Diagnosis of Renal Cell Carcinoma
There are a number of examinations and test that can be administered for the diagnosis of renal cell carcinoma. Often times, a number of these tests will be used in combination to provide the most accurate diagnosis. Initially, a medical professional will perform a physical examination and discuss personal and familial medical history. Physical symptoms of renal cell carcinoma will be evaluated along with high-risk factors, such as smoking or inherited syndromes. Although this initial evaluation can be revealing, further tests are needed to make an accurate diagnosis.
The next step in the diagnosis of renal cell carcinoma is testing various body functions through the examination of bodily fluids. Blood is extracted and analyzed to determine certain substance levels. A liver function test is performed in this way; a blood sample will show hormones and enzymes being released by the liver. Lower or higher-than-normal hormone or enzyme levels will alert a medical professional to a possible renal cancer tumor. A urinalysis is another way to test bodily fluid. A sample of urine is taken and analyzed for abnormal colors or chemical contents. Both blood and urine tests can be deceiving; further examinations are often needed to be certain of the diagnosis.
Another test for the development of renal cell carcinoma is an intravenous pyelogram (IVP). This test involves a series of x-rays of the kidneys, ureters and bladder. These x-rays are taken in five and ten minute intervals until the desired area glows white from an injected contrast dye, revealing any abnormal lumps or masses. This process can take anywhere from a few minutes to a few hours. It is essentially a painless procedure with few possible side effects.
An ultrasound examination can be used to determine the diagnosis of renal cell carcinoma. During an ultrasound examination, high-energy sound waves are bounced off internal tissues and organs to create echoes. These echoes are made into a sonogram picture, which can reveal abnormal masses located in the kidneys and surrounding tissues and organs. The procedure is completely painless and believed to be harmless.
The most reliable test for diagnosing renal cell carcinoma is a surgical biopsy of the renal mass. A small sample of the mass is removed via a needle. The sample is then examined under a microscope to determine its status as a cancerous entity. Once the mass has been diagnosed as cancerous, the Fuhrman Grading scale can be used to determine the aggressiveness of renal cancer development. The Fuhrman Grading is based on how similar the cancer cell nuclei are in appearance to normal kidney cells. Grade I means there is little difference between the nuclei and the prognosis is good; Grade IV denotes extremely different nuclei and a poor prognosis.
Other common renal cell carcinoma tests include: chest x-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) and nuclear bone scans. Chest x-rays can detect if renal cancer has spread to the lungs. CT scans are detailed x-rays that produce cross-sectional images of the body. They expose metastatic kidney cancer – renal cancer that has spread to the liver or other organs – and can help to guide the needle during biopsies. MRIs use radio waves and strong magnets to map the body instead of x-rays. The images produced by MRIs are both cross-sections and parallel slices of the body. They are extremely useful when performing a metastatic kidney cancer test on the brain and spinal cord.