Kidney Cancer Treatment

Stages of Kidney Cancer

Your Palmer radiation oncologists will classify your tumor using a common “grading” system with the criteria TMN to help determine the stages of kidney cancer.

1. Tumor – The larger the primary tumors, the more serious.
2. Node – If the kidney cancer has spread to nearby lymph nodes, it is considered a later stage.
3. Metastasis – Later stages mean the cancer has spread from the kidneys to other parts of the body.

Cancer specialists assign levels for each of the above factors and then combine these levels into stages,  according to the American Joint Committee on Cancer (AJCC), the stages include:

• Stage I: The tumor is 7 cm or smaller and is only located in the kidney. It has not spread to the lymph nodes or distant organs.
• Stage II: The tumor is larger than 7 cm and is only located in the kidney. It has not spread to the lymph nodes or distant organs.
• Stage III: Either of these conditions:
  • A tumor of any size is located only in the kidney. It has spread to the regional lymph nodes but not to other parts of the body.
  • The tumor has grown into major veins or perinephric tissue and may or may not have spread to regional lymph nodes. It has not spread to other parts of the body.
• Stage IV: Either of these conditions:
  • The tumor has spread to areas beyond Gerota’s fascia and extends into the adrenal gland on the same side of the body as the tumor, possibly to lymph nodes, but not to other parts of the body (T4; any N; M0).
  • The tumor has spread to any other organ, such as the lungs, bones, or the brain.

Kidney Tumor Types

Cancer treatment recommended by your North Cascade Cancer Center experts will depend on several factors, including the type of cancer you are diagnosed with. There are several types of kidney cancers.

• Renal cell carcinoma (RCC)

This is by far the most common type of kidney cancer accounting for 85 to 90 percent of kidney cancer cases. RCC usually forms as a single tumor in the tubules of the kidney. Occasionally, there is more than one tumor in both kidneys at the same time.

There are many subtypes of RCC that are named mostly by how the cancer cell looks under a microscope. These subtle varieties are sometimes treated differently and can sometimes help determine if your cancer might be genetic.

• Clear cell renal cell carcinoma. This is the most common form of renal cell carcinoma. About 7 out of 10 people with RCC have this kind of cancer. When seen under a microscope, the cells that make up clear cell RCC look very pale or clear.
• Papillary renal cell carcinoma. This is the second most common subtype – about 1 in 10 RCCs are of this type. These cancers form little finger-like projections (called papillae) in some, if not most, of the tumor. Some radiation oncologists call these cancers chromophilic because the cells take in certain dyes and look pink under the microscope.
• Chromophobe renal cell carcinoma. This subtype accounts for about 5% (5 cases in 100) of RCCs. The cells of these cancers are also pale, like the clear cells, but are much larger and have certain other features that can be recognized.
• Rare types of renal cell carcinoma. These subtypes are very rare, each making up less than 1% of RCCs:
  • Collecting duct RCC
  • Multilocular cystic RCC
  • Medullary carcinoma
  • Mucinous tubular and spindle cell carcinoma
  • Neuroblastoma-associated RCC
  • Unclassified renal cell carcinoma

Rarely, renal cell cancers are labeled as unclassified because the way they look doesn’t fit into any of the other categories or because there is more than one type of cell present.

• Other types of kidney cancers

Other types of kidney cancers include transitional cell carcinomas, Wilms tumors, and renal sarcomas.

• Transitional cell carcinoma. Of every 100 cancers in the kidney, about 5 to 10 are transitional cell carcinomas (TCCs), also known as urothelial carcinomas. Transitional cell carcinomas don’t start in the kidney itself, but in the lining of the renal pelvis (where the urine goes before it enters the ureter). This lining is made up of cells called transitional cells that look like the cells that line the ureters and bladder. Cancers that develop from these cells look like other urothelial carcinomas, such as bladder cancer, under the microscope. Like bladder cancer, these cancers are often linked to cigarette smoking and being exposed to certain cancer-causing chemicals in the workplace. About 9 out of 10 TCCs of the kidney are cured if they are found at an early stage. The chances for cure are lower if the tumor has grown into the ureter wall or main part of the kidney or if it looks more aggressive (high grade) when seen under a microscope.
• Wilms tumor (nephroblastoma). Wilms tumors almost always occur in children. This type of cancer is very rare among adults. To learn more about this type of cancer, see Wilms Tumor.
• Renal sarcoma. Renal sarcomas are a rare type of kidney cancer that begin in the blood vessels or connective tissue of the kidney. They make up less than 1% of all kidney cancers.
• Benign (non-cancerous) kidney tumors

Some kidney tumors are benign (non-cancerous). This means they do not metastasize (spread) to other parts of the body, although they can still grow and cause problems. Benign kidney tumors can be treated by removing or destroying them, using many of the same treatments that are also used for kidney cancers. These types include: renal adenoma, oncocytoma, and angiomyolipoma.

General Treatment Information

Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patient’s preferences and overall health. Surgery is the primary treatment for most newly diagnosed cases of kidney cancer. In some cases, systemic and/or radiation therapy also is recommended.

The main treatments for stomach cancer are:

• Surgery
• Immunotherapy
• Targeted therapy  
• Radiation therapy
• Chemotherapy