Kidney cancer is a complex disease. There are different types of kidney cancer including renal cell cancer and upper track urothelial cancer. To determine what type of kidney cancer you may have, it’s important to understand the diagnostic tools available and what that can mean for a potential diagnosis and treatment.
Kidney cancer diagnosis
If any type of kidney cancer is suspected, experts at the OSUCCC – James will examine you, and record your medical history and any symptoms and risk factors you may have.
Laboratory tests
Blood chemistry tests
This procedure analyzes blood for certain chemicals, such as enzymes released by cells into the body. Chemicals above or below a certain level may indicate cancer.
Liver function tests
A blood sample is tested to measure certain proteins or other substances released into the blood. Certain levels of enzymes may indicate the presence of cancer in the liver.
Urinalysis
Urine color and contents are checked for the presence and level of substances such as sugar and red or white blood cells.
Imaging tests
Imaging tests produce pictures of the inside of the body. Some of these tests may include one of the following:
Intravenous pyelogram (IVP)
A series of images is conducted via a computer tomography (CT) scan of the kidneys, ureters (the tubes that send urine from the kidneys to the bladder) and bladder to check for cancer. A contrast dye is used during this procedure to help see any blockages.
Ureteroscopy
In this procedure, a ureteroscope is inserted through the urethra to look at the bladder, ureter and renal pelvis. This is usually reserved for upper track urothelial cancer screenings.
Computed tomography scan (CT scan)
A type of X-ray test that produces detailed, cross-sectional images of your body.
Magnetic resonance imaging Scan (MRI scan)
MRI scans use radio waves and strong magnets instead of X-rays. MRI scans are helpful when the OSUCCC – James specialists need to see the entire body.
Ultrasound
A test that uses sound waves and echoes to take a picture of internal organs or masses. Ultrasound can be used to look at lymph nodes near the surface of the body or to look for enlarged organs inside the abdomen such as the kidneys, liver and spleen.
Biopsy
A piece of tissue or tumor is removed so that a specially trained OSUCCC – James pathologist can examine the cells under a microscope for any signs of cancer.
Staging kidney cancer
If you are diagnosed with kidney cancer, staging is just one of many ways to determine the amount and location of your cancer, and it can help OSUCCC – James specialists choose the most effective, personalized treatment options for your cancer. The staging classification remains the same throughout treatment.
The two most common types of kidney cancer — renal cell cancer and upper track urothelial cancer — are staged differently.
Renal cell cancer staging
Renal cell cancer is classified as one of four stages:
Stage I
Stage I is broken up into two subgroups:
- Stage IA - The tumor is up to 4 centimeters and only in the kidney.
- Stage 1B – The tumor is larger than 4 centimeters and up to 7 centimeters and is only in the kidney.
Stage II
The tumor is larger than 7 centimeters and is found only in the kidney.
Stage III
- The tumor is any size and cancer is found only in the kidney and in one or more nearby lymph nodes; or
- Cancer is found in the main blood vessels of the kidney or in the layer of fatty tissue around the kidney; cancer may be found in one or more nearby lymph nodes.
Stage IV
- Cancer has spread beyond the layer of fatty tissue around the kidney to the adrenal gland or nearby lymph nodes; or
- Cancer has spread to other organs, such as the lungs, liver, bones or brain, and may have spread to lymph nodes.
Upper track urothelial cancer
The renal pelvis is in the upper portion of the ureter, which is a tube that connects the kidney to the bladder. Transitional cells line both the renal pelvis and ureter and when they become cancerous, it is known as upper track urothelial cancer.
Upper track urothelial cancer is classified into one of four stages as well:
Stage 0 (noninvasive papillary carcinoma and carcinoma in situ)
In Stage 0, abnormal cells are found in the lining of the renal pelvis or ureter. These abnormal cells may become cancerous and spread into other tissue.
Stage 0 is further classified into substages:
- Stage 0A is noninvasive papillary carcinoma and appears as thin, long growths that emerge from the tissue surrounding either the renal pelvis or ureter.
- Stage 0 is carcinoma in situ, which occurs when a flat tumor develops in the lining of the renal pelvis or ureter.
Stage I
A Stage I diagnosis of upper track urothelial cancer occurs when cancer has formed and has spread from the lining inside the renal pelvis or ureter to the connective tissue layer.
Stage II
In Stage II, the cancer has spread from the renal pelvis or ureter to the muscle layer.
Stage III
For Stage III, the cancer has spread from the muscle layer of the renal pelvis or ureter to other tissue in the kidney or fat layers around the ureter/renal pelvis.
Stage IV
In Stage IV upper track urothelial cancer, the cancer has spread to one or more of the following: a nearby organ, the layer of fat around the kidney, lymph nodes, or other organs such as lung or liver.
Localized, regional, metastatic or recurrent upper track urothelial cancer
In addition, this cancer can be classified as localized, regional, metastatic or recurrent.
Localized – cancer is only in the kidney
Regional – cancer has spread to surrounding kidney tissue or nearby lymph nodes and blood vessels
Metastatic – the cancer has spread to other parts of the body
Recurrent – the cancer has come back (recurred) after treatment; may reappear in the renal pelvis, ureter or other parts of the body
If you’ve been diagnosed with kidney cancer, would like a second opinion or would like to speak with a kidney cancer specialist, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.
Related Resources
Kidney Cancer Symptoms and Causes
Kidney Cancer Treatment
Kidney Cancer Treatment Team