Kidney Cancer Stages
The Stages of Kidney Cancer
If you’ve received a kidney cancer diagnosis, one of the first steps toward treatment is to determine the stage of your cancer. This process, known as staging, gives your doctor a way to categorize your condition in terms of location as well as the extent to which it has spread. This process also helps your doctor determine effective treatments.
In addition to determine the trajectory for treatment, staging also enables your doctor to give you a more accurate determination of recovery or outlook. Outlook is often discussed in terms of survival rate. For example, a five-year survival rate refers to the percentage of people who lived at least five years beyond a diagnosis of cancer.
While each person’s situation is unique knowing your cancer stage as well as the survival rates associated with that stage will help you better understand your outlook and the progression of your condition that you may be able to suspect. In any case, though, survival rate as well as cancer development can be influenced by a number of different factors, including how well your body responds to treatment.
How Is Stage Determined?
After your doctor has diagnosed your cancer, he or she will conduct a number of additional assessments. These examinations, including biopsies, imaging tests, and a physical exam are used to determine the location and spread of your cancer.
There are actually 2 types of staging for kidney cancer:
- The clinical stage is your doctor’s determination of the extent of your disease, based of the physical exam, laboratory tests, and any imaging results you have received.
- If your cancer requires surgery during treatment, you will also be given a pathologic stage, which is a determination of the condition of your based on all of the prior factors as well as what is discovered during surgery and upon further examination of the removed tissue.
If you do have surgery, it is not uncommon for the stage of your condition to change following surgery. This may happen, for example, if your cancer is found to have spread further than previously suspected. Pathologic staging is typically considered more accurate because it provides your doctor a firsthand look at the extent of your condition.
TNM Staging System
The most common staging system for kidney cancer is known as the TNM system, established by the American Joint Committee on Cancer. (This system is not used to stage cancer that begins in the renal pelvis.)
This system describes 3 primary factors of your cancer:
- Tumor (T): This descriptor is an identifying factor for the main tumor and whether it has extended into adjacent areas.
- Node (N): This indicator provides a description for the extent to which the cancer has spread to the nearby lymph node.
- Metastasis (M): This factor describes the metastasis or whether the cancer has spread to additional areas of the body, such as the lungs, bones, liver, brain, and more distant lymph nodes.
To provide more accurate descriptions of each indicator, numbers or letters are attached to the T, N, and M. The numbers range from 0 to 4 and indicate increasing severity. The letter “X” is given if the indicator cannot be determined based on the information available.
After the T, N, and M categories have been determined, your doctor will use the information to assign a comprehensive stage of I, II, III, or IV. This stage grouping identifies cancers that have common prognoses or outlooks and can be treated in a similar way. Typically patients with lower stage numbers tend to have a better outlook.
Additional Survival Predictors
While the stage of your cancer is an important predictor of survival rate, several other factors are also important indicators in a prognostic assessment. In fact, researchers have actually linked certain factors with shorter survival times for individuals with kidney cancer that has spread beyond the kidneys. These survival predictors include:
- High level of blood lactate dehydrogenase
- High level of blood calcium
- Anemia or low red blood cell count
- Cancer spread to 2 or more distant sites
- Less than a year from diagnosis to the need for systemic treatment, such as targeted therapy, immunotherapy, or chemotherapy
- Poor performance status
Typically, individuals with none of these survival predictors are considered to have a good prognosis. Those with 1 or 2 predictors are considered intermediate, and those with 3 or more are considered to have a poor prognostic expectation.