In my experience I had symptoms of blood in my urine, and a CT showed the growths/tumors. It's not possible to tell fir certain that it's cancer without a biopsy... but they can tell that it's something that should not be there. My urologist recommended my surgeon... and after meeting him, I had confidence in him. I also researched his reviews. We opted for surgery and made a plan for what would be done during it , given the size of the tumor. I had partial nephrectomys which means removal of tumor and reconstruction of the kidneys with robotic technology...so it was less invasive... about 7 small incisions instead of large ones.