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Kidney Cancer - Introduction

Approved by the Cancer.Net Editorial Board, 10/2021

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Kidney Cancer. Use the menu to see other pages. Think of that menu as a roadmap for this entire guide.

About the kidneys

Every person has 2 kidneys, which are located above the waist on both sides of the spine. These reddish-brown, bean-shaped organs are each about the size of a small fist. They are located closer to the back of the body than to the front.

The kidneys filter blood to remove impurities, excess minerals and salts, and extra water. Every day, the kidneys filter about 200 quarts of blood to generate 2 quarts of urine. The kidneys also produce hormones that help control blood pressure, red blood cell production, and other bodily functions.

Most people have 2 kidneys. Each kidney works independently. This means the body can function with less than 1 complete kidney. With dialysis, a mechanized filtering process, it is possible to live without functioning kidneys. Dialysis can be done through the blood, called hemodialysis, or by using the patient’s abdominal cavity, called peritoneal dialysis.

About kidney cancer

Kidney cancer begins when healthy cells in 1 or both kidneys change and grow out of control, forming a mass called a renal cortical tumor. A tumor can be malignant, indolent, or benign. A malignant tumor is cancerous, meaning it can grow and spread to other parts of the body. An indolent tumor is also cancerous, but this type of tumor rarely spreads to other parts of the body. A benign tumor means the tumor can grow but will not spread.

Types of kidney cancer

There are several types of kidney cancer:

  • Renal cell carcinoma. Renal cell carcinoma is the most common type of adult kidney cancer, making up about 85% of diagnoses. This type of cancer develops in the proximal renal tubules that make up the kidney’s filtration system. There are thousands of these tiny filtration units in each kidney. The treatment options for renal cell carcinoma are discussed later in this guide.

  • Urothelial carcinoma. This is also called transitional cell carcinoma. It accounts for 5% to 10% of the kidney cancers diagnosed in adults. Urothelial carcinoma begins in the area of the kidney where urine collects before moving to the bladder, called the renal pelvis. This type of kidney cancer is treated like bladder cancer because both types of cancer begin in the same cells that line the renal pelvis and bladder.

  • Sarcoma. Sarcoma of the kidney is rare. This type of cancer develops in the soft tissue of the kidney; the thin layer of connective tissue surrounding the kidney, called the capsule; or surrounding fat. Sarcoma of the kidney is usually treated with surgery. However, sarcoma commonly comes back in the kidney area or spreads to other parts of the body. More surgery or chemotherapy may be recommended after the first surgery.

  • Wilms tumor. Wilms tumor is most common in children and is treated differently from kidney cancer in adults. Wilms tumors make up about 1% of kidney cancers. This type of tumor is more likely to be successfully treated with radiation therapy and chemotherapy than the other types of kidney cancer when combined with surgery. This has resulted in a different approach to treatment.

  • Lymphoma. Lymphoma can enlarge both kidneys and is associated with enlarged lymph nodes, called lymphadenopathy, in other parts of the body, including the neck, chest, and abdominal cavity. In rare cases, kidney lymphoma can appear as a lone tumor mass in the kidney and may include enlarged regional lymph nodes. If lymphoma is a possibility, your doctor may perform a biopsy (see Diagnosis) and recommend chemotherapy instead of surgery.

Types of kidney cancer cells

Knowing which type of cell makes up a kidney tumor helps doctors plan treatment. Pathologists have identified more than 30 different types of kidney cancer cells. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. Computed tomography (CT) scans or magnetic resonance imaging (MRI) (see Diagnosiscannot always show the difference between benign, indolent, or malignant renal cortical tumors before surgery.

The most common types of kidney cancer cells are listed below. In general, the grade of a tumor refers to the degree of differentiation of the cells, not how fast they grow. Differentiation describes how much the cancer cells look like healthy cells. The higher the grade, the more likely the cells are to spread or metastasize over time.

  • Clear cell. About 70% of kidney cancers are made up of clear cells. Clear cells range from slow growing (grade 1) to fast growing (grade 4). Immunotherapy and targeted therapy (see Types of Treatment) are particularly effective at treating clear cell kidney cancer.

