Kidney cancer

You will have blood samples taken. These help your doctors to check how well your kidneys and liver are working. They also show the number of blood cells in your blood. This is called a full blood count.

An ultrasound scan uses sound waves to create a picture of the kidneys, ureters and bladder. This test scan can look for changes in the shape of the kidneys. It can help show whether a lump is a cyst or a more solid tumour. It can also show the position of a cancer and its size.

A CT scan takes a series of x-rays which create a three-dimensional (3D) picture of the inside of the body.

If doctors see a possible kidney cancer while doing a scan for another reason, they may request a CT scan to look at the kidneys. Your doctor or nurse may call this a triple-phase CT scan.

A CT urogram is a type of CT scan. It looks at the kidneys, ureters and bladder. You may have this type of scan if you have blood in your urine.

A flexible cystoscopy looks for changes inside the bladder. You may have this test if you have blood in the urine. You usually have this test under a local anaesthetic, so you are awake during it. Before the cystoscopy you are asked to give a sample of urine, which is checked for infection.

A biopsy is when a sample of tissue is taken from the body and tested for cancer cells. Usually, the sample is collected from an abnormal area of the kidney. But if doctors think that kidney cancer has spread to a different part of the body, the sample may be taken from there. 

Not everyone will have a biopsy. The doctor may decide you need a biopsy to plan the treatment most suitable for you. The doctor uses an ultrasound scan or a CT scan to guide them to the area of kidney they want to take the biopsy from.

During a biopsy, the doctor injects some local anaesthetic into the skin to numb the area around the kidney. They then guide a needle through the skin into the kidney. They use the needle to take a small sample of tissue. They send the sample to the laboratory to be checked for cancer cells. If cancer is found, tests are used to find out more about the type and grade of kidney cancer.

You may need to stay in hospital for a few hours, or overnight, after a biopsy.

A CT scan takes a series of x-rays which create a three-dimensional (3D) picture of the inside of the body. You may have a CT scan of your chest, tummy (abdomen) and pelvis. This is usually done to see whether the cancer has spread outside of the kidney to other parts of your body.

An MRI scan uses magnetism to build up a detailed picture of areas of your body. is sometimes done to see whether a kidney cancer has spread to other parts of the body, such as the bones or brain.

Depending on the stage of the cancer and your general health, you may have surgery to remove part of your kidney or the whole kidney. You may also have some surrounding tissue and lymph nodes removed.

Rarely, surgery may be used to remove cancer that has spread to another part of the body.

Tumour ablation may be used instead of surgery to treat small kidney cancers. It destroys the cancer cells with very high or low temperatures.

Arterial embolisation may be offered if surgery is not possible for you. It can shrink the tumour and help control symptoms by blocking its blood supply.

Monitoring a kidney cancer is way of delaying treatment until it is needed. It is sometimes called active surveillance. The main advantage of monitoring is that you can avoid the risks or side effects of treatment. You may be offered monitoring if you have very small, slow-growing kidney cancer. It is most likely to be offered to people who have health problems that would increase the risks of surgery.

Targeted therapy drugs affect the way that cancer cells grow. They are used to treat kidney cancer that has spread to other parts of the body (advanced or metastatic kidney cancer).

Immunotherapy drugs encourage the body’s immune system to fight cancer cells. They are used to treat kidney cancer that has spread to other parts of the body (advanced or metastatic kidney cancer). 

Radiotherapy uses high-energy rays to destroy cancer cells. You may have radiotherapy to control kidney cancer that cannot be removed with surgery. Radiotherapy is also given to treat the symptoms of kidney cancer such as bleeding. It can also be used to treat kidney cancer cells that have spread to other parts of the body such as the lung, brain or bones.

Below is a sample of the sources used in our kidney cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

Escudier B, et al. Renal cell carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology 30: 706-720, 2019. doi:10.1093/annonc/mdz056 Published online 21 February 2019. Available from www.annalsofoncology.org/action/showPdf?pii=S0923-7534%2819%2931157-3 (accessed April 2021).

European Association of Urology. Renal cell carcinoma guidelines. EAU Guidelines. Edn. presented at the EAU Annual Congress Milan 2021. ISBN 978-94-92671-13-4. Available from www.uroweb.org/guideline/renal-cell-carcinoma (accessed April 2021).

National Institute for Health and Care Excellence (NICE): Nivolumab with ipilimumab for untreated advanced renal cell carcinoma. Technology appraisal guidance (TA581). Published 15 May 2019. Available from www.nice.org.uk/guidance/ta581 (accessed April 2021).

This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Lisa Pickering, Consultant Medical Oncologist.

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