After renal cell cancer has been diagnosed, tests are done to find out if cancer cells have spread within the kidney or to other parts of the body.

The process used to find out if cancer has spread within the kidney or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:

• CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
• MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
• Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
• Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.

The following stages are used for renal cell cancer:

Pea, peanut, walnut, and lime show tumor sizes.

Stage I

In stage I, the tumor is 7 centimeters or smaller and is found only in the kidney.

Stage II

In stage II, the tumor is larger than 7 centimeters and is found only in the kidney.

Stage III

In stage III, cancer is found:

• in the kidney and in 1 nearby lymph node; or
• in an adrenal gland or in the layer of fatty tissue around the kidney, and may be found in 1 nearby lymph node; or
• in the main blood vessels of the kidney and may be found in 1 nearby lymph node.

Stage IV

In stage IV, cancer has spread:

• beyond the layer of fatty tissue around the kidney and may be found in 1 nearby lymph node; or
• to 2 or more nearby lymph nodes; or
• to other organs, such as the bowel, pancreas, or lungs, and may be found in nearby lymph nodes.