Kidney cancer is often found during an imaging test for another reason. Your doctor will ask about your symptoms (if you have any), and medical and family history. The abdominal, pelvic, and back areas will be carefully examined. Your doctor may recommend different tests in order to identify any tumors and confirm diagnosis.

Certain urinary symptoms can be caused by a range of medical conditions. If you are having urinary symptoms, your doctor may conduct certain tests to identify abnormalities. These may include:

  • Urine tests—To check for the presence of blood, infection, or other abnormal cells in the urine. Urine tests are also useful to evaluate how well the kidneys are working.
  • Blood tests—May identify markers in the blood. For example, tumor markers or specific blood proteins may be elevated in the presence of cancer. Blood tests can also show how well the kidneys and liver are working.

Unlike other cancers, kidney cancer can be diagnosed with imaging tests. Imaging tests can also help assess tumor size and location. Some tests use contrast material to highlight structures so images are more clear and detailed. Imaging tests may include:

If for some reason these tests are unclear, a biopsy can be done to confirm a diagnosis. A biopsy is done with a fine needle or core needle (a wider, hollow cylinder). The device is inserted into the kidney to collect tissue samples. The samples are examined under a microscope for the presence of cancer cells.

If kidney cancer is confirmed, results from completed tests and new tests will help determine the stage of cancer. Staging is used to identify characteristics of the tumor that will help determine the prognosis and treatment plan. Factors that play a role on staging include how far the original tumor has spread, whether lymph nodes are involved, if cancer has spread to other tissue, and microscopic cellular details.

Imaging tests are used to help determine how deep the tumor has moved into the kidney or nearby structures. They may also help to determine if there are any metastatic growths in other areas of the body. Contrast material may be used in some tests to enhance details. Imaging tests may include:

Kidney cancer is staged from I-IV.

  • Stage I—Tumor is 7 centimeters (cm) OR LESS in size. The tumor is contained WITHIN the kidney.
  • Stage II—Tumor is OVER 7 cm in size. The tumor is contained WITHIN the kidney.
  • Stage III
    • Tumor is any size AND cancer is in 1 or more lymph nodes near the kidney OR
    • Cancer is in the primary artery or vein of the kidney, or the layer of fat around the kidney AND MAY BE in 1 or more lymph nodes near the kidney
  • Stage IV
    • Cancer has spread beyond the layer of fat around the kidney AND MAY BE in the adrenal gland (which sits nearly on top of the kidney) OR in lymph nodes near the kidney OR
    • Cancer has spread to other parts of the body through the lymph and blood streams. The most common sites for metastatic kidney cancer are lymph nodes in other parts of the body, the bones, lungs, liver, and brain.