  • Papillary. Papillary kidney cancer is found in 10% to 15% of all kidney cancers. It is divided into 2 different subtypes, called type 1 and type 2. Localized papillary kidney cancer is often treated with surgery. If papillary kidney cancer spreads or metastasizes, it is often treated with blood vessel blocking agents. Using immunotherapy to treat metastatic papillary cancers is still being researched. Many doctors recommend treatment through a clinical trial for metastatic papillary cancers.

  • Sarcomatoid features. Each of the tumor subtypes of kidney cancer (clear cell, chromophobe, and papillary, among others) can show highly disorganized features under the microscope. These are often described by pathologists as “sarcomatoid.” This is not a distinct tumor subtype, but when these features are seen, doctors are aware that this is a very aggressive form of kidney cancer. There is promising scientific research for immunotherapy treatment options for people with a tumor with sarcomatoid features. Most recently, this included the approved combination of ipilimumab (Yervoy) and nivolumab (Opdivo) and the unapproved combination of atezolizumab (Tecentriq) and bevacizumab (Avastin).

  • Medullary. This is a rare and highly aggressive cancer but is still considered a renal cortical tumor. It is more common in Black people and is highly associated with having sickle cell disease or sickle cell trait. Sickle cell trait means that a person has inherited 1 copy of the sickle cell gene from a parent. Combinations of chemotherapy with blood vessel inhibitors are currently recommended treatment options based on some scientific data, and clinical trials are ongoing to better define treatment decisions.

  • Collecting duct: Collecting duct carcinoma is more likely to occur in people between the ages of 20 and 30. It begins in the collecting ducts of the kidney. Therefore, collecting duct carcinoma is closely related to transitional cell carcinoma (see "Urothelial carcinoma," above). This is a difficult cancer to treat successfully long term, even with combinations of systemic chemotherapy and surgery.

  • Chromophobe. Chromophobe is another uncommon cancer that may form indolent tumors that are unlikely to spread but are aggressive if they do. Clinical trials are ongoing to find the best ways to treat this type of cancer.

  • Oncocytoma. This is a slow-growing type of kidney cancer that rarely, if ever, spreads. The treatment of choice is surgery for large, bulky tumors.

  • Angiomyolipoma. Angiomyolipoma is a benign kidney tumor that has a unique appearance on a CT scan and when viewed under a microscope. Usually, it is less likely to grow and spread. It is usually treated with surgery or, if it is small, with active surveillance (see Types of Treatment). Significant bleeding is a rare event but more likely in pregnant and premenopausal women. An aggressive form of angiomyolipoma, called epithelioid, can in rare instances invade the renal vein and inferior vena cava and spread to nearby lymph nodes or organs, such as the liver.

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If you would like more of an introduction, explore these related items. Please note that these links will take you to other sections on Cancer.Net:

The next section in this guide is StatisticsIt helps explain the number of people who are diagnosed with kidney cancer and general survival rates. Use the menu to choose a different section to read in this guide.

Kidney Cancer - Statistics

Approved by the Cancer.Net Editorial Board, 02/2022

ON THIS PAGE: You will find information about the number of people who are diagnosed with kidney cancer each year. You will also read general information on surviving the disease. Remember, survival rates depend on several factors. Use the menu to see other pages.

This year, an estimated 79,000 adults (50,290 men and 28,710 women) in the United States will be diagnosed with kidney cancer. Worldwide, an estimated 431,288 people were diagnosed with kidney cancer in 2020.

In the United States, kidney cancer is the sixth most common cancer for men. It is the ninth most common cancer for women. The average age at diagnosis for people with kidney cancer is 64, and most people are diagnosed between the ages of 65 and 74. Kidney cancer is not common in people younger than age 45. It is more common in Black people and American Indian people.

The number of new kidney cancers in the United States has been increasing for several decades, although that increase has slowed in recent years. Between 2009 and 2018, rates rose by around 1% each year. Some of the increase has been due to an increase in the overall use of imaging tests. Imaging tests can find small kidney tumors unexpectedly when the tests are done for another reason unrelated to the cancer.

It is estimated that 13,920 deaths (8,960 men and 4,960 women) from this disease will occur in the United States this year. Between 2015 and 2019, deaths from kidney cancer decreased by 2.5% per year. In 2020, an estimated 179,368 people worldwide died from kidney cancer.

