Renal cell carcinoma (RCC), also called renal cell cancer or renal cell adenocarcinoma, is a common type of kidney cancer. Renal cell carcinomas account for about 90 percent of all kidney cancers.
RCC usually begins as a tumor growing in one of your kidneys. It can also develop in both kidneys. The disease is more common in men than women.
If a cancerous tumor is discovered in one of your kidneys, the usual treatment is to surgically remove part or all of the affected kidney.
If the tumor is not removed, it’s more likely that the cancer will spread to either your lymph nodes or other organs. The spread of cancer is called metastasis.
In the case of RCC, the tumor can invade a large vein leading out of the kidney. It can also spread to the lymph system and other organs. The lungs are especially vulnerable.
Kidney cancer is described in stages that the American Joint Committee on Cancer developed. The system is better known as the TNM system.
- “T” refers to the tumor. Doctors assign a “T” with a number that’s based on the size and growth of the tumor.
- “N” describes whether the cancer has spread to any nodes in the lymph system.
- “M” means the cancer has metastasized.
Based on the characteristics above, doctors assign RCC a stage. The stage is based on the size of the tumor and the spread of the cancer.
There are four stages:
- Stages 1 and 2 describe cancers in which the tumor is still in the kidney. Stage 2 means that the tumor is larger than seven centimeters across.
- Stages 3 and 4 mean the cancer has either spread into a major vein or nearby tissue or to lymph nodes.
- Stage 4 is the most advanced form of the disease. Stage 4 means that the cancer has spread to the adrenal gland or has spread to distant lymph nodes or other organs. Because the adrenal gland is attached to the kidney, the cancer often spreads there first.
Five-year survival rates for kidney cancer are based on the percentage of people who live at least 5 years with the disease after it’s been diagnosed.
The American Cancer Society (ACS) reports the percentage of people living 5 years or more after diagnosis according to three stages based on data from the National Cancer Institute.
These stages are:
- localized (cancer has not spread beyond the kidney)
- regional (cancer has spread nearby)
- distant (cancer has spread to distant parts of the body)
According to the ACS, the RCC survival rates based on these three stages are:
- localized: 93 percent
- regional: 70 percent
- distant: 12 percent
The type of treatment you receive largely depends on the stage of your cancer. Stage 1 RCC may be treated with surgery.
However, by the time the cancer has advanced to stage 4, surgery may not be an option.
If the tumor and metastasis can be isolated, surgical removal of the cancerous tissue and/or treatment of the metastatic tumor by removal or other procedures such as stereotactic body radiation therapy or thermal ablation may still be possible.
If you have stage 4 RCC, your doctor will consider the location and spread of your cancer and your overall health to determine your eligibility for surgery.
If surgery isn’t a realistic option to treat stage 4 RCC, your doctor may recommend systemic therapies using a combination of drugs.
A sample of your tumor, called a biopsy, may be obtained to help determine the best therapy for your specific type of cancer. Treatment may depend on whether you have clear cell or non-clear cell RCC.
Targeted therapy and immunotherapy, including tyrosine kinase inhibitors and anti-PD-1 monoclonal antibodies, can be used to treat stage 4 RCC. A specific drug may be given alone or in combination with another drug.
Treatments may include:
- axitinib + pembrolizumab
- pazopanib
- sunitinib
- ipilimumab + nivolumab
- cabozantinib
New treatments may be available through clinical trials. You can discuss the option of enrolling in a
Your doctor may also recommend supportive treatments to help with any side effects or symptoms.
If you’ve been diagnosed with stage 4 RCC, remember that published survival rates are estimates.
Your individual prognosis depends on your specific type of cancer and how far it has advanced, response to treatments, and your overall health.
The key is to:
- follow your doctor’s advice
- go to your appointments
- take your medications
Also, be sure to follow through with any treatment suggestions or lifestyle changes to address any side effects and symptoms. This can help support your overall health and well-being while going through treatment.