Kidney Cancer Screening
Screening tests, like mammograms for breast cancer, are used to detect illness in a general population, including people who have no symptoms.
There are no screening tests for kidney cancer. A routine urine test sometimes reveals small amounts of blood that may indicate kidney cancer, but there are many diseases that can cause blood in the urine, and many kidney cancers do not.
Imaging like computed tomography (CT) and magnetic resonance imaging (MRI) scans can find small renal cell carcinomas, but these tests are expensive and cannot always distinguish benign from cancerous tumors, so they are generally recommended only for people with hereditary risk factors or who have been on long-term dialysis. Ultrasound is less expensive and may also detect kidney cancer, but it has not been demonstrated that any of these tests improve survival for those not at substantially elevated risk.
Kidney cancers are sometimes found during tests for other illnesses. These cancers are usually at a very early stage and have no symptoms; the survival rate of these cancers is very high.
Kidney Cancer Tests and Diagnosis
If you have any symptoms of kidney cancer, your WellStar physician will take a complete medical history to discern your risk factors and symptoms. A physical examination can find signs of kidney cancer, like an abnormal mass in the abdomen.
If your medical history and/or the physical examination indicate the possibility of kidney cancer, imaging and/or laboratory tests will be conducted.
Imaging Tests
A computed tomography (CT) scan can find and examine kidney tumors, and can reveal whether a cancer has spread to other organs and tissues.
Magnetic resonance imagery (MRI) scans are used less often than CT scans in detecting kidney cancer. They may be used in such cases as when a person is allergic to the CT contrast dye; if the cancer might have grown into major blood vessels, since MRI provides a better picture of blood vessels; or if the cancer might have spread to the spinal cord or brain.
Ultrasound can help determine whether kidney mass is solid or filled with fluid. The echoes from most kidney tumors look different from those from normal kidney tissue, and can distinguish some types of tumors from one another. If a kidney biopsy is needed, ultrasound can guide the biopsy needle.
An intravenous pyelogram (IVP) is an x-ray of the urinary system taken after a special dye is injected into a vein is removed by the kidneys and is sent to the bladder. Similarly, an angiography uses a dye injected directly into the renal artery to reveal the blood vessels to the kidneys.
If the kidney cancer is advanced, a chest x-ray or CT scan can reveal if it has spread to your lungs, a common site of kidney cancer metastasis. If there is an indication that the cancer may have spread to the skeleton, a bone scan can reveal damaged bone using a low-level radioactive substance.
Lab Tests
Lab tests do not often diagnose kidney cancer, but they can provide a hint of its presence and to help determine whether a cancer has spread.
Urinalysis is one of the first tests done if kidney cancer possible. About half of all patients with RCC have detectable blood in their urine, and a microscopic examination of urine sometimes shows kidney cancer cells.
A complete blood count (CBC) measures the quantities different cells in the blood. Anemia (too few red blood cells) is very common in people with kidney cancer; less often, they have too many red blood cells. The blood count is also important to ensure that a person is healthy enough for surgery.
Blood chemistry tests detect abnormal levels of blood chemicals, like liver enzymes, that may indicate kidney cancer; a high calcium level may reveal that the cancer has spread to the bones.
Biopsy
Since imaging usually provides sufficient information to diagnose kidney cancer, biopsy is not often used. However, in those cases where imaging is not conclusive, a fine needle aspiration (FNA) biposy may be used to obtain a small sample of cells from a suspicious area. Biopsy may also be used in patients too frail for surgery, or if non-surgical treatment is being considered.
The Fuhrman grade is found by examining at kidney cancer cells with a microscope. It quantifies on a scale of 1 to 4 how similar the cancer cells' nuclei look to normal kidney cells. Grade 1 RCC nuclei look much like normal nuclei; these cancers usually grow slowly. Grade 4 nuclei look quite different, and usually grow much more aggressively.
Kidney Cancer Stages
When a cancer of the kidney is diagnosed, your WellStar physician will categorize it by its current stage. Each stage describes the progression of the disease and whether the cancer has spread to other parts of the body. You should talk to your WellStar physician to understand each stage, and what it means for your treatment plan.