In many cases, kidney cancer is diagnosed after routine check ups and scans, as the condition does not always have obvious symptoms.
Seeing your GP
You should see a GP if you do have any symptoms of kidney cancer, such as blood in your urine or a constant pain below your ribs.
Your GP will examine you and, if they think your symptoms need further assessment, refer you to a specialist urologist.
If you notice blood in your urine, your GP will usually carry out a blood test and take a urine sample. The results will help rule out other possible causes, such as infection or kidney stones.
The National Institute for Health and Clinical Excellence (NICE) has issued guidance for GPs about referring patients with cancer to specialist services, including a list of symptoms which may require an urgent referral. If you need to be referred urgently, you will usually be seen within two weeks.
Further tests
If your GP refers you to a hospital specialist, further tests will help determine whether you have kidney cancer.
Ultrasound scan
An ultrasound scan uses high-frequency sound waves to create an image of an organ in the body. It can often detect changes in the shape of the kidney that could possibly be due to the development of a cancerous tumour.
An ultrasound scan may be required if the cause of the blood in your urine cannot be found.
Computerised tomography scan
You may also be referred for a computerised tomography (CT) scan. During a CT scan, a scanner takes detailed images of the inside of your body and a computer puts them together.
If you have a CT scan you may be given a special dye to drink or it may be injected. The dye makes the results of the CT scan clearer.
Image-guided biopsy
An image-guided biopsy is occasionally carried out for some cases of kidney cancer. It is a minor surgical procedure carried out under local anaesthetic. This means you will be awake during the procedure, but the area surrounding the affected kidney will be numbed, so that you do not feel anything.
During an image-guided biopsy a radiologist or surgeon will use an ultrasound or CT scan to guide a needle through your skin and into your kidney. A small sample of tissue is removed from your kidney and studied under a microscope to check for the presence of cancerous cells.
Magnetic Resonance Imaging scan
A Magnetic Resonance Imaging (MRI) scan may be ordered to produce detailed images of your kidneys. These images can determine the existence of a tumour, as well as its size.
Cystoscopy
A cystoscopy looks inside your bladder and urinary system. This procedure does not inspect the kidneys, but can rule out or confirm whether any bleeding is coming from problems in the bladder.
Intravenous pyelogram (IVP)
An intravenous pyelogram (IVP) test involves the injection of a dye into your bloodstream. X-rays are taken after a short time, with the dye highlighting any growths present in the kidneys.
Staging and grading
If kidney cancer is confirmed, it is usually possible to determine its grade and stage.
The stage of the kidney cancer describes how far the cancer has spread, while the grade describes how aggressive the cancer is and how quickly it is likely to spread.
Both the stage and grade of your kidney cancer will help determine your recommended treatment and the likelihood of achieving a cure.
Healthcare professionals use the TNM system to stage kidney cancer:
- T: indicates how large the tumour has grown (a tumour is a lump of cancerous tissue)
- N: indicates whether nearby lymph nodes are affected (lymph nodes are small, oval-shaped glands of tissue found throughout the body and they help protect it against infection)
- M: indicates whether the cancer has spread to another part of the body – M stands for metastases, which is the medical term for cancer that has spread
The stages of tumour size are:
- T1a: where the tumour is less than 4cm in diameter
- T1b: where the tumour is 4-7cm in diameter
- T2: where the tumour is larger than 7cm in diameter but has not yet spread out of the kidney
- T3a: where the tumour has spread into the adrenal gland or into the layer of fat that surrounds the kidney
- T3b: where the tumour has spread into the renal vein (the vein that carries blood back from the kidney to the heart) or into the vena cava (the vein that carries blood back from the top half of the body)
- T3c: where the tumour has spread past the diaphragm
- T4: where the tumour has spread beyond the tough layer of tissue that surrounds and protects the kidney
There are three lymph node stages:
- N0: where no lymph nodes have been affected
- N1: where there are cancer cells in one lymph node
- N2: where there are cancer cells in two or more lymph nodes
M0 means that the cancer has not spread to another part of the body, and M1 means that the cancer has spread.
Kidney cancer is graded using a scale of one to four. The higher the number, the more aggressive the cancer.
Coping with cancer
If you have been diagnosed with cancer, talking to a counsellor or a psychiatrist may help you combat feelings of depression and anxiety, antidepressants may also be used to help you through this process.
For more information and advice, see living with cancer and what sort of support is available for people with cancer?
You may also find the information and advice about living with kidney cancer from some of the UK’s leading cancer charities useful. For example:
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