The 5-year survival rate tells you what percent of people live at least 5 years after the cancer is found. Percent means how many out of 100. The 5-year survival rate for people with kidney cancer in the United States is 76%. However, survival rates depend on several factors, including the type, cell type, and stage of the cancer when it is first diagnosed.

About two-thirds of people are diagnosed when the cancer is located only in the kidney. For this group, the 5-year survival rate is 93%. If kidney cancer has spread to surrounding tissues or organs and/or the regional lymph nodes, the 5-year survival rate is 71%. If the cancer has spread to a distant part of the body, the 5-year survival rate is 14%.

Researchers continue to study how certain factors affect survival rates, including tumor size, whether the cancer involves the lymph nodes, and how far the cancer has spread. Many of these studies calculate survival rates after surgery is done. These studies suggest that kidney cancer that spreads to the lymph nodes or distant areas of the body will have lower survival rates. However, recent advances in treatment, especially with immunotherapy (see Types of Treatment), are allowing some people with metastatic kidney cancer to live much longer than before.

It is important to remember that statistics on survival rates for people with kidney cancer are an estimate. The estimate comes from annual data based on the number of people with this cancer in the United States. Also, experts measure the survival statistics every 5 years. This means the estimate may not reflect the results of advancements in how kidney cancer is diagnosed or treated from the last 5 years. Talk with your doctor if you have any questions about this information. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society's (ACS) publication, Cancer Facts & Figures 2022, the ACS website, and the International Agency for Research on Cancer website. (All sources accessed January 2022.)

The next section in this guide is Medical Illustrations. It offers drawings of body parts often affected by kidney cancer. Use the menu to choose a different section to read in this guide.

Kidney Cancer - Medical Illustrations

Approved by the Cancer.Net Editorial Board, 10/2021

ON THIS PAGE: You will find a drawing of the kidneys. Use the menu to see other pages.

Illustration of the kidneys in the body.

Every person has 2 kidneys, which are located above the waist on both sides of the spine. These reddish-brown, bean-shaped organs are each about the size of a small fist. They are located closer to the back of the body than to the front. The renal artery brings blood to the kidney and branches into the multi-sectioned medulla. Surrounding the medulla is the cortex. The renal pelvis is the broad opening at the top of the ureter. The renal pelvis connects the center of the kidney to the ureter, which connects to the bladder. 

The next section in this guide is Risk Factors and PreventionIt describes the factors that may increase the chance of developing kidney cancer and what people can do to lower their risk. Use the menu to choose a different section to read in this guide.

Kidney Cancer - Risk Factors and Prevention

Approved by the Cancer.Net Editorial Board, 10/2021

ON THIS PAGE: You will find out more about the factors that increase the chance of developing kidney cancer and what people can do to lower their risk. Use the menu to see other pages.

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. Knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

The following factors may raise a person’s risk of developing kidney cancer:

  • Smoking. Smoking tobacco doubles the risk of developing kidney cancer. It is believed to cause about 30% of kidney cancers in men and about 25% in women.

  • Gender. Men are 2 to 3 times more likely to develop kidney cancer than women.

  • Race. Black people have higher rates of kidney cancer.

  • Age. Kidney cancer is typically found in adults and is usually diagnosed between the ages of 50 and 70.

  • Nutrition and weight. Research has often shown a link between kidney cancer and obesity.

  • High blood pressure. Men with high blood pressure, also called hypertension, may be more likely to develop kidney cancer.

  • Overuse of certain medications. Painkillers containing phenacetin have been banned in the United States since 1983 because of their link to transitional cell carcinoma.

  • Exposure to cadmium. Some studies have shown a connection between exposure to the metallic element cadmium and kidney cancer. Working with batteries, paints, or welding materials may increase a person’s risk as well. This risk is even higher for smokers who have been exposed to cadmium.

  • Chronic kidney disease. People who have decreased kidney function but do not yet need dialysis may be at higher risk for developing kidney cancer.

  • Long-term dialysis. People who have been on dialysis for a long time may develop cancerous cysts in their kidneys. These growths are usually found early and can often be removed before the cancer spreads.

