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Confirming Your Kidney Cancer Diagnosis
Most people with kidney cancer first come to Fred Hutch after being diagnosed by another physician, often their primary care physician. We confirm this diagnosis and other details about your disease so we can provide the right treatment for you. Diagnosing kidney cancer involves a series of blood and urine tests as well as imaging tests — such as an ultrasound, X-ray, CT or MRI scans — to check the size of the tumor or spread of the cancer. A tumor biopsy or tumor surgery gives us details about the stage of your kidney cancer.
Staging Kidney Cancer
Staging means finding out how far kidney cancer has spread in your kidney or other parts of your body. Knowing the stage of your cancer helps your physician predict how well a treatment may work and which treatments are most likely to control your disease or slow down its growth.
Stages of Renal Cell Carcinoma
Physicians use Roman numerals I (one), II (two), III (three) and IV (four) to name stages of cancer, with I being the least advanced and IV being the most advanced. All stages can be treated.
- Stage I: The tumor is up to 7 cm (centimeters) across and is only in one kidney. It has not spread into blood vessels, lymph nodes or distant organs.
- Stage II: The tumor is larger than 7 cm and remains only in one kidney.
- Stage III: The tumor can be any size and may be outside the kidney, in blood vessels, or may have spread to nearby lymph nodes.
- Stage IV: The tumor is growing and has spread to distant parts of the body, such as the lungs, liver or bones.
Tests to Diagnose the Stage of Disease
To diagnose the stage of your kidney cancer, you need imaging tests and blood tests.
Imaging tests show where the cancer cells are inside your kidney, if other organs are affected and if you have any large tumors.
Blood tests help to show your physicians how severe your disease is, if your organs are working well and how urgently you need treatment.
Imaging tests to stage kidney cancer may inlcude:
- Abdominal ultrasound
- Chest X-ray
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI)
- Fluorodeoxyglucose positron emission tomography (FDG-PET) scan
Blood tests to stage kidney cancer include:
- Complete blood count (CBC)
- Comprehensive metabolic panel
- Lactate dehydrogenase (LDH)
Other tests you might need:
Your doctor recommends other tests based on your kidney cancer subtype and your signs and symptoms. For example, if kidney cancer appears to affect your brain or spinal cord, you may need brain imaging or a lumbar puncture. If kidney cancer affects your bones, your doctor may order a bone scan.
Types of Treatment for Kidney Cancer
There are more treatment options today than ever before to control kidney cancer or help you live a full life with kidney cancer.
Renal Cell Carcinoma
About 90 percent of all kidney cancers are renal cell carcinoma (RCC). It grows in the lining of the tiny tubules inside the kidney that filter the blood and make urine. Usually, it grows as a single mass inside a kidney. Sometimes, there are two or more tumors in one kidney or even tumors in both kidneys at the same time.
There are several subtypes of RCC:
- Clear cell: This is the most common form, affecting about 70 percent of people with RCC. Sometimes, it is also associated with another condition called von Hippel-Lindau syndrome, but this is rare.
- Papillary kidney cancer: About 10 percent of RCC cases are papillary kidney cancer. It is associated with hereditary papillary RCC, hereditary leiomyomatosis and RCC syndromes.
- Chromophobe renal cell carcinoma: About five percent of cases are chromophobe renal cell carcinoma. Birt-Hogg-Dubé syndrome, a genetic mutation, is associated with chromophobe RCC.
- Collecting duct renal cell carcinoma: This type of cancer is very rare.
- Translocation renal cell carcinoma: This form of cancer is rare, but getting more common. It appears in late adolescence and young adulthood.
- Medullary renal cell carcinoma: This type of cancer is very rare, affecting younger patients and is closely associated with sickle cell hemoglobinopathies.
- Unclassified renal cell carcinomas: These are cancers that do not fit into any other categories or may have more than one type of cell. They often include aggressive tumors that do not respond well to traditional therapies for RCC. Our sub-specialized genitourinary pathologists are experts in diagnosing these unclassified renal cell carcinomas.
