Classic kidney cancer symptoms include:
- Hematuria, or blood in the urine;
- Abdominal pain: pain in the area of the kidney, or rib cage;
- Palpable abdominal mass: means that the patient or the doctor can palpate the mass through the skin.
The above 3 points can be called the “triad” of kidney cancer, but only 6% to 7% of patients with kidney cancer will have these symptoms. Most patients with kidney cancer do not have any obvious symptoms.
Hematuria, or blood in the urine, is an important warning sign of a urinary tumor, just as important as blood in the stool and hemoptysis. However, blood in the urine does not always mean cancer; it can have a number of possible conditions:
- Cancer of the kidney or bladder – that’s what we’re worried about.
- Other cancers of the urinary tract in the body, such as ureteral and urethral tumors.
- Stones in the kidney, ureter, or bladder, where abrasion of the stones causes bleeding from mucosal epithelial damage.
- Acute and chronic urinary tract infections, both of the bladder (cystitis) and of the kidneys (pyelonephritis).
- Trauma or injury to the urinary tract, usually associated with strenuous exercise or traffic accidents.
- Benign prostatic hyperplasia.
- Glomerulonephritis.
- Benign renal or bladder vascular abnormalities.
Patients with blood in the urine, either microscopic or visual hematuria, should be evaluated and identified. This usually requires the following tests:
- Blood tests to determine kidney function.
- Urine testing to detect infection or urine exfoliation cytology to detect cancer cells.
- Fluoroscopic radiographs of the kidneys and high-dose intravenous pyelogram.
- Ultrasound examination of the kidneys and bladder.
- Cystoscopy (direct view of the bladder from the inside).
All of these tests are necessary for adults who present with symptoms of hematuria and want to find out the cause. In addition, hematuria can occur with kidney cancer invading the renal pelvis, but some kidney tumors do not present with hematuria.