Maybe you've had kidney cancer symptoms such as side pain, weight loss, or extreme fatigue. Or maybe your doctor has found a lump in your side during a routine exam or a sign of kidney cancer during a test for another disease. Regardless, to confirm a diagnosis of kidney cancer, you will need a thorough physical exam, health history, and tests.

Your doctor will feel your abdomen and side for lumps and check for fever and high blood pressure, among other things. You will also answer questions about your health habits, any past illnesses, and types of treatment. To make a diagnosis of kidney cancer, your doctor will also order one or more tests like these:

• Urine tests check for blood in your urine or other signs of problems.
• Blood tests show how well your kidneys are working.
• Intravenous pyelogram (IVP) involves X-raying your kidneys after the doctor injects a dye that travels to your urinary tract, highlighting any tumors.
• Ultrasound uses sound waves to create a picture of your kidneys. It can help tell if a tumor is solid or fluid-filled.
• A CT scan uses X-rays and a computer to create a series of detailed pictures of your kidneys. This may also require an injection of dye. CT scans have virtually replaced pyelogram and ultrasound as a tool for diagnosing kidney cancer.
• Magnetic resonance imaging (MRI) uses strong magnets and radio waves to create detailed images of soft tissues in your body. You may need an injection of a contrast agent to create better pictures.
• Renal arteriogram. This test is used to evaluate the blood supply to the tumor. It is not given often but may help diagnose small tumors and has other uses as well.

Unlike with many other cancers, your doctor may be pretty certain about a diagnosis of kidney cancer without a biopsy. In rare cases, it may be done to confirm the diagnosis. A doctor may use a needle biopsy to remove a sample of tissue, which is then examined under a microscope for cancer cells. The biopsy may also tell the grade of the cancer -- how aggressive the cancer is likely to be. Often, the surgeon will simply remove the entire tumor and then have a sample of tissue examined.

Once your doctor makes a diagnosis of kidney cancer, you may need other tests to tell if the cancer has spread within your kidney, to the other kidney, or to other parts of your body. When cancer spreads from the place where it first started, it has metastasized. You might need a CT scan or MRI. A chest X-ray can show whether the cancer has spread to your lungs. A bone scan can see if it is in your bones. PET scans are helpful in telling if cancer has spread to lymph nodes near the kidney. These tests will help your doctor know the stage of kidney cancer.

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