Tests for kidney cancer

Usually, you begin by seeing your GP who will ask you about your general health and examine you.

Your GP will ask you to give a urine sample. They will test for small amounts of blood (haematuria) which can be a sign of kidney cancer. Often the amount of blood in the urine is so small that it can't be seen but it can be picked up by the test. The doctor may also take some blood to do other tests. They may do a physical examination to feel for any lumps or swelling. But because the kidneys are deep inside the body, the doctor may not be able to feel small tumours.

Your doctor should refer you to see a specialist at the hospital if you have blood in your urine. It is important that you tell the doctor if anyone else in your family has had kidney cancer. This could help the doctor decide what tests to do.

There are guidelines for GPs to help them decide who needs an urgent referral to a specialist. These referral guidelines are covered in this section.

The specialist will begin by asking you about your medical history and symptoms. If your urine test has picked up blood the doctor will do more urine tests. You will be asked to have more blood tests.

It is important for the doctor to take a look at your kidneys with one of the following tests

• Ultrasound
• CT urogram
• Intravenous pyelogram (IVP)

You will probably need to have a cystoscopy so that the doctor can check inside your bladder to make sure that any blood in your urine isn't coming from there.

Ultrasound can show any growths inside the kidney. There is information about having an ultrasound scan in the cancer tests section.

You may have a special computerised tomography (CT) scan called a CT urogram instead of an IVP (see below). Or you may have both tests. The CT scanner creates computerised, three dimensional pictures that allow your doctor to see the whole urinary tract clearly. 

For a CT urogram you have an injection of a dye into a vein. Then a CT scanner takes a series of X-rays to give a detailed picture of the kidneys, ureters and bladder.

There is information about having a CT scan in the section about cancer tests. Before the test you may have a drug called furosemide to make you produce more urine and give better pictures of the kidneys.

IVP is also sometimes called intravenous urogram or IVU. A dye is injected into your bloodstream during this test. A short time afterwards you have X-rays of the kidneys, ureters and bladder. The dye can show any growths in the tubes inside or leading from the kidneys. There is information about having an IVP in the about cancer section.

Your doctor may also want to look directly inside your bladder because this is part of the same body system as your kidneys. You might have this test if you have blood in your urine. To do this test the doctor uses a cystoscope, which is a tube put into your urethra and up into the bladder. It has a light at one end and an eyepiece at the other. You can have a cystoscopy under local or general anaesthetic. You may have a cystoscopy under local anaesthetic at your first appointment because it can be done quickly and simply. There is information about having a cystoscopy under local anaesthetic and about cystoscopy under general anaesthetic in the bladder cancer section.

Your doctor will ask you to go back to the hospital when your test results have come through. But this is bound to take a little time, even if only a few days. This can be a very anxious time. 

While you are waiting for results it may help to talk to a close friend or relative about how you feel. Or you may  want to contact a cancer support group to talk to someone who has been through the same experiences.

Our kidney cancer organisations page gives details of people who can help and support you. You can also find details of counselling organisations in our counselling section. Our kidney cancer reading list has information about books and leaflets on kidney cancer and its treatment.