How kidney cancer is diagnosed

Kidney cancer is often diagnosed when people have a scan for another reason. Sometimes, people notice symptoms like blood in their urine.

If you have symptoms, you usually start by seeing your GP. They will examine you and arrange for you to have some tests.

If you are diagnosed with kidney cancer, there are different tests to find out more information about the cancer. These include:

  • a blood test
  • an ultrasound scan
  • a CT scan
  • an MRI scan
  • a guided biopsy.

Waiting for test results can be difficult. You may want to talk to someone close to you or one of our cancer support specialists on 0808 808 00 00.

Getting diagnosed

Sometimes kidney cancer is diagnosed when a person is having a scan for another reason.

If you have symptoms, you usually start by seeing your GP. They will examine you and arrange for you to have some tests. They may test your urine (pee). 

They may also do blood tests to check:

  • your general health
  • the number of cells in your blood (blood count)
  • how well your kidneys and liver are working.

If your GP is not sure what the problem is or they think your symptoms could be caused by cancer, they will usually refer you to the hospital to see a specialist doctor. 

This doctor is called a urologist. They specialise in treating urinary, bladder and kidney problems.

If you have blood in your urine, you may be referred to a specialist clinic. This is called a haematuria clinic. 

Often these clinics can do tests on the same day.

If tests or symptoms suggest you could have a kidney cancer, you should be seen by a specialist within 2 weeks.


At the hospital

The urologist or specialist nurse will ask you about your symptoms and your general health. They will also examine you and arrange some of the following tests.

Blood tests

You will have blood samples taken. These help your doctors to check how well your kidneys and liver are working. 

They also show the number of blood cells in your blood. This is called a blood count.

Ultrasound scan

This test uses sound-waves to build up a picture of the kidneys, ureters and bladder. It is a painless test and only takes a few minutes.

You lie on your back and the person doing the ultrasound spreads gel over your tummy (abdomen) area. 

They pass a small, hand-held device that produces sound-waves over your tummy. A computer turns the sound-waves into a picture.

If doctors also want to look at the bladder, you will need to have a full bladder for the scan. The hospital will give you instructions about this.

The ultrasound scan can look for changes in the shape of the kidneys. 

It can help show whether a lump is a cyst (a fluid-filled lump) or a tumour. It can also show the position of a cancer and its size.

CT urogram

A CT urogram is a type of CT scan. It looks at the kidneys, ureters and bladder.

A CT scan takes a series of x-rays that build up a three-dimensional picture of the inside of the body. The scan is painless and takes about 60 minutes (1 hour). 

CT scans use a small amount of radiation, which is very unlikely to harm you and will not harm anyone you come into contact with.

Your will be given instructions on how to prepare for the test. Before the test, you can usually eat and drink normally. Just before the test, you may be asked to empty your bladder.

You will be given an injection of a dye. This helps the doctor see your bladder, ureters and kidneys more clearly. 

The dye may make you feel hot all over for a few minutes. Some people have a stronger reaction to the dye. 

Tell your doctor if you have asthma or an iodine allergy, because you could have a stronger reaction to the injection. 

You should also tell your doctor if you have kidney problems or diabetes, particularly if you take metformin. You will need a blood test before the scan to check how well your kidneys are working.

The dye travels through the bloodstream to the kidneys. The doctor looks at a screen to see the dye passing through the kidneys and ureters.

You should be able to go home as soon as the scan is over.

Guided biopsy

This is done if you need to have a sample of tissue taken from the kidney (a biopsy). 

The doctor uses ultrasound or a CT scan to guide them to the exact area of kidney they want to take the biopsy from.

The doctor injects some local anaesthetic into the skin to numb the area over the kidney. 

They then guide the needle through the skin into the kidney. They use the needle to take a small sample of tissue. 

They send the sample to the laboratory to be checked for cancer cells.

You may need to stay in hospital for a few hours, or overnight, after this procedure.


Further tests

If the tests show you have kidney cancer, your doctor may want to do some further tests. 

These tests will help them find out the size and position of the cancer and whether it has spread to other parts of the body. 

This is called staging and will help you and your doctor decide on the best treatment for you. 

These may include some of the following tests.

CT (computerised tomography) scan

A CT scan takes a series of x-rays, which build up a three-dimensional picture of the inside of the body. 

The scan takes 10 to 30 minutes and is painless. 

It uses a small amount of radiation, which is very unlikely to harm you and will not harm anyone you come into contact with.

CT scan
CT scan

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You may be given a drink or injection of a dye, which allows particular areas to be seen more clearly. 

This may make you feel hot all over for a few minutes. 

It is important to let your doctor know if you are allergic to iodine or have asthma, because you could have a more serious reaction to the injection.

You will probably be able to go home as soon as the scan is over.

MRI scan

An MRI scan uses magnetism to build up a detailed picture of areas of your body. The scanner is a powerful magnet so you may be asked to complete and sign a checklist to make sure it is safe for you. The checklist asks about any metal implants you may have, such as a pacemaker, surgical clips or bone pins, etc.

You should also tell your doctor if you have ever worked with metal or in the metal industry as very tiny fragments of metal can sometimes lodge in the body. If you do have any metal in your body, it is likely that you will not be able to have an MRI scan. In this situation, another type of scan can be used. Before the scan, you will be asked to remove any metal belongings including jewellery.

Some people are given an injection of dye into a vein in the arm, which does not usually cause discomfort. This is called a contrast medium and can help the images from the scan to show up more clearly. During the test, you will lie very still on a couch inside a long cylinder (tube) for about 30 minutes. It is painless but can be slightly uncomfortable, and some people feel a bit claustrophobic. It is also noisy, but you will be given earplugs or headphones. You can hear, and speak to, the person operating the scanner.

Chest x-ray

This uses x-rays to take a picture of your chest, to check your lungs and heart.


Waiting for test results

Waiting for test results can be a difficult time. It may take from a few days to a couple of weeks for the results of your tests to be ready. You may find it helpful to talk with your partner, family or a close friend.

Your specialist nurse can also provide support. You can also talk things over with one of our cancer support specialists on 0808 808 00 00.