Metastatic renal cell carcinoma

Renal cell carcinoma, also called kidney cancer, occurs when cancer cells form in the tubules of the kidney. Tubules are tiny tubes in your kidney that help filter waste products from your blood in order to make urine.

Smoking, hypertension, obesity, and hepatitis C all increase the risk of renal cell carcinoma. Renal cell carcinoma becomes metastatic renal cell carcinoma when it spreads beyond your kidney to your lymph system, bones, or other organs.

Renal cell carcinoma can spread from a mass of cancer cells or tumor to other parts of your body. This process is called metastasis. It occurs in one of three ways:

  • Cancer cells spread into the tissue around the tumor in your kidney.
  • The cancer moves from your kidney into your lymph system, which has vessels throughout the body.
  • Kidney cancer cells enter the bloodstream and are carried and deposited to another organ or location in your body.

When renal cell carcinoma is in its early stages, it’s unlikely that you’ll experience obvious symptoms. Noticeable symptoms are often a sign that the disease has metastasized.

Symptoms typically include:

  • blood in the urine
  • pain on one side of the lower back
  • lump in the back or side
  • weight loss
  • fatigue
  • fever
  • swelling of the ankles
  • night sweats

A physical exam and a review of your medical history may prompt further testing to determine the health of your kidneys.

Lab tests

A urinalysis can’t confirm kidney cancer, but it can help reveal the health of your kidneys. In some cases, a urinalysis suggests that the cancer has spread to other body parts.

Another useful lab test is a complete blood count, which includes a count of your red and white blood cell levels. Abnormal levels suggest a possible risk of cancer.


Doctors use imaging tests to find the location and size of a tumor. Screenings help doctors determine if the cancer has spread. CT scans and MRI screenings are especially useful in helping doctors diagnose kidney cancer.

Chest X-rays and bone scans can determine whether the cancer has spread to other parts of your body. Imaging also is a useful tool to see if a particular treatment is working.

To determine the right treatment, renal cell carcinoma is classified as one of four stages:

  • Stages 1 and 2: Cancer is present only in your kidney.
  • Stage 3: The cancer has spread to a lymph node near your kidney, a main kidney blood vessel, or fatty tissue around your kidney.
  • Stage 4: The cancer has spread to another organ or other lymph nodes or tissue.

Treatment options for metastatic renal cell carcinoma may include surgery, immunotherapy, or chemotherapy.


Kidney cancer surgery is often reserved for stage 1 or 2. Stage 3 cancers can also be operated on, but the extent to which the cancer has spread will determine if surgery is a possibility.

Surgery to remove cancerous growths in stage 4 cancer can be done. This usually includes drug therapy, too. For some patients, a single surgery is done to remove the tumor from their kidney and the metastasized tumors from other locations in their body.

Immunotherapy and chemotherapy

In addition to surgery, two other common treatments are available: immunotherapy and chemotherapy.

In immunotherapy, drugs are given to boost your immune system to fight off the cancer.

Chemotherapy involves the use of a pill or injections to kill cancer cells. But it carries side effects and often requires additional treatments such as a surgery.

Renal cell carcinoma usually strikes older adults. A healthy lifestyle can increase a younger person’s chances of avoiding this disease later on.

Smoking is easily the main risk factor for renal cell carcinoma. If you never start smoking, or quit soon, you have a better chance of avoiding renal cell carcinoma.

Manage your blood pressure and control your weight if necessary to help preserve kidney health.

The five-year survival rates of renal cell carcinoma vary greatly depending on which stage you’re diagnosed with. According to the American Cancer Society, the five-year survival rates for kidney cancer are as follows:

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

Survival rates are statistics from the general population of previously diagnosed patients and can’t predict your own case.