End stage kidney cancer what to expect

What is cancer staging?

If you’ve been diagnosed with kidney cancer, your doctor will go through a staging process. Staging is a way to describe a cancer in terms of location and how far it has spread; it helps doctors determine the best course of treatments.

Staging also allows doctors to predict a person’s chance of recovery or outlook. Outlooks are often talked about in terms of survival rates. For example, a five-year survival rate refers to what percentage of people lived at least five more years after a cancer diagnosis.

Knowing survival rates by stage can help you understand your outlook based on the progression of your kidney cancer, but each person’s situation is unique. Survival rates are affected by how well you respond to treatment, along with other risk factors. That means someone with a later stage cancer may live a longer life than a person who’s been diagnosed with an earlier stage cancer, or vice versa.

Learn more about kidney cancer stages and what they mean.

One method doctors use to stage kidney cancer is called the TNM system.

• T refers to the size of the primary tumor and if it has invaded surrounding tissue.
• N is used to identify how far the cancer has spread to lymph nodes.
• M indicates whether the cancer has metastasized, or spread into other organs or more distant lymph nodes.

For example, if you’re told your cancer is T1, N0, M0, that means you have a small tumor in one kidney, but it hasn’t spread to your lymph nodes or organs.

Stage 1 is the least aggressive stage and has the highest five-year survival rate. According to the TNM system, the cancerous tumor is relatively small in the first stage, so it receives a designation of T1. The tumor only appears in one kidney and there’s no evidence that it has spread to lymph nodes or other organs, so it receives N0 and M0 designations.

In stage 1, the cancerous kidney will probably be removed and follow-up therapy might not be necessary. The chances for recovery are good. The five-year survival rate for stage 1 kidney cancer is 81 percent. That means that out of 100 people, 81people diagnosed with stage 1 kidney cancer are still alive five years after their original diagnosis.

Stage 2 is more serious than stage 1. In this stage, the tumor is larger than 7 centimeters across but only appears in the kidney. Now it’s considered T2. But, like stage 1, there’s no evidence that it has spread to nearby lymph nodes or other organs, so it’s also considered N0 and M0.

As in stage 1, a stage 2 cancerous kidney will probably be removed, and follow-up therapy might not be necessary. The five-year survival rate for stage 2 kidney cancer is 74 percent. That means out of 100 people, 74 people diagnosed with stage 2 kidney cancer are still alive five years after being diagnosed.

The TNM system describes two scenarios for stage 3 kidney cancer. In the first scenario, the tumor has grown into a major vein and nearby tissue, but has not reached nearby lymph nodes. This is referred to as T3, N0, M0.

In the second scenario, the tumor can be any size and may appear outside the kidney. In this case, cancer cells also have invaded nearby lymph nodes, but have not gone further. It’s considered, T1-T3, N1, M0.

In either case, treatment will be aggressive. If the cancer has reached the lymph nodes, they may be surgically removed. The five-year survival rate for stage 3 kidney cancer is 53 percent. That means that out of 100 people, 53 people diagnosed with stage 3 kidney cancer will still be living five or more years after being diagnosed.

Stage 4 kidney cancer also can be classified in two ways. In the first, the tumor has grown larger and reached tissue beyond the kidney. It may or may not have spread to nearby lymph nodes, but it still hasn’t metastasized. In this case, the designation is T4, any N, M0.

In the second, the tumor can be any size, may be in lymph nodes, and has metastasized to other organs or further lymph nodes: any T, any N, M1.

The five-year survival rate in this stage drops to 8 percent. That means that out of 100 people, 8 people diagnosed with stage 4 cancer will still be living five years after receiving their diagnosis.

TNM designation and stages are related. For example, stage 1 will never have an M1 designation. Below are the TNM designations you may find in each stage. A checkmark indicates that the TNM designation is possible in that stage.

Certain factors may lower survival rates in stage 3 or 4 kidney cancer. These include:

• a high blood lactate dehydrogenase (LDH) level, which indicates cell damage
• a high blood calcium level
• low red blood cell count

Other factors that affect outlook are:

• if the cancer has spread to two or more distant sites
• if it’s been less than a year from the time of diagnosis to the need for systemic treatment
• age
• type of treatment

Starting your treatment as soon as possible can help your chances for survival. Treatment may include surgery to remove the tumor, immunotherapy drugs, or targeted drugs.

Five-year survival rate statistics are determined by observing large numbers of people. Each cancer case is unique, however, and the numbers can’t be used to predict outlooks for individuals. If you have kidney cancer and want to understand your life expectancy, speak with your doctor.

Five-year survival rate by stage

If you’ve been diagnosed with kidney cancer, talk to your doctor about your stage and possible treatment plans. Don’t be afraid to ask a lot of questions, including why they chose a specific treatment method or if there are alternative treatment plans that may work for you.

It’s also a good idea to find out about clinical trials you may be able to participate in. Clinical trials are another way to obtain new treatments, especially if standard treatment options were found to be ineffective.