Kidney (Renal Cell) Cancer

• A contrast-enhanced CT or MRI of the abdomen showing the tumour size, position and any involvement of the renal vein or caval vein.
• A chest CT, to check for spread to the lungs, which is routine in staging.
• Blood tests including creatinine and eGFR, haemoglobin and calcium, plus a split renal function scan if kidney function is in question.
• Biopsy results if one was done, showing the subtype such as clear cell or papillary and the grade.
• Details of other health problems, especially hypertension, diabetes and any family history of kidney cancer or genetic syndrome.

1. What are the stage and grade of my tumour, and what subtype is it?
2. Can my tumour be removed with a partial nephrectomy, and what is the effect on my remaining kidney function?
3. Is a robotic or laparoscopic approach suitable, and how experienced is the surgeon with it?
4. Are surveillance, ablation or radiotherapy reasonable alternatives for me?
5. What follow-up scans will I need and for how long, and what signs of recurrence should I look for?
6. If the cancer has spread, which drug treatments could be used?

Outlook depends largely on stage. Small tumours confined to the kidney are often cured by surgery, and five-year survival is high. Larger tumours, spread to veins or lymph nodes, and distant spread lower the outlook, though modern immunotherapy and targeted drugs have improved control of advanced disease. Follow-up scans are needed for years because recurrence can occur late.