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Diagnosis and Types of Kidney Cancer

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Diagnosis and Types of Kidney Cancer Produced September 2016 Page 1 Fact sheet Diagnosis and types of Kidney Cancer Introduction Our series of kidney cancer fact For more information relating These fact sheets are meant as an sheets have been developed to help to other aspects of kidney cancer introduction only and are not meant you understand more about kidney please see our other fact sheets: to be a substitute for your doctor’s cancer. This fact sheet provides • Kidney Cancer or healthcare professional’s advice. information about the tests you may • Localised Kidney Cancer Always consult your doctor or have if your doctor thinks you may • Advanced Kidney Cancer healthcare professional for have kidney cancer. It also gives more advice. • Support for Kidney Cancer information about the different types and stages of kidney cancer. • Advanced Kidney Cancer – Dealing with the side effects of medication: targeted therapy • Kidney Cancer – Make the most of your visit to the doctor What tests will I need to have? Your doctor will use different tests to diagnose and get more information about your kidney cancer. The tests done for kidney cancer can be divided into blood and urine tests, imaging, tissue biopsy and cystoscopy. 1. Blood and urine tests The tests you have will depend Blood tests: Chemical tests of the on your particular situation. blood can detect findings associated You may not necessarily need to with kidney cancer. have all the tests described below. Urine test (urinalysis): A common sign of a kidney cancer is blood in the urine. Remember that blood in the urine can be caused by conditions other than cancer as well. This test can also detect other abnormalities in the urine such as protein. Connect with us www.kidney.org.au Freecall 1800 454 363 Kidney Health Australia Diagnosis and types Produced September 2016 of Kidney Cancer Page 2 MRI scan PET scan An MRI scan uses a combination A positron emission tomography of magnetism and radio waves to (PET) scan is a specialised scan get detailed pictures of organs in the that uses radioactivity to show the body. They provide different details to chemical function of an organ or a CT scan and give information about: tissue. It can detect cancers even 2. Imaging • Whether the tumour has before they are ‘seen’ on other types Imaging is important for the diagnosis spread into the veins of scans. PET scans can create an and classification of kidney cancer. • Whether the tumour has image of the entire body. This means The most common imaging techniques spread into the spinal cord. that they can show if (and where) used are ultrasound scans, computed cancer is spreading to other parts tomography (CT) scans and magnetic of the body. PET scans can also be resonance imaging (MRI) scans. You • An MRI takes about used to see if tumours, are benign may have more than one type of scan. 40–60 minutes (not cancer) or malignant (cancer) and to tell the difference between • The MRI scanner is a large tumour or scar tissue. Ultrasound magnetic metal cylinder open A type of scan where sound waves at both ends. You lie still on are used to produce a picture of the a table inside the cylinder internal organs on a computer screen. • A PET scan takes about 2 hours • You may be given contrast Any abnormalities in the kidney and • You may need to not eat or other organs can be seen on the screen. • It is painless. However, the drink before the scan scanner can be noisy and • You will be given an injection some people feel anxious of radioactive material about being in a small space. • An ultrasound takes about • The amount of radiation 15–20 minutes Talk to you doctor if you think this may be a problem for you. you receive is small • A gel is spread over your back • It is painless. or side and an ultrasound probe is slid over the skin Bone scan • It is painless. Chest x-ray A bone scan is used to see if An x-ray of organs and bones cancer has spread to the bones. within the chest: CT scan A CT scan uses x-rays to get detailed • A bone scan takes about 5 hours pictures of organs in the body. They • A chest X-ray takes • A small and harmless amount provide information about: a few minutes of radioactive material is • Where the tumour is located • It is painless. in the kidney and its size injected into a vein • Whether a tumour looks like • The substance slowly moves through your blood into your it maybe cancer (malignant) Contrast bones. It particularly goes into or not cancer (benign) Most CT and MRI scans are done the cancer cells • Whether there are enlarged with contrast (a kind of dye). Contrast lymph