Your child will have a number of tests to investigate their symptoms and confirm a diagnosis of a kidney tumour, including:
- medical history and physical examination
- blood tests
- urine tests
- medical imaging, which may include
- computed tomography (CT) scan
- magnetic resonance imaging (MRI)
- bone scan
- biopsy – where a small sample of the cancer is removed to be examined under a microscope. The sample can also be tested for genetic changes that can help determine the best type of treatment for your child.
These tests are explained in more detail in How is cancer diagnosed?.
If your child is diagnosed with a kidney tumour, some of the diagnostic tests will also help to stage the tumour. Staging determines where the tumour is, how big it is and whether it has spread to other parts of the body. This is important to determine the outlook (prognosis) for your child, and to decide on the best options for treatment.
There are different ways to assess the stage or extent of disease. One of the most common ways of describing stages for Wilms tumour is as follows:
- Stage I – the tumour was in 1 kidney, and the outer layer of the kidney has not been broken. The tumour has not spread and was completely removed by surgery.
- Stage II – the tumour has grown beyond the kidney into nearby tissue or blood vessels, but not to the lymph nodes, and was completely removed by surgery.
- Stage III – the tumour was not completely removed by surgery, but it has not spread beyond the belly. There might be cancer cells around the edges of the surgery site or elsewhere within the belly cavity, or the tumour might have invaded important tissues nearby (such as a major blood vessel) so that it could not be removed during surgery. The cancer might have spread to nearby lymph nodes.
- Stage IV – the cancer has spread to other organs that are far away from the kidneys, such as the lungs, liver, brain, bone or distant lymph nodes.
- Stage V – there are tumours in both kidneys when Wilms tumour is first diagnosed.