans.

The most common tests carried out at the hospital are:

  • Renal ultrasound scan – used to detect and differentiate between tumours and cysts on the kidney
  • Computerised tomography (CT) scan – used to get detailed pictures of organs in the body and look for any abnormalities in the kidney
  • Chest X-ray – an X-ray of organs and bones within the chest
  • Urine test – to test for infection, blood and protein in the urine
  • Blood tests – to test kidney and liver function
  • Cystoscopy and/or CT urogram – this might be done to see is you have a type of kidney cancer called transitional cell carcinoma (TCC).

Other tests, such as magnetic resonance imaging (MRI), positron emission tomography (PET), or a bone scan might be undertaken to assess the spread of the disease.

The majority of kidney cancers are initially discovered by scans (ultrasound or CT scan), showing a mass or lump on the kidney. This does not prove it is kidney cancer, however, and it must be examined under the microscope to be sure. Sometimes your doctor may recommend immediate surgery; other times your doctor might order a biopsy. During a biopsy, a thin needle is used to remove some cells from the tumour. A doctor will then look at the cells to see if they are cancerous or not. Up to 20% of small kidney masses (or lumps) are non-cancerous.

The advantage of early detection is successful removal of the affected kidney to prevent the spread of the disease. As the tumour grows and the lymph nodes become involved, survival time decreases as the cancer spreads.