nodes or not • After 3–4 hours a scan is done is administered through a drip line that detects radioactivity. If the • Whether the tumour has in one of your veins (intravenous cancer has spread to the bones spread to other parts of line), usually your arm. The contrast it will show up as a large the body (metastasised). highlights the arteries and veins, amount of radioactivity giving more information about the • It is painless. tumour. It may make you feel hot • A CT scan takes about and flushed for a few minutes. Some 30–40 minutes people are allergic to contrast so let the person doing the scan • The CT scanner is like a large know if you feel unwell. round metal doughnut. You lie still on a table that goes through the hole of the scanner • You may be given contrast • It is painless. Connect with us www.kidney.org.au Freecall 1800 454 363 Kidney Health Australia Diagnosis and types Produced September 2016 of Kidney Cancer Page 3 In the majority of cases of kidney cancer a biopsy is not necessary. • A kidney biopsy takes about This is because the CT or MRI scan an hour and is done as has already given enough information an outpatient for your doctor to recommend surgery • Local anaesthetic is given or other treatments for your kidney to numb the area cancer. However, a biopsy may be 3. Kidney (renal) biopsy • The biopsy is taken whilst recommended if: Sometimes your doctor will a scan is being done so • The results of your scan suggest recommend that you have a kidney the tumour can be found that the tumour is benign biopsy. A kidney biopsy is where • A fine needle is used to get one samples of tissue are taken from • The tumour is small and can be or two samples of the tumour treated with active surveillance, the tumour so that the cells can • Biopsies may cause a small radiotherapy ablation or cryotherapy then be examined under a amount of blood in the urine, (see later in the treatment section). microscope. This gives the doctors which is normal. more information about what sort • You will have to lie flat for of kidney tumour is present. 4 hours after the biopsy • Then you should expect to take it easy for the rest of the day • Rarely a biopsy can cause more severe bleeding and if this happens when you are home you should go straight back to the hospital. • A cystoscopy takes about an hour and is done as an outpatient (you will not need to stay overnight in the hospital) 4. Cystoscopy • You will be given either a If you have blood in your urine you local or general anaesthetic may have a cystoscopy. This is a test • A telescope is passed into your that lets your doctor look into your bladder through the urethra bladder and urethra using a telescope with a lens and a light. It is used to see • You should take it easy for if the blood in your urine is coming the rest of the day from your bladder or urethra. • You may feel a burning sensation when having a wee or notice blood in your urine. This is normal but let your doctor know if it lasts more than a few days. Connect with us www.kidney.org.au Freecall 1800 454 363 Kidney Health Australia Diagnosis and types Produced September 2016 of Kidney Cancer Page 4 What are the different types of kidney cancer? Not all kidney cancers are the same. 1. The exact subtype of kidney This information can be used by your The results of the tests you have cancer – how the cancer cells doctor to guide treatment and help had give information about: look under a microscope and other plan long-term follow-up care. features. Different subtypes come from different cells in the kidney. 2. The grade of kidney cancer – how abnormal the cells are and how fast they’ll probably grow. 3. The stage of kidney cancer – how large the cancer is and how far it has spread. 1. Different subtypes of kidney cancer Renal cell carcinoma (RCC) Urothelial carcinoma There are different types of kidney cancer based on what the cancer • 9 out of 10 kidney cancers • 1 out of 10 kidney cancers cells look like under a microscope and other factors. Renal cell carcinoma • Comes from the cells of • Comes from the cells of the (RCC) is the most common type of the kidney’s nephrons drainage system of the kidney kidney cancer and the second most (the renal pelvis or ureters) common type is urothelial carcinoma. This series of fact sheets mainly gives Subtypes: • Behaves like bladder cancer and information about RCC. • Clear cell – about 75 out so is treated differently to RCC of 100 RCC are this type • Also known as transitional cell The type of kidney cancer is not • Papillary cell – about 10 out carcinoma (TCC) usually important for surgery, but of 100 RCC are this type it can be very important if more treatment is needed.
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