Kidney Cancer |Stage 4 Renal Cell Carcinoma: Metastasis, Survival Rates, and Treatment

What Is Renal Cell Carcinoma?

Renal cell carcinoma (RCC), also called renal cell cancer or renal cell adenocarcinoma, is a common type of kidney cancer. About 90 percentof all kidney cancers are renal cell carcinomas.

RCC usually begins as a tumor growing in one of your kidney. It can also develop in both kidneys. The disease is more common in men than women.

How Does It Spread?

If a cancerous tumor is discovered in one of your kidneys, the usual treatment is to remove part or all of the affected kidney surgically. If the tumor is left, 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.

TMN Staging and the Stages of Kidney Cancer

Kidney cancer is described in stages developed by the American Joint Committee on Cancer. The system is better known as the TMN system.

  • The “T” refers to the tumor. Doctors assign a “T” with a number from one to three, based on the size and growth of the tumor.
  • An “N” describes whether the cancer has spread to a node in the lymph system.
  • The “M” means the cancer has metastasized.

Doctors also assign RCC a stage 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 growing and is larger than seven centimeters across.
  • Stages 3 and 4 mean the cancer has spread either into a major vein, to lymph nodes, or to other organs.
  • Stage 4 is the most advanced form of the disease. Stage 4 means that the cancer has metastasized to the lymph system or other organs. Because the adrenal gland is attached to the kidney, the cancer often spreads there first. Stage 4 kidney cancer also means that the cancer may have spread into more than one lymph node near the kidney or elsewhere in the body.
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What’s the Outlook?

Five-year survival rates for RCC are based on the percentage of patients who live at least five years with the disease after it’s been diagnosed.

The American Cancer Society reports the following five-year survival rates, according to stage:

  • stage 1: 81 percent
  • stage 2: 74 percent
  • stage 3: 53 percent
  • stage 4: 8 percent

What Are the Treatment Options?

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 is often not an option. If the tumor and metastasis can be isolated, surgical removal of the cancerous tissue may still be possible. If the cancer has spread to the lungs, partial lung removal may eliminate the cancer. If you have stage 4 RCC, your doctor will consider your overall health to determine your eligibility for major surgery.

If surgery isn’t a realistic option to treat stage 4 RCC, other therapies may help. One approach is embolization, which is the blocking of blood flow to cancer cells. However, there’s a risk that the substance that blocks the blood flow will also interfere with circulation to healthy cells.

Another option is radiation therapy. This therapy uses high-energy radiation to target cancer cells. But, it’s not usually successful when the cancer has spread to many locations.


The best way to beat stage 4 RCC is to aggressively treat the cancer before it gets to stage 4. If you’re in stage 4 RCC, remember that published survival rates are averages.

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The key is to follow your doctor’s advice, go to your appointments, and take your medications. Also, make sure to make whatever lifestyle changes your doctor suggests.

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