How is kidney cancer staging determined?
If kidney cancer is diagnosed, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment. The stage is based on the size of the kidney tumor and whether the cancer has invaded nearby tissues or spread to other parts of the body.
Your doctor may order one or more tests:
- Blood tests: Your doctor can check for substances in your blood. Some people with kidney cancer have high levels of calcium or LDH. A blood test can also show how well your liver is working.
- Chest x-ray: An x-ray of the chest can show a tumor in your lung.
- CT scan: CT scans of your chest and abdomen can show cancer in your lymph nodes, lungs, or elsewhere.
- MRI: MRI can show cancer in your blood vessels, lymph nodes, or other tissues in the abdomen.
When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary (original) tumor. For example, if kidney cancer spreads to a lung, the cancer cells in the lung are actually kidney cancer cells. The disease is metastatic kidney cancer, not lung cancer. It's treated as kidney cancer, not as lung cancer. Doctors sometimes call the new tumor “distant” disease.
These are the stages of kidney cancer:
- Stage I: The tumor is no bigger than a tennis ball (almost 3 inches or about 7 centimeters). Cancer cells are found only in the kidney.
- Stage II: The tumor is bigger than a tennis ball. But cancer cells are found only in the kidney.
- Stage III: The tumor can be any size. It has spread to at least one nearby lymph node. Or it has grown through the kidney to reach nearby blood vessels.
- Stage IV: The tumor has grown through the layer of fatty tissue and the outer layer of fibrous tissue that surrounds the kidney. Or cancer cells have spread to nearby lymph nodes or to the lungs, liver, bones, or other tissues.
Common treatment options for people with kidney cancer are surgery, targeted therapy, and biological therapy. You may receive more than one type of treatment.
The treatment that's right for you depends mainly on the following:
- The size of the tumor
- Whether the tumor has invaded tissues outside the kidney
- Whether the tumor has spread to other parts of the body
- Your age and general health
You may have a team of specialists to help plan your treatment. Your doctor may refer you to a specialist, or you may ask for a referral.
You may want to see a urologist, a surgeon who specializes in treating problems of the urinary tract. Other specialists who treat kidney cancer include urologic oncologists (surgeons who specialize in cancers of the urinary tract), medical oncologists, and radiation oncologists. Your health care team may also include an oncology nurse and a registered dietitian.
Your health care team can describe your treatment choices, the expected results of each, and the possible side effects. Because cancer therapy often damages healthy cells and tissues, side effects are common. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. You and your health care team can work together to develop a treatment plan that meets your needs.
At any stage of disease, supportive care is available to control pain and other symptoms, to relieve the side effects of treatment, and to ease emotional concerns. Information about such care is available on NCI's Web site at http://www.cancer.gov/cancertopics/coping. For example, some people with kidney cancer may need to have radiation therapy to relieve pain or certain other problems. Radiation therapy uses highenergy rays to kill cancer cells.
You may want to talk with your doctor about taking part in a clinical trial. Clinical trials are research studies testing new treatments. They are an important option for people with all stages of kidney cancer.
You may want to ask your doctor these questions before you begin treatment:
- How large is the tumor? What is the stage of the disease? Has the tumor grown outside the kidney or spread to other organs?
- What are my treatment choices? Which do you suggest for me? Why?
- What are the expected benefits of each kind of treatment?
- What can I do to prepare for treatment?
- Will I need to stay in the hospital? If so, for how long?
- What are the risks and possible side effects of each treatment? How can side effects be managed?
- What is the treatment likely to cost? Will my insurance cover it?
- How will treatment affect my normal activities?
- Would a research study (clinical trial) be a good choice for me?
- Can you recommend a doctor who could give me a second opinion about my treatment options?
- How often should I have checkups?