screening-and-testing-for-kidney-cancer

Screening and Testing for Kidney Cancer

da Vinci® Partial Nephrectomy

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Unfortunately, there are no blood or urine tests that detect kidney cancer. When kidney cancer is suspected, your doctor will order a kidney imaging study. The initial imaging study is usually an ultrasound or CT scan. In some cases, a combination of imaging studies may be needed to completely evaluate the tumor.

Tests to Determine Kidney Cancer Stage

If cancer is suspected, you should be evaluated to see if it has spread beyond the kidney (metastasized). An evaluation consists of imaging studies such as an ultrasound or CT scan. These tests may be followed by an MRI, X-rays and blood tests. You may also need a bone scan if you have had bone pain, recent fractures, or abnormal blood tests. Additional tests may be ordered if your doctor feels they are needed to completely evaluate the tumor. The most common tests to diagnose and evaluate kidney cancer are:1

Computed Tomography (CT scan)

A CT scan is a highly specialized x-ray used to visualize internal organs and provides a very accurate cross section picture of specific areas of the body. It is one of the primary imaging tools for assessing kidney cancer. CT scans are more detailed then ordinary x-rays, taking pictures of your organs one thin slice at a time from different angles. Then a computer puts the images together to show the size and location of any abnormalities. To enhance the image of the abdominal organs, dye may be swallowed before the scan or delivered intravenously (IV directly into a vein).

Magnetic Resonance Imaging (MRI)

An MRI is a highly specialized scan that is similar to a CT scan, but may be better for assessing certain areas of the body like the bones. It creates an accurate cross-section picture of specific organs within the body to allow for a layer-by-layer examination using a powerful magnet to produce the images.

Ultrasonography (ultrasound or US)

If there is blood in the urine, an ultrasound of the abdomen with special attention to the kidneys, ureters, and bladder may be ordered. Ultrasound uses sound waves to produce images of internal organs. That helps the radiologist to detect any masses that may be present.

Intravenous Pyelogram (IVP)

An intravenous pyelogram (IVP) test may also be used. Special dye is injected into a blood vessel, usually in the arm. The dye circulates through the blood stream to the different organs of the body including the kidneys. X-rays are taken of the kidneys as the dye circulates through them. This will identify any abnormalities within the kidney. If either the ultrasound or IVP is abnormal, a CT scan may be ordered.

Chest X-ray

A plain x-ray of the chest may be done to see if the cancer has spread to the lungs. If something is seen on the x-ray, the doctor may order a CT scan of the chest to help determine what it is.

Angiography

This procedure is used to visualize location and function of arteries. A catheter is usually threaded up a large artery in the leg into an artery leading to your kidney (renal artery). A contrast dye is then injected into the artery to outline blood vessels. Angiography can outline the blood vessels that supply a kidney tumor, which can help a surgeon better plan an operation.

Biopsy Procedure

If, after diagnostic tests are completed, there is a strong suspicion that the kidney mass is malignant (cancerous), surgical removal of the kidney tumor will be performed immediately. If the diagnostic test results are not clear, a biopsy may be performed. During a biopsy procedure a small sample of tissue is removed from the mass and examined to determine whether it is benign or malignant. There are several ways to perform a biopsy of a kidney mass. The most common method is a procedure called a fine needle aspiration (FNA) or fine needle biopsy. Using ultrasound or a CT scanner for guidance, the doctor will insert a long thin needle through the skin directly into the mass and remove the sample tissue for analysis by a pathologist.

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  1. "About Kidney Cancer", Kidney Cancer Association, www.kidneycancer.org , URL: http://www.kidneycancer.org/knowledge/learn/about-kidney-cancer

All surgery presents risk, including da Vinci Surgery. Results, including cosmetic results, may vary. Serious complications may occur in any surgery, up to and including death. Examples of serious and life-threatening complications, which may require hospitalization, include injury to tissues or organs; bleeding; infection, and internal scarring that can cause long-lasting dysfunction or pain. Temporary pain or nerve injury has been linked to the inverted position often used during abdominal and pelvic surgery. Patients should understand that risks of surgery include potential for human error and potential for equipment failure. Risk specific to minimally invasive surgery may include: a longer operative time; the need to convert the procedure to an open approach; or the need for additional or larger incision sites. Converting the procedure to open could mean a longer operative time, long time under anesthesia, and could lead to increased complications. Research suggests that there may be an increased risk of incision-site hernia with single-incision surgery. Patients who bleed easily, have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci Surgery. Other surgical approaches are available. Patients should review the risks associated with all surgical approaches. They should talk to their doctors about their surgical experience and to decide if da Vinci is right for them. For more complete information on surgical risks, safety and indications for use, please refer to http://www.davincisurgery.com/da-vinci-surgery/safety-information.php.

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