Urothelial Carcinoma (Transitional Cell Carcinoma)
Urothelial carcinoma, also called transitional cell carcinoma (TCC), makes up five to ten percent of adult kidney cancers. Urothelial carcinoma and bladder cancer both develop in the cells that line the renal pelvis and bladder. The renal pelvis is the part of the kidney where urine collects before moving to the bladder.
Renal Sarcoma
Renal sarcoma is the rarest kidney cancer and makes up just one percent of all kidney cancer cases. It develops in the fat or the connective tissue around the kidney. While this type of cancer is typically treated with surgery, it often comes back in the kidney area or reappears in other parts of the body, so it often requires additional surgery or chemotherapy.
Wilms Tumor
Wilms tumor, also known as nephroblastoma, almost always happens in children and makes up about one percent of adult kidney cancers. Surgery and chemotherapy are usually the most successful treatments for this type of tumor.
Resources
There are many resources online for learning about your disease. Health educators at the Fred Hutch Patient and Family Resource Center have compiled a list of trusted sources to help you get started.
Whether you are newly diagnosed, going through treatment or know someone with cancer, our staff are available to tailor personalized resources and answer questions about support options in the community.
Cancer Research Organizations
Our list of online resources provides accurate health information from reliable and reputable sources, like the National Cancer Institute (NCI), the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN).
American Cancer Society
American Cancer Society (ACS): Overview of Kidney Cancer
If you have kidney cancer or are a caregiver for someone who does, knowing what to expect can be helpful. Here you can find out all about kidney cancer in adults, including risk factors, symptoms and how they are found and treated.
American Society of Clinical Oncology
American Society of Clinical Oncology (ASCO): Guide to Kidney Cancer
This is Cancer.Net's Guide to kidney cancer. Here you can learn more about kidney cancer, treatment, the latest research and clinical trials.
American Society of Clinical Oncology
ASCO Answers: Kidney Cancer
ASCO Answers is a collection of oncologist-approved patient education materials developed by ASCO for people with cancer and their caregivers. Here you can find illustrations and information on kidney cancer.
CancerCare
CancerCare Treatment Update: Kidney Cancer
The CancerCare Connect® Booklet Series offers up-to-date, easy-to-read information on the latest treatments, managing side effects and coping with cancer.
CancerCare
CancerCare: Kidney Cancer General Information and Support
CancerCare provides free, professional support services for people affected by kidney cancer, as well as kidney cancer treatment information and additional resources, including financial and co-pay assistance.
National Cancer Institute
National Cancer Institute (NCI): Kidney (Renal Cell) Cancer-Patient Version
The NCI is the federal government's principal agency for cancer research and training. Here you can find more information about kidney cancer treatment, research and coping with cancer.
National Comprehensive Cancer Network
National Comprehensive Cancer Network (NCCN) Guidelines for Patients: Kidney Cancer
This step-by-step guide to the latest advances in cancer care features questions to ask your physician, patient-friendly illustrations and glossaries of terms and acronyms.
Cancer Support Organizations
Our list includes local and national organizations that are dedicated to improving the quality of life for patients and family members through providing emotional support, education and community.
Fred Hutchinson Cancer Center
Fred Hutch hosted the free, virtual Kidney Cancer Patient and Caregiver Education Symposium, in partnership with KidneyCAN and Kidney Cancer Association on July 27, 2024. Medical experts discussed newly emerging treatment options, updates on the Kidney Cancer Multispecialty Clinic (KCMC), surgical advancements, and nutrition. The webinar also included introductions from patient advocacy and support groups.
Fred Hutchinson Cancer Center
Kidney and Bladder Cancer Support Group
The Fred Hutch Kidney and Bladder Support Group is open to all patients, survivors and their families. Meetings are held at the South Lake Union Clinic.
Kidney Cancer Association
Kidney Cancer Association (KCA)
KCA is a charitable organization made up of patients, family members, physicians, researchers and other health professionals globally. It is the world’s first international charity dedicated specifically to the eradication of death and suffering from renal cancers.