Stages of kidney cancer
With so much information to absorb and decisions to make, a kidney cancer diagnosis can be overwhelming. Rest assured, you’re not alone, and there are many options for managing the condition.
This guide covers all the major kidney cancer stages, from the earliest signs within the kidney cells to advanced kidney cancer that has spread beyond the kidney tumour. Like most cancers, kidney cancer staging helps health professionals plan your cancer treatments and gives important information about your kidney cancer prognosis.
Our guide is here to help you understand private kidney cancer treatment and the main treatment options available.
What is kidney cancer staging?
Staging for kidney cancer is the process doctors use to classify the cancer based on the size and position of the primary tumour, and whether the cancer cells have grown into nearby tissues, blood vessels or lymph nodes. This systematic approach, called staging, uses the TNM staging system and the number staging system to provide a complete, standardised picture of your diagnosis.
This detailed picture is essential for building a treatment plan and selecting the common treatment options that will work for your specific stage.
The TNM staging system explained
The TNM staging system is the most widely used method for staging kidney cancer.
T – primary tumour
The ‘T’ in the TNM system describes the size and extent of the primary kidney tumour. Doctors assess if the tumour is completely contained within the kidney or if it has spread. Small kidney cancers, often considered early-stage disease, may be suitable for partial nephrectomy or radiofrequency ablation. Large tumours may require a radical nephrectomy, which removes the entire kidney and sometimes the adrenal gland.
N – nearby lymph nodes
The ‘N’ component indicates whether the cancer has spread to nearby lymph nodes. Cancer cells in the lymph nodes or those that spread can alter your staging and the treatment plan significantly.
M – metastasis
The ‘M’ shows if the cancer has spread (metastasis) to distant organs or parts of the body. When kidney cancer spreads, doctors diagnose metastatic kidney cancer, also sometimes called stage IV kidney cancer. At this point, advanced kidney cancer treatments such as targeted therapy, stereotactic body radiation therapy, palliative therapy, or clinical trials become central to management.
Understanding the number staging system
In addition to the TNM staging system, doctors use the number staging system to help patients and kidney cancer understand their cancer stage more simply.
Stage I: Early stage kidney cancer
Stage I kidney cancer describes a kidney tumour that is 7 centimetres or smaller, is contained within the kidney and has not spread. Prognosis for this stage is excellent, with surgery to remove just the primary tumour or a partial nephrectomy as a common treatment.
Stage II: Tumour growth within the kidney
Stage II means the tumour is larger than 7 centimetres but still completely contained within the kidney. There is still no spread to nearby lymph nodes, blood vessels, or distant organs. Radical nephrectomy – removal of the whole kidney, may be recommended.
Stage III: Locally advanced kidney cancer
Stage III kidney cancer means the tumour may have grown into nearby tissues, major blood vessels or invaded nearby lymph nodes (but not distant organs). Sometimes the entire kidney or surrounding tissues, including the adrenal gland, are affected.
Stage IV: Metastatic kidney cancer
Stage iv kidney cancer is also called advanced kidney cancer, where cancer has spread to distant parts of the body. Both imaging tests and blood tests help confirm the extent of cancer spread. Stage 4 kidney cancer patients may have supportive or palliative therapy, targeted therapy drugs, radiation therapy for symptom control and may be considered for clinical trials or new treatments.
Clinical staging vs. pathological staging
Clinical staging is based on data gathered before any surgery, using imaging exams, computed tomography, MRIs, and a physical exam. Pathological staging, sometimes called surgical staging, is assessed after surgery to remove the tumour, lymph nodes, or other tissues.
Cancer grade and treatment planning
Beyond staging, doctors assign a cancer grade based on how much the cancer cells differ from healthy cells under a microscope. Higher grades indicate aggressive behaviour. Renal cell carcinoma is the most common type, but rarer types, like transitional cell carcinoma or renal sarcoma, are managed differently.
Additional factors in kidney cancer assessment
Other important considerations are your overall health, kidney function and risk factors such as von Hippel-Lindau disease or tuberous sclerosis.
Some patients have other symptoms, such as low red blood cells, which may impact treatment choice. Family history or other health problems, such as high blood pressure or chronic kidney disease, can increase your risk and affect your treatment journey.
The role of imaging tests in staging
Imaging tests like ultrasound, computed tomography (CT), and MRI scans are important for finding abnormal areas, assessing the kidney mass, checking for cancer spread, and staging the primary tumour and surrounding tissues. Blood tests look at kidney function, the number of blood cells, and help plan successful treatment.
Treatment planning based on stage and grade
Early-stage disease may be treated with partial nephrectomy or ablation. Advanced stages usually need radical nephrectomy or systemic therapies. Your plan is shaped by whether the cancer is contained or has spread to nearby tissues.
Clinical trials for chemotherapy medications, immunotherapy, or targeted drugs may be considered for metastatic kidney cancer.
Living with advanced kidney cancer
Living with advanced or metastatic kidney cancer involves a multi-disciplinary team supporting your treatment decision-making, symptom control, and overall health. New targeted therapy and immunotherapy drugs are improving cancer recurrence rates, life expectancy, and quality of life for many patients.
Taking control of your care journey
You don’t have to navigate this process alone. Whether you are newly diagnosed with kidney cancer or on a treatment journey, experienced doctors, surgeons, and specialist nurses will guide you.
Understanding the stages of kidney cancer is just the first step. Expert treatment is available at every point along your care journey, helping to ensure the best outcome for you and your family.
We know the benefits of cancer care at home
Our specialist cancer services ensure private medically insured and self-paying patients who want an alternative to hospital can start their treatment faster. We consider all cancer treatments, including those not currently available in hospitals.
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Your guide to kidney cancer treatment
A kidney cancer diagnosis can be overwhelming. Rest assured, you’re not alone, and there are many options for managing the condition and tailoring treatment to suit your individual needs.
Our guide is here to help you understand private kidney cancer treatment and the main treatment options available.
