Kidney Cancer (cont.)

How is kidney cancer staging determined?

Staging

To plan the best treatment, the doctor needs to know the stage (extent) of the disease. The stage is based on the size of the tumor, whether the cancer has spread and, if so, to what parts of the body.

Staging may involve imaging tests such as an ultrasound or a CT scan. The doctor also may use an MRI. For this test, a powerful magnet linked to a computer makes detailed pictures of organs and blood vessels.

Doctors describe kidney cancer by the following stages:

  • Stage I is an early stage of kidney cancer. The tumor measures up to 2 3/4 inches (7 centimeters). It is no bigger than a tennis ball. The cancer cells are found only in the kidney.
  • Stage II is also an early stage of kidney cancer, but the tumor measures more than 2 3/4 inches. The cancer cells are found only in the kidney.
  • Stage III is one of the following:
    • The tumor does not extend beyond the kidney, but cancer cells have spread through the lymphatic system to one nearby lymph node; or
    • The tumor has invaded the adrenal gland or the layers of fat and fibrous tissue that surround the kidney, but cancer cells have not spread beyond the fibrous tissue. Cancer cells may be found in one nearby lymph node; or
    • The cancer cells have spread from the kidney to a nearby large blood vessel. Cancer cells may be found in one nearby lymph node.
  • Stage IV is one of the following:
    • The tumor extends beyond the fibrous tissue that surrounds the kidney; or
    • Cancer cells are found in more than one nearby lymph node; or
    • The cancer has spread to other places in the body such as the lungs.
  • Recurrent cancer is cancer that has come back (recurred) after treatment. It may come back in the kidney or in another part of the body.

Treatment

Many people with kidney cancer want to take an active part in making decisions about their medical care. They want to learn all they can about their disease and their treatment choices. However, shock and stress after the diagnosis can make it hard to think of everything they want to ask the doctor. It often helps to make a list of questions before an appointment. To help remember what the doctor says, people may take notes or ask whether they may use a tape recorder. Some also want to have a family member or friend with them when they talk to the doctor-to take part in the discussion, to take notes, or just to listen.

The doctor may refer the patient to a specialist, or the patient may ask for a referral. Specialists who treat kidney cancer include doctors who specialize in diseases of the urinary system (urologists) and doctors who specialize in cancer treatment (medical oncologists and radiation oncologists).

Getting a second opinion

Before starting treatment, a person with kidney cancer might want a second opinion about the diagnosis and the treatment plan. Some insurance companies require a second opinion; others may cover a second opinion if the patient or doctor requests it. Do not be afraid to request a second opinion. It should not offend your doctor. This is a serious medical condition and a patient may quite understandable wish to get as much information as possible before consenting to treatments.

There are a number of ways to find a doctor for a second opinion:

  • The patient's doctor may refer the patient to one or more specialists. At cancer centers, several specialists often work together as a team.
  • The Cancer Information Service, at 1-800-4-CANCER, can tell callers about nearby treatment centers.
  • A local or state medical society, a nearby hospital, or a medical school can usually provide the names of specialists.
  • The American Board of Medical Specialties (ABMS) offers a list of doctors who have met specific education and training requirements and have passed a specialty examination. Their directory-the Official ABMS Directory of Board Certified Medical Specialists-lists doctors' names along with their specialty and their educational background. The directory is available in most public libraries. Also, ABMS offers this information by telephone and on the Internet. The toll-free telephone number is 1-866-ASK-ABMS (1-866-275-2267). The Internet address is http://www.abms.org.

Preparing for treatment

Treatment depends mainly on the stage of disease and the patient's general health and age. The doctor can describe treatment choices and discuss the expected results. The doctor and patient can work together to develop a treatment plan that fits the patient's needs.

People may want to ask the doctor these questions before treatment begins:

  • What is the stage of the disease? Has the cancer spread? If so, where?
  • What are my treatment choices? Which do you recommend for me? Will I have more than one kind of treatment?
  • What are the expected benefits of each kind of treatment? Will it cure or control the disease?
  • What are the risks and possible side effects of each treatment? Will I be given anything to control side effects?
  • How long will treatment last?
  • Will I have to stay in the hospital?
  • What is the treatment likely to cost? Is this treatment covered by my insurance plan?
  • How will treatment affect my normal activities?
  • How often should I have checkups?
  • Would a clinical trial (research study) be appropriate for me?

People do not need to ask all their questions or understand all the answers at once. They will have other chances to ask the doctor to explain things that are not clear and to ask for more information.

Medically Reviewed by a Doctor on 3/28/2014

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