What are the chances of kidney cancer spreading

What is cancer staging?

If you’ve been diagnosed with kidney cancer, your doctor will go through a staging process. Staging is a way to describe a cancer in terms of location and how far it has spread; it helps doctors determine the best course of treatments.

Staging also allows doctors to predict a person’s chance of recovery or outlook. Outlooks are often talked about in terms of survival rates. For example, a five-year survival rate refers to what percentage of people lived at least five more years after a cancer diagnosis.

Knowing survival rates by stage can help you understand your outlook based on the progression of your kidney cancer, but each person’s situation is unique. Survival rates are affected by how well you respond to treatment, along with other risk factors. That means someone with a later stage cancer may live a longer life than a person who’s been diagnosed with an earlier stage cancer, or vice versa.

Learn more about kidney cancer stages and what they mean.

One method doctors use to stage kidney cancer is called the TNM system.

• T refers to the size of the primary tumor and if it has invaded surrounding tissue.
• N is used to identify how far the cancer has spread to lymph nodes.
• M indicates whether the cancer has metastasized, or spread into other organs or more distant lymph nodes.

For example, if you’re told your cancer is T1, N0, M0, that means you have a small tumor in one kidney, but it hasn’t spread to your lymph nodes or organs.

Stage 1 is the least aggressive stage and has the highest five-year survival rate. According to the TNM system, the cancerous tumor is relatively small in the first stage, so it receives a designation of T1. The tumor only appears in one kidney and there’s no evidence that it has spread to lymph nodes or other organs, so it receives N0 and M0 designations.

In stage 1, the cancerous kidney will probably be removed and follow-up therapy might not be necessary. The chances for recovery are good. The five-year survival rate for stage 1 kidney cancer is 81 percent. That means that out of 100 people, 81people diagnosed with stage 1 kidney cancer are still alive five years after their original diagnosis.

Stage 2 is more serious than stage 1. In this stage, the tumor is larger than 7 centimeters across but only appears in the kidney. Now it’s considered T2. But, like stage 1, there’s no evidence that it has spread to nearby lymph nodes or other organs, so it’s also considered N0 and M0.

As in stage 1, a stage 2 cancerous kidney will probably be removed, and follow-up therapy might not be necessary. The five-year survival rate for stage 2 kidney cancer is 74 percent. That means out of 100 people, 74 people diagnosed with stage 2 kidney cancer are still alive five years after being diagnosed.

The TNM system describes two scenarios for stage 3 kidney cancer. In the first scenario, the tumor has grown into a major vein and nearby tissue, but has not reached nearby lymph nodes. This is referred to as T3, N0, M0.

In the second scenario, the tumor can be any size and may appear outside the kidney. In this case, cancer cells also have invaded nearby lymph nodes, but have not gone further. It’s considered, T1-T3, N1, M0.

In either case, treatment will be aggressive. If the cancer has reached the lymph nodes, they may be surgically removed. The five-year survival rate for stage 3 kidney cancer is 53 percent. That means that out of 100 people, 53 people diagnosed with stage 3 kidney cancer will still be living five or more years after being diagnosed.

Stage 4 kidney cancer also can be classified in two ways. In the first, the tumor has grown larger and reached tissue beyond the kidney. It may or may not have spread to nearby lymph nodes, but it still hasn’t metastasized. In this case, the designation is T4, any N, M0.

In the second, the tumor can be any size, may be in lymph nodes, and has metastasized to other organs or further lymph nodes: any T, any N, M1.

The five-year survival rate in this stage drops to 8 percent. That means that out of 100 people, 8 people diagnosed with stage 4 cancer will still be living five years after receiving their diagnosis.

TNM designation and stages are related. For example, stage 1 will never have an M1 designation. Below are the TNM designations you may find in each stage. A checkmark indicates that the TNM designation is possible in that stage.

Certain factors may lower survival rates in stage 3 or 4 kidney cancer. These include:

Other factors that affect outlook are:

• if the cancer has spread to two or more distant sites
• if it’s been less than a year from the time of diagnosis to the need for systemic treatment
• age
• type of treatment

Starting your treatment as soon as possible can help your chances for survival. Treatment may include surgery to remove the tumor, immunotherapy drugs, or targeted drugs.

Five-year survival rate statistics are determined by observing large numbers of people. Each cancer case is unique, however, and the numbers can’t be used to predict outlooks for individuals. If you have kidney cancer and want to understand your life expectancy, speak with your doctor.

Five-year survival rate by stage

If you’ve been diagnosed with kidney cancer, talk to your doctor about your stage and possible treatment plans. Don’t be afraid to ask a lot of questions, including why they chose a specific treatment method or if there are alternative treatment plans that may work for you.

It’s also a good idea to find out about clinical trials you may be able to participate in. Clinical trials are another way to obtain new treatments, especially if standard treatment options were found to be ineffective.

Kidney cancers are tumors that start growing inside the kidney. Cells begin to grow out of control, multiplying in huge numbers. These cells can build up to form a mass, or tumor, within the kidney.

The Centers for Disease Control and Prevention (CDC) say that renal cell cancer is the most common type of kidney cancer affecting adults in the United States.

