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NCCN Guidelines for Patients



Kidney Cancer, Version 1.2017


Treatment guide

Stage IV and relapsed kidney cancer

A baseline CT or MRI scan should be done before

starting treatment. A baseline test is a starting point

to which future tests are compared. After the baseline

test, ongoing imaging tests are used to show if the

cancer grows or shrinks over time.

Imaging tests of your head will show if the cancer

has spread to your brain. Your doctor may want to

do a baseline CT or MRI scan of your brain before

starting treatment. After that, you may have a CT or

MRI scan of your head once a year. Imaging tests

should also be done as needed such as to check out

certain symptoms.

Other imaging tests, such as a bone scan or MRI

scan of your spine, aren’t recommended as standard

follow-up tests for all patients. These tests may

be done as needed such as if there are signs or

symptoms of cancer spread. An MRI of your spine

may be done if you have symptoms that suggest

cancer has spread to your brain or spinal cord.

Some symptoms of cancer in the brain are chronic

headaches, seizures, loss of balance, and weakness

on one side of the body. If you have bone pain or

high levels of ALP in your blood, then a bone scan

may be done to show if cancer has spread to your


Guide 9. Follow-up testing during treatment with drugs

Follow-up tests


Medical history and physical exam

• Every 6 to 16 weeks during drug treatment, or more

frequently as needed based on the drug given

Blood chemistry panel and other blood tests

• As needed based on the drug given

Imaging tests of the chest, abdomen, and pelvis

• Baseline CT or MRI before starting treatment or


• Tests every 6 to 16 weeks based on the doctor’s

judgment and cancer status

CT or MRI of the head

• Possible baseline test before treatment and as needed

• Possible testing once a year based on doctor’s


MRI of the spine

• As needed

Bone scan

• As needed