How We Diagnose Kidney Cancer

Beginning with your first appointment at the Lank Center for Genitourinary Oncology at Dana-Farber Brigham Cancer Center, you will be matched with specialists and researchers who deal exclusively with genitourinary cancers.

Finding the right team of pathologists and radiologists to manage your kidney cancer diagnosis is key to developing a successful treatment plan. Ours is the world's largest team of genitourinary cancer specialists, and we are one of the few clinical centers globally with a team focused on genitourinary cancers.

Testing for Kidney Cancer

With recent advancements in detection, fewer than 40 percent of kidney cancer cases are advanced when discovered. However, if you have been diagnosed with a kidney tumor or kidney cancer at any stage, it's important to be treated as early as possible. Early diagnosis can improve your chances for successful treatment and recovery.

Tests to Diagnose Kidney Cancer

These tests are most commonly used to diagnose kidney cancer:

  • Physical exam
  • Blood test: A blood sample is checked to measure for certain substances released into the blood by organs and tissues in the body. An unusual amount of a substance (higher or lower than normal) can be a sign of disease in the organ or tissue that makes it.
  • Liver function test: A test in which a sample of blood is checked to measure the amounts of enzymes released by the liver. An abnormal amount of an enzyme can be a sign that cancer has spread to the liver.
  • Urine test: A test to check the color of urine and its contents, such as sugar, protein, red blood cells, and white blood cells.
  • Ultrasound: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.
  • Biopsy: The removal of a small tissue sample for review under a microscope
    • Fine-needle (FNA) biopsy: the removal of tissue or fluid, using a thin needle

Tests to Determine the Stage of Kidney Cancer

If kidney cancer is found after a biopsy, some of the following tests may be conducted to determine if the cancer cells have spread beyond the kidney(s) to other parts of the body. The process used to find out if, and how far, the cancer has spread is called staging. It is important to know the stage of the cancer — in other words, how far the cancer has progressed or is likely to progress — in order to plan treatment. The following tests and procedures may be used in the diagnostic and staging process:

  • Chest X-ray: An x-ray of the organs and bones inside the chest
  • PET/CT (CAT) scan: A painless procedure in which a small amount of radioactive glucose (sugar) is injected into a vein, and a scanner is used to trace and create computerized pictures of the solution inside your body. The procedure has no side effects.
  • MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. The procedure is similar to a CT scan, except the MRI does not deliver radiation.
  • Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.

Stages of Kidney Cancer

The stage of kidney cancer is the most important factor in determining your treatment plan. The stages — or categories — are based on the size and spread of cancer beyond the kidney and into other places in the body (metastasis), such as the lymph nodes, blood, or other organs. The stages of kidney cancer are:

  • Stage I: The tumor is seven centimeters or smaller and is found only in the kidney
  • Stage II: The tumor remains in the kidney only, but the tumor is larger than seven centimeters
  • Stage III: Cancer cells may be found in the kidney and one nearby lymph node, an adrenal gland, tissue surrounding the kidney, or in the main blood vessels of the kidney
  • Stage IV: The cancerous cells have spread beyond the tissue surrounding the kidney to one or more lymph nodes, or other organs, such as the bowel, pancreas, or lungs

Kidney cancer may also be described as localized, regional, or metastatic:

  • Localized: Cancer is found only in the kidney
  • Regional: Cancer has spread to tissues around the kidney, as well as lymph nodes and blood vessels in the pelvis
  • Metastatic: Cancer has spread to other parts of the body

Our Kidney Cancer Research

The Dana-Farber Brigham Cancer Center kidney cancer team is at the forefront of kidney cancer research, converting breakthroughs into safe and more effective treatments. Each kidney cancer patient benefits from this quality research and the discoveries our team is making.

Research by our experts includes testing new drugs when approved drugs have failed, developing new treatments for aggressive cases, tackling rare subtypes of kidney cancer, profiling and sequencing genes, and closely collaborating with esteemed scientists and epidemiologists all over the world.

Dana-Farber Brigham Cancer Center experts have built an extensive database of over 8,000 genitourinary cancer tissue samples used to study and diagnose your specific type of kidney cancer. Patients have the opportunity for tumor assessment using OncoPanel, a screening test that carefully identifies known and unknown genetic mutations. That means we can precisely identify genetic mutations and cellular patterns in the DNA of cancer cells, and in some cases recommend treatment tailored just for you.

Read more about our kidney cancer research.

Second Opinions

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Consultations and Second Opinions

Our diagnostic team provides second opinions and we are happy to consult with you, your primary care physician, or other specialists. We are frequently asked for second opinions from oncologists all over the country. You may want to consider a second opinion:

  • To confirm your diagnosis
  • To have original biopsies or other tissue diagnosis confirmed
  • For details on the type and stage of cancer
  • To better understand your treatment options
  • To learn if you are eligible for clinical trials

Phone: 877-442-3324
Online: Complete the Appointment Request Form

Can't travel to Boston? Our Online Second Opinion service lets patients from all over the world receive expert second opinions from Dana-Farber oncologists.

For Referring Physicians

Because the patient's primary care physician or community specialist is an integral part of the patient's care team, we are committed to collaborating in the care of your patient.

If you are a physician and have a patient with kidney cancer, we look forward to working with you.

Find out more about how to refer a patient to Dana-Farber Brigham Cancer Center.

Find out about Physician Gateway, our portal that helps you keep track of patients you have referred for care. Physician Gateway is available for primary care providers, referring providers, and your authorized office staff.