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NCCN Guidelines for Patients



Kidney Cancer, Version 1.2017



Urine tests | Tissue tests

Urine tests

Doctors test urine to look for signs of disease and

assess your general health. These tests are not used

to confirm (diagnose) kidney cancer. But, abnormal

results may signal there’s a problem with your

kidneys or other organs. Abnormal results may be

caused by kidney cancer or other health conditions.

For a urine test, your doctor will ask you to fill a small

container with your urine. You may only need to give

one sample of urine for the test. Or, your doctor may

want to collect your urine over a 24-hour period. The

urine sample will be sent to a lab for testing. The

urine tests that may be used for kidney cancer are

described below.


Urinalysis is a test that checks the content of urine

using a microscope and chemical tests. Doctors use

this test to look for small amounts of blood or other

abnormal substances in urine that can’t be seen with

the naked eye. Blood in urine may be caused by

kidney cancer or other health problems.

Urine cytology

Urine cytology is a test in which urine is examined

with a microscope to check for cancer cells. Urine

cytology is not used for kidney cancer. But, this test

may be used if your doctor suspects TCC or bladder


Tissue tests

A biopsy is a procedure that removes samples of

tissue from your body for testing. Doctors test tumor

tissue to check for cancer cells and to look at the

features of the cancer cells. A biopsy is the only way

to confirm (diagnose) most types of cancer.

For those cancers, a biopsy must be done before

starting cancer treatment. Kidney cancer is different.

Imaging tests are very good at showing if a kidney

tumor is cancer. Doctors can often confirm kidney

cancer based on the imaging test results. Thus, a

biopsy of the tumor is rarely needed before starting

treatment. Instead, a biopsy may be done when the

tumor is removed with surgery.

A biopsy may be done before treatment in some

cases, such as when:



A tumor is very small and might not be treated

with surgery. In this case, a biopsy may be

done to confirm kidney cancer and to help

guide the treatment plan.



Doctors think a tumor might be TCC. In this

case, a biopsy may be done to confirm the

cancer type.

There is more than one type of biopsy. For kidney

cancer, a biopsy is done with a needle. This is called

a needle biopsy. A needle biopsy uses a long, hollow

needle that is inserted through your skin to remove a

sample of the tumor.

Before the biopsy, the area of skin near your kidney

will be cleaned. It will also be numbed with local

anesthesia. Next, you may be asked to hold your

breath while your doctor inserts the needle. Your

doctor will push the needle through your skin and into

the tumor in your kidney. Imaging tests such as a CT

scan or ultrasound will help guide the needle to the

right spot. A sample of tumor tissue will be collected

in the hollow center of the needle.

A needle biopsy may take up to one hour to

complete. You may feel some pain in your belly area

afterward. Rarely, serious problems like bleeding

may occur.