Kidney Cancer Stages

Kidney cancer staging: what you should know

Kidney cancer occurs when abnormal cells develop in the tissue of your kidneys. Over time, these cells can grow into a tumor that can spread to other organs in your body if left untreated. Renal cell carcinoma is the most common type of kidney cancer, affecting an estimated 9 out of 10 individuals with cancer of kidney origin.¹

If you are diagnosed with kidney cancer, your healthcare provider will use a cancer staging system to determine the extent of the disease. Identifying the progression of the disease is an important part of choosing the appropriate treatment option for your particular needs.

What is cancer staging?

Staging refers to the process of determining where the disease is located, where it has potentially spread, and if it's affecting other areas of your body. Staging can help your healthcare provider give you an idea of your chance of recovery and the expected survival rate with your particular cancer diagnosis, depending on how well you respond to treatment. 

Specific diagnostic tests are used to identify each stage of cancer, including:

• Bone scan

• CT scan

• MRI scan

• PET/CT

• Biopsy

Stages of kidney cancer

Kidney cancer can be staged as I, II, III, or IV. The higher the stage, the more serious the condition of the disease. In most cases, the stage is determined by three factors provided by the American Joint Committee on Cancer (AJCC) TNM System:²

• The size and location of the tumor (T)

• If the cancer has spread to the regional lymph nodes (N)

• Whether the cancer has metastasized (M), i.e., spread to distant areas of your body, such as your bones, lungs, or brain (M0 means the cancer has not spread, M1 means that it has.)

The stages of kidney cancer include:

• Stage I: The tumor is less than or equal to 7cm (smaller than a tennis ball) in size and is only located in the kidney.

• Stage II: The tumor is larger than a tennis ball but is only located in the kidney.

• Stage III: The size of the tumor can vary, but it has spread to major surrounding blood vessels or tissues around the kidney

• Stage IV: The tumor has spread to nearby lymph nodes, organs, or other tissues.

The TNM system

After your T, N, and M categories have been given, numbers and letters can be added to these factors to provide a more specific diagnosis of the disease. 

• The T category may be given an additional number or letter:

  • TX means the main tumor cannot be measured or has no other information.

  • T0 means the main tumor can't be found.

  • Tis, also known as pre-cancer, means the abnormal cells are growing where they first developed and haven't spread to deeper layers of tissue.

  • A number after T, such as T1 or T2, could refer to the size of the tumor. The higher the number behind T, the bigger the tumor may be.

• The N category may be given an additional number or letter:

  • NX means the nearby lymph nodes cannot be measured or there’s no other information.

  • N0 means the nearby lymph nodes have not been affected by the tumor.

  • N1 means that the cancer has spread to the regional lymph nodes

• The M category will be assigned a number:

  • M0 means that the cancer hasn't spread to other areas of the body.

  • M1 means that the cancer has spread to one or more areas of the body.

The letters and numbers for each category can vary depending on the type of kidney cancer you're diagnosed with. For instance, a number could indicate the tumor size in one type of cancer or how deeply it has spread in another. 

Because the stages of cancer can be complex and nuanced depending on particular conditions, it's important to work closely with your healthcare provider to ensure you understand what your kidney cancer diagnosis means.

Who does kidney cancer affect?

Almost 5% of all cancers are kidney cancer, and most people diagnosed with kidney cancer are between the ages of 65 and 74, with a median age of 64 years. It's twice as likely to occur in men than in women and is more prevalent in people who are Native American or black.

Kidney cancer in children is very rare. It's estimated that 500–600 children are diagnosed with a type of kidney cancer called Wilms tumor in the US every year.

Is kidney cancer curable?

If the tumor has not spread to areas outside of your kidneys, kidney cancer is usually curable with the help of surgery to remove the affected area of the kidney or the entire organ itself. If the cancer has spread, whether or not it can be cured depends on where the cancer is located and how much it has progressed. 

Even if the chances of removing the cancer in its entirety are small, medicine, surgery, or radiation may be able to treat your symptoms and slow down the disease's progression. It's estimated that the five-year survival rate for all types of kidney cancer combined is around 75%, which means that you're 75% as likely to live at least five years with kidney cancer as someone without it.

What questions should I ask my healthcare provider?

If your primary care provider suspects you may have kidney cancer, they will likely refer you to a urinary tract/kidney surgeon (a urologist) or a cancer doctor (an oncologist). It's a good idea to write down any symptoms you may be experiencing as well as any questions or concerns you have to discuss at your appointment.

Here are some questions to consider asking your healthcare provider:

• What tests do you recommend I undergo?

• If I have cancer, has it spread to areas beyond my kidney?

• What are my treatment options?

• Which treatment do you recommend and why?

• What are the potential side effects of each treatment?

• Can my cancer be cured?

• How will kidney cancer or the cancer treatment affect my other health conditions?

• What additional brochures, books, or websites do you recommend I read to learn more about my condition?

The lowdown

Kidney cancer is a serious medical condition that most commonly occurs in individuals between the ages of 65 and 74.

If you're diagnosed with kidney cancer, your healthcare provider will carry out a series of tests to determine the extent of your cancer, including the size of the tumor and whether it has spread to other areas of your body, such as your lymph nodes. 

Your doctor will use a cancer staging system to describe the extent of your kidney cancer, determine the best treatment option for your needs, and provide a prognosis. Working closely with your healthcare provider by writing down questions before your appointment and understanding what your cancer stage means can help your treatment plan go as smoothly as possible.