Your doctor can begin the diagnosis by asking you questions about the symptoms you experience and your medical history. He will do a physical examination searching for signs indicating the presence of the cancer. In addition, he will recommend blood and urine tests to detect kidney failure and look for presence of blood in your urine, which is a vivid sign of renal cell carcinoma.
However, confirmation of the diagnosis is based on biopsy and imaging techniques: ultrasound, CT, MRI, intravenous urography (UVI).
Ultrasound, CT & MRI – an abdominal ultrasound or CT scan allows your doctor to see if the renal vessels and the surrounding tissue are affected or compressed by the tumor, chest x-ray and CT scan can be performed to search for lung metastases. The role of the abdominal MRI is to clarify the extent of the tumor in the renal area and detect if it has spread.
Biopsy – a renal biopsy is an essential procedure in the diagnosis of kidney cancer. During the exam, your physician removes a tiny sample of cells from your diseased kidney. To get access to the renal tissue, the physician can perform a transcutaneous intervention, use of a needle or a trocar; or open surgery, done through skin incision.
Open biopsies are rare and are usually performed by an experienced surgeon. Although useful, open biopsies of the kidney are accompanied with risk of infection and bleeding. In addition, the biopsies can cause the tumor to spread to other areas of your body.
Intravenous urography (IVU) – also called intravenous pyelogram, an IVU is a painless medical procedure that enables your physician, after intravenous injection of a contrast agent, to visualize and examine your urinary tract organs: kidneys, ureters, and bladder. Using this test, it is possible for your doctor to detect abnormalities such as malformations, tumors or stone in the ureter.