  • Family history of kidney cancer. People who have a strong family history of kidney cancer may have an increased risk of developing the disease. This can include individuals with first-degree relatives, such as a parent, brother, sister, or child. Risk also increases if other extended family members have also been diagnosed with kidney cancer, including grandparents, aunts, uncles, nieces, nephews, grandchildren, and cousins. Specific factors in family members may increase the risk of a hereditary kidney cancer disorder, including diagnosis at an early age, rare types of kidney cancer, cancer in both kidneys (called bilaterality), more than 1 tumor in the same kidney (called multifocality), and other types of benign or cancerous tumors.

    If you are concerned that kidney cancer may run in your family, it is important to get an accurate family history and to share the results with your doctor. By understanding your family history, you and your doctor can take steps to reduce your risk and be proactive about your health.

Genetic conditions and kidney cancer

Although kidney cancer can run in families, inherited kidney cancers linked to a single, inherited gene are uncommon, accounting for 5% or less of kidney cancers. Over a dozen unique genes that increase the risk of developing kidney cancer have been found, and many are linked to specific genetic syndromes. Most of these conditions are associated with a specific type of kidney cancer (see the Introduction).

Finding a specific genetic syndrome in a family can help a person and their doctor develop an appropriate cancer screening plan and, in some cases, help determine the best treatment options. Only genetic testing can determine whether a person has a genetic mutation. Most experts strongly recommend that people considering genetic testing first talk with someone with expertise in cancer genetics, such as a genetic counselor, who can explain the risks and benefits of genetic testing.

Genetic conditions that increase a person's risk of developing kidney cancer include:

  • Von Hippel-Lindau (VHL) syndrome. People with VHL syndrome have an increased risk of developing several types of tumors. Up to 60% of people with this disorder develop clear cell kidney cancer.

  • Hereditary papillary renal cell carcinoma (HPRCC). HPRCC is a very rare genetic condition that increases the risk of type 1 papillary renal cell carcinoma. People who have HPRCC have a very high risk of developing more than 1 kidney tumor on both kidneys, but no increased risk for other cancers or conditions.

  • Birt-Hogg-Dubé (BHD) syndrome. BHD syndrome is a rare genetic condition associated with multiple noncancerous skin tumors, lung cysts, and an increased risk of noncancerous and cancerous kidney tumors. Tumors are most often chromophobe, oncocytoma, or a mixture of both, which are called hybrid tumors.

  • Hereditary leiomyomatosis and renal cell carcinoma (HLRCC). HLRCC is associated with an increased risk of about 16% of developing a form of kidney cancer that resembles type 2 papillary or collecting duct renal cell carcinoma. Skin nodules called leiomyomata are often found, mainly on the arms, legs, chest, and back. HLRCC can often cause uterine fibroids known as leiomyomas. Rarely, adrenal tumors can form. 

  • Tuberous sclerosis complex (TSC) syndrome. TSC syndrome is a genetic condition associated with changes in the skin, brain, kidney, and heart. More than half of individuals with TSC develop angiomyolipomas of the kidney. About 2% of those individuals will develop kidney cancer (see the Introduction).

  • Succinate dehydrogenase (SDH) complex syndrome. SDH is a related group of hereditary cancer syndromes associated with tumors called pheochromocytoma and paraganglioma. Gastrointestinal stromal tumors (GISTs) and kidney cancers may also be seen that are related to this syndrome.

  • BAP1 tumor predisposition syndrome (BAP1 TPS). An inherited mutation in the BRCA1-associated protein 1 (BAP1) gene is associated with melanoma of the skin and of the eye, mesothelioma, and clear cell RCC.

Other genetic conditions may be associated with an increased risk of kidney cancer. Research to find other genetic causes of kidney cancer is ongoing.


Different factors cause different types of cancer. Researchers continue to look into what factors cause kidney cancer, including ways to prevent it. Although there is no proven way to completely prevent kidney cancer, you may be able to lower your risk by:

  • Quitting smoking

  • Lowering blood pressure

  • Maintaining a healthy body weight

  • Eating a diet high in fruits and vegetables and low in fat

Talk with your health care team for more information about your personal risk of cancer.

