Renal cell carcinoma is rarely detected in the early stages of disease, since there are often no obvious symptoms until the disease has reached an advanced stage.

However, if symptoms do present such as blood-tinged urine or pain below the ribs, a blood test and urine sample will be taken. If the GP suspects kidney cancer may be present, the patient will be referred for further tests.

Diagnostic steps

Some of the steps taken to diagnose renal cell carcinoma include:

• A detailed medical examination is performed and the patient is asked about factors such as any history of high blood pressure or kidney disorders and lifestyle factors such as diet, alcohol consumption and smoking.
• Imaging studies

One of the first tests performed is an ultrasound scan, which uses high-frequency soundwaves to generate images of the inside of the kidney. The scan is used to check for any changes in the shape of the kidney that may indicate cancer. Other imaging studies that may also be performed include a computed tomography (CT) scan and a magnetic resonance imaging (MRI) scan.

Image-guided biopsy

In some cases, an image-guided biopsy may be performed during which a surgeon uses ultrasound or CT imaging to guide a needle towards the kidney and remove a small sample of tissue. This is then sent for analysis under the microscope to check for the presence of cancer cells.

Once a diagnosis is confirmed, the stage and grade of the cancer can be determined, which helps to plan the most suitable treatment approach and predict patient outcoms. The stage refers to how far the cancer has spread, while grade refers to how aggressive it is. Kidney cancer is graded on a scale of one to four, where one represents the least aggressive cancer and four represents the most aggressive.