If kidney cancer is suspected, the doctor prescribes the necessary examinations. With their help, he can find out if there is a tumor, and if so, what type of tumor and how far the disease has gone.
History and examination of the patient
Before starting treatment for kidney cancer in Germany, the doctor asks in detail about current complaints, medical history, possible risk factors (anamnesis). Then he examines the patient, including palpation of the abdomen for the presence of nodes. In men, varicose veins in the testicles can sometimes indicate a kidney tumor.
In order to check the function of the kidneys and other organs such as the liver, heart and lungs, the patient's blood and urine are examined before choosing a treatment for kidney cancer in Germany. A small proportion of patients with kidney cancer have blood in their urine. Certain changes in the blood, such as anemia (anemia), changes in blood proteins, increased calcium levels, an increase in a certain enzyme (alkaline phosphatase), and an altered erythrocyte sedimentation rate, may indicate the type of disease. Until now, there is no known specific tumor marker (substances intensively produced by tumor cells) that is reliably suitable for recognizing kidney cancer.
Ultrasound examination (sonography)
Ultrasound is the most important research method for diagnosing renal carcinoma. Experienced physicians can distinguish a tumor from a benign cyst in 90% cases. Ultrasound can also determine whether the tumor has spread to other organs (metastasis formation). Other abdominal organs, especially the liver and lymph nodes, are examined for metastases. In addition, sonography makes it possible to evaluate the renal vessels and vena cava. These blood vessels may be completely or partially blocked by tumor tissue. In this case, they speak of a "tumor thrombus". Evaluation of vessels is primarily important for planning the operation.
Computed tomography (CT) of the chest and abdomen
Computed tomography is the most reliable when it is required to distinguish a benign tumor from a malignant kidney tumor. In addition, it serves to accurately determine the spread of the tumor and the search for metastases.
Especially in cases of small tumors ("SRM`s, «small renal masses“) in very old people, the question may arise whether it is necessary to treat kidney cancer in Germany surgically, whether such a tumor should be operated on at all. Indeed, not all such small tumors are malignant. Therefore, in each specific case, it is possible to discuss sampling by means of a biopsy with a thin hollow needle or a puncture biopsy, after which the further path of treatment can be individually determined with the patient or his relatives.
Magnetic resonance imaging (MRI)
MRI is performed, as a rule, in cases where computed tomography is not possible due to intolerance to the contrast medium by the patient. In exceptional cases, an MRI is prescribed if the results of a CT scan cannot be unambiguously assessed.
Angiography (image of blood vessels with a contrast agent)
Angiography is prescribed in cases where a particularly complex organ-preserving operation is needed. With the help of angiography, the urologist can determine the state of the tumor in relation to the vessels. This is important for the planning of the operation.
Skeletal bone scintigraphy
If there is a suspicion that the tumor has affected the bones (bone metastases), a scintigraphy of the bones of the skeleton can be performed. To do this, a small amount of a radioactive substance is injected into the bloodstream with a syringe, which accumulates especially in diseased bones. A camera that registers radioactive radiation determines the location of areas suspected of metastases. The examination is not burdensome, and the radiation quickly weakens.