The next section in this guide is Screening. It explains how tests may find cancer before signs or symptoms appear. Use the menu to choose a different section to read in this guide.

Kidney Cancer - Screening

Approved by the Cancer.Net Editorial Board, 10/2021

ON THIS PAGE: You will find out more about screening for kidney cancer. You will also learn the risks and benefits of screening. Use the menu to see other pages.

Screening is used to look for cancer before you have any symptoms or signs. Scientists have developed, and continue to develop, tests that can be used to screen a person for specific types of cancer. The overall goals of cancer screening are to:

  • Lower the number of people who die from the disease, or eliminate deaths from cancer altogether

  • Lower the number of people who develop the disease

Learn more about the basics of cancer screening.

Screening information for kidney cancer

Routine screening tests to detect early kidney cancer are not available. Doctors may recommend that people with a high risk of the disease have imaging tests (see Diagnosis) to look inside the body. For people with a family history of kidney cancer, computed tomography (CT) scans or renal ultrasounds are sometimes used to search for early-stage kidney cancer. However, CT scans have not been proven to be a useful screening tool for kidney cancer for most people.

The next section in this guide is Symptoms and Signs. It explains what body changes or medical problems kidney cancer can cause. Use the menu to choose a different section to read in this guide.

Kidney Cancer - Symptoms and Signs

Approved by the Cancer.Net Editorial Board, 10/2021

ON THIS PAGE: You will find out more about changes and other things that can signal a problem that may need medical care. Use the menu to see other pages.

Often, kidney cancer is found when a person has an imaging test, such as ultrasound, magnetic resonance imaging (MRI), or computed tomography (CT) scan (see Diagnosis), for another reason. In its earliest stages, kidney cancer causes no pain. Therefore, symptoms of the disease usually appear when the tumor grows large and begins to affect nearby organs.

People with kidney cancer may experience the following symptoms or signs. Symptoms are changes that you can feel in your body. Signs are changes in something measured, like by taking your blood pressure or doing a lab test. Together, symptoms and signs can help describe a medical problem. Sometimes, people with kidney cancer do not have any of the symptoms and signs described below. In other cases, the cause of a symptom or sign may be a medical condition that is not cancer.

  • Blood in the urine

  • Pain or pressure in the side or back

  • A mass or lump in the side or back

  • Swelling of the ankles and legs

  • High blood pressure

  • Anemia, which is a low red blood cell count

  • Fatigue

  • Loss of appetite

  • Unexplained weight loss

  • Fever that keeps coming back and is not from a cold, flu, or other infection

  • In the testicles, a rapid development of a cluster of enlarged veins, known as a varicocele, around a testicle, particularly the right testicle, may indicate that a large kidney tumor may be present

If you are concerned about any changes you experience, please talk with your doctor. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help figure out the cause of the problem, called a diagnosis.

If cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. Managing symptoms may also be called "palliative care" or "supportive care." It is often started soon after diagnosis and continued throughout treatment. Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is DiagnosisIt explains what tests may be needed to learn more about the cause of the symptoms. Use the menu to choose a different section to read in this guide.

Kidney Cancer - Diagnosis

Approved by the Cancer.Net Editorial Board, 10/2021

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. Use the menu to see other pages.

Doctors use many tests to find, or diagnose, cancer. They also do tests to learn if cancer has spread to another part of the body from where it started. If the cancer has spread, it is called metastasis. Doctors may also do tests to learn which treatments could work best.

For most types of cancer, a biopsy is the only sure way for the doctor to know if an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis.

How kidney cancer is diagnosed (updated 06/2022)

This section describes options for diagnosing kidney cancer. Not all tests listed below will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • The type of cancer suspected

  • Your signs and symptoms

  • Your age and general health

  • The results of earlier medical tests

In addition to a physical examination, the following tests may be used to diagnose kidney cancer:

  • Blood and urine tests. The doctor may recommend having a blood test to check the number of red blood cells in the blood. A urine test may be recommended to look for blood, bacteria, or cancer cells. These tests may suggest that kidney cancer is present, but they cannot be used to make a definite diagnosis.

  • Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. This is usually performed as an outpatient procedure using