In this article, we will look at the likelihood of renal cell cancer spreading to other parts of the body, as well as the possible areas of the body to which it may spread. We will also explain what symptoms to look for and what to expect from treatment.

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According to the American Cancer Society (ACS), renal cell carcinoma (RCC) accounts for about 90% of kidney cancer diagnoses among adults in the U.S. The most common subtypes of RCC are clear cell, papillary, and chromophobe.

In an article published in the World Journal of Oncology, scientists explain that the clear cell subtype is both the most common and the most aggressive, or fast-growing, kind of RCC. Clear cell RCC accounts for 75% of diagnoses.

The article authors state that clear cell RCC is most likely to spread, or metastasize, to the lungs, liver, or bones. Chromophobe RCC, which accounts for 5% of diagnoses, spreads in only 7% of cases.

The National Kidney Foundation explains that many people do not have symptoms in the early stages of RCC and that people may receive a diagnosis after getting tests for something else. An article in the Asian Journal of Urology says that by the time doctors diagnose RCC, it will have spread in approximately one-third of cases.

The subtype of RCC plays a significant role in how fast this cancer grows and spreads, according to an article in the World Journal of Oncology. The article authors explain that genetic factors may also be important.

For example, nonhereditary, or somatic, mutations in the von-Hippel-Lindau gene account for 45% of clear cell RCC cases. However, it is important to note that this is not a von-Hippel-Lindau syndrome — it is a one-off mutation in that particular gene. Von-Hippel-Lindau disease itself accounts for 5% of cases.

Other general risk factors include:

• Age: RCC typically affects older people.
• Sex: RCC is more common in males than females.
• Race: The article authors note that African American, Hispanic American, and Native American people have a greater risk of RCC; African Americans have a reduced chance of recovering from RCC; and there is increased incidence of RCC among Hispanic and Native American populations. Healthcare inequities may be one reason for these disparities.
• Weight: Scientists have noted a consistent link between a high body mass index and RCC.
• Blood pressure: High blood pressure, or hypertension, can damage the kidneys and increase the risk of kidney cancers. According to the journal, high blood pressure almost doubles the risk of developing RCC.

The ACS explains that RCC starts in the linings of tiny tubes, called tubules, inside the kidneys. Cells multiply out of control and build up in a mass, or tumor, in the kidney.

Cancer cells can spread through the body in different ways, according to the National Cancer Institute (NCI). These include:

• growing into, or invading, nearby tissue
• invading the walls of nearby blood vessels or lymph nodes
• traveling through blood vessels or lymph nodes to other parts of the body

Researchers continue to investigate the biomechanics of what makes RCC metastasize, but it seems to follow certain patterns. Places RCC may spread to include the:

• lungs, which are the most common site of metastasis, accounting for 45% of cases
• bones
• lymph nodes
• liver
• pancreas
• adrenal glands
• brain

Ongoing research and new treatment options are increasing survival rates, according to a report published in the Journal of Oncology Practice. The results of trials show that the average survival time is more than 4 years.

In a 2020 trial, the median survival rate was a little over 48 months in groups with intermediate or poor risk. Some people experience better outcomes.

The site of the metastasis does impact survival rates, and people with lung-only or pancreatic metastasis may have a more favorable outlook than those with bone, liver, or brain metastasis.

The ACS estimates that the 5-year survival rate in the years 2011–2017 for people with metastatic RCC was 13%. However, this has likely improved with the development of new treatments.

The ACS notes that treatment for RCC depends on whether the cancer has spread to other parts of the body, as well as the size of the original tumor.

Depending on the cancer tissue structure and the number of metastases, a person may receive surgery to remove affected areas, as well as either the whole kidney (radical nephrectomy) or the affected part of the kidney (partial nephrectomy).

Traditional chemotherapy is not typically effective in metastatic RCC. Instead, combinations of immunotherapy and other targeted substances have become the main treatment for many people, even those with widespread metastases.

Additionally, a 2021 study found that a combination of immunotherapy and targeted therapy improved the survival rates for people with RCC.

Active surveillance

Doctors may consider some people for active surveillance (AS). This means they will closely monitor a person’s condition without starting treatment. Doctors may choose to do this when a person is diagnosed with a condition but does not have any symptoms.

For example, researchers in a 2016 trial carefully selected 48 people to undergo AS, and those people did not require active treatment for just under 15 months. Individuals may discuss AS with their doctor to establish whether it could be appropriate for them.

The psychological impact of having any cancer can be enormous and can correlate to a poor outcome, according to a study published in the journal Therapeutic Advances in Urology.

Some oncology services work alongside counselors that have specific experience working with people who have received a cancer diagnosis. A person might consider exploring this option to help better manage their mental health.

According to the NCI, relaxation and breathing techniques can help with stress and depression that may come about after a cancer diagnosis or during cancer treatment.

Practical concerns, such as travel to and from appointments and unexpected costs, can increase the burden on someone with RCC. The ACS explains that help is available and suggests some ways to find it.

Clear cell renal cell cancer is the most common form of kidney cancer in the U.S. that can spread to other parts of the body. It is more common among older people.

To treat the cancer, doctors may initially recommend active surveillance before starting treatments such as surgery and combination therapies. However, this may depend on where and how much the cancer has spread.

Researchers continue to investigate the disease and potential treatment options.