Tests for kidney cancer

Most kidney cancers are found when people are having tests for something else. 

If you have symptoms that may be due to kidney cancer, you usually have a number of tests.

These tests can also help your doctor decide what treatment you need if you are diagnosed with kidney cancer. 

Tests your GP might do

Most people start by seeing their GP if they have symptoms of kidney cancer. They can do some tests to help decide whether you need to see a specialist. Your GP might:

• do a physical examination
• test your urine
• arrange blood tests
• send you for an ultrasound scan of your tummy (abdomen)

If you have blood in your urine (haematuria), your GP may refer you to a one stop haematuria clinic if there is one in your area. This means you may have all the tests and see a specialist on the same day.

Physical examination

Depending on your symptoms, your GP may do a physical examination. They feel for any areas in your tummy (abdomen) that might be swollen or not normal. If you have any pain, they feel those areas too. It might feel tender as they examine you. 

Your kidneys are deep in your body so they might not be able to feel any lumps on them.

Your GP might also feel around your neck, armpits and groin for swollen lymph nodes .

Urine tests

Your GP may ask you for a small amount (sample) of your urine. They dip a testing stick in it to show if there are tiny amounts of blood that can't be seen. This is a quick test your GP can do at the surgery.

Your GP may send a sample of your urine to the laboratory. This is to check for other causes of your symptoms like an infection.

Blood tests

Your GP may ask you to have some blood tests to check your general health and to find out if parts of your body aren't working normally. You might have blood tests to check:

• how well your kidneys and liver are working
• the number of red blood cells , white blood cells and platelets
• how well your blood is clotting
• the amount of calcium in your blood

Ultrasound scan

Your GP might ask you to have an ultrasound scan of your abdomen. This will help them decide if you need to see a specialist.

Ultrasound scans use high frequency sound waves to create a picture of a part of the body. you might have an ultrasound scan of your abdomen. The scan looks at your urinary system (bladder, kidneys, ureters and urethra). 

It is an external ultrasound scan. This means your doctor or sonographer moves a probe over your skin. A sonographer is a trained professional who specialises in ultrasound scanning. They might ask you to move position during the scan.

An ultrasound scan can show if there are any signs of cancer in your kidneys. It can also show any blockages in the tubes from your kidneys to your bladder (ureters).

Tests your specialist doctor might do

Depending on the results of your tests, your GP might refer you to a specialist. You usually see a urologist or a specialist nurse (CNS). A urologist is a doctor who specialises in treating problems of the urinary system such as the kidneys and bladder.

They usually arrange more tests. These may include:

• an ultrasound of your abdomen if not arranged by your GP
• a CT scan
• an MRI scan
• taking a sample of tissue (a biopsy) from the kidney

These tests help your doctor to diagnose kidney cancer and to find out its size and whether it has spread (the stage of the cancer).

Ultrasound scan

Your specialist may ask you to have an ultrasound scan of your abdomen if your GP hasn't arranged one. This can show up any abnormal areas of the abdomen.

CT scan

CT (or CAT) scan stands for computed (axial) tomography. It is a test that uses x-rays and a computer to create detailed pictures of the inside of your body.

You might have a CT scan of your abdomen and chest. You may have an injection of contrast into a vein beforehand. This is a special dye that makes body tissues easier to see on the scan.

A CT scan can tell your doctor if you have cancer, how big it is and if it has spread.

MRI scan

MRI stands for magnetic resonance imaging. It uses magnetism and radio waves to take pictures of the inside of your body.

You might have an MRI scan if you can't have the contrast used in a CT scan. This may be because your kidneys don't work very well, or you have an allergy to it.

You may also have an MRI scan if your doctor wants to know if the cancer is in the main blood vessels near the kidney.

Kidney biopsy

Your doctor might want to take a small piece of tissue from your kidney. They may do this if other tests are not able to say whether the abnormal area is cancer. This sample of tissue is called a biopsy. Your doctor sends the biopsy to the laboratory to be looked at under a microscope.

The scans you have usually give enough information for your doctor to say if you have kidney cancer. If you're having surgery to remove the kidney or part of the kidney, you won't normally have a biopsy first. A specialist doctor checks the kidney or part of the kidney, under a microscope after the operation. This will tell them what type of kidney cancer it is.

If you are not able to have surgery you may have a biopsy. This means your doctor can still find out what type of kidney cancer you have.

If the cancer has spread to another part of your body, your doctor may ask you to have a kidney biopsy. This is so they can see what type of kidney cancer it is. Knowing this helps them decide on the best treatment for you.

Genetic tests

Some kidney cancers are due to inherited or new changes in genes . If your doctor thinks your kidney cancer is due to a change in your genes they may do a genetic test to check.

They may refer you to a genetic specialist if you have a strong family history of cancer. The specialist will ask you questions about other members of your family. They will also tell you about the genetic test and what the results mean. 

Other tests

Occasionally your doctor may want you to have other tests. This may include looking at the blood vessels in your kidney.

Any other tests you may have will depend on your general health, symptoms and the cancer. Your doctor will explain what the tests are for and how to prepare for them.

Getting your results from the specialist

Once you’ve had your tests, a group of health professionals look at the results. The group is called a multidisciplinary team (MDT). They work together to plan your treatment and care.

The MDT normally includes: 

• your urologist
• doctors who specialise in cancer drug treatments (medical oncologist)
• doctors who specialise in radiotherapy (clinical oncologist)
• doctors who specialise in x-rays and scans (radiologist)
• clinical nurse specialists

Your urologist will tell you the test results at your follow up appointment. They will also explain what the results mean.

If the biopsy shows you have kidney cancer, they will talk to you about a treatment plan.

Some people find it helps to have a friend or relative with them at this appointment.