If a person is suspected to have kidney cancer due to the presence of signs and symptoms, some investigations are required to confirm the diagnosis of the disease. Further, these investigations can help in determining the extent of loco-regional invasion or spread of the disease to other body parts, which in turn help in choosing an appropriate treatment option. Following are some commonly used diagnostic tools for kidney cancer:
1. Urinalysis: In this test, a urine sample (collected from the patient presented with symptoms of kidney cancer) is tested in a laboratory for the various biochemical parameters, including blood cells (RBCs and WBCs). Apart from this, urine culture and urine cytology are also performed to exclude any possibility of urinary tract infection and transitional cell carcinoma of the lower urinary tract, respectively. These conditions can also produce symptoms similar to that of kidney cancer.
2. Ultrasound: In this technique, a special probe is used, which directs very high-frequency sound waves towards the internal body parts to be examined. The sound waves are reflected off the internal structures depending upon their ability to reflect these waves and collected by a special detector to produce a real-time image of the internal tissues on a computer screen. This test can distinguish between solid tumors (appear as a solid mass) and fluid-filled cysts. This test can also provide information regarding bilateral kidneys involvement, and ascites (abnormal collection of fluid), if any. It also enables collection of biopsy samples from the affected area via a special biopsy instrument.
3. Imaging Tests: These tests are generally employed after the establishment of the pathological diagnosis. They help to detect the spread of disease to distant body parts and assess the stage of the disease so that an appropriate treatment option can be selected. Alternatively, these tests are employed after treatment to evaluate the treatment efficacy and to detect disease response, progression, or recurrence.
-Computed tomography (CT) scan: In this technique, detailed cross-sectional images of body organs are generated using x-rays, with or without a contrast medium. It can help diagnose the spread of disease to nearby/distant lymph nodes and other organs, and may also be used to guide a biopsy needle into the affected area.
-Magnetic resonance imaging (MRI) scan: This technique provides detailed images of tissues inside the body using radio waves, a strong magnetic field, and gadolinium contrast. It can accurately diagnose the extent of invasion and spread of disease to nearby/distant body parts.
-Positron emission tomography (PET) scan: This technique uses a radioactive substance (e.g.fluorodeoxyglucose [FDG]) that is given intravenously prior to the procedure. Cancer cells absorb larger amounts of the radioactive substance than normal cells. The areas of higher radioactivity indicate cancerous tissue on the PET scan. Thus, this technique can diagnose the spread of disease to distant body parts. It is usually combined with CT scan (PET/CT).
-Intravenous pyelogram (IVP): In this technique, various x-ray images are taken of the urinary system after injecting a contrast (dye) into patient’s vein. The dye outlines the complete urinary system on the x-ray images and is excreted in the urine by kidneys. This helps the doctor to examine the urinary tract for any abnormal areas.
-Bone Scan: In this test, a radioactive material is injected into the vein of the patient, which gets accumulated in the areas of bones affected by the disease, which are then detected with the help of radioactivity detectors. In this way, it may help to detect the spread of cancer to bones.
4. Laboratory Tests for Biopsy Samples: Biopsy samples contain a small number of cells or a tiny piece of tissue collected from the affected area or lymph node with the help of biopsy instrument. These samples provide very useful information about the cancer cells such as the type of cancer, the severity of cancerous changes involved, and the presence of specific defective genes or proteins.
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