NCCN Guidelines for Patients
Kidney Cancer, Version 1.2017
Urine tests | Tissue 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
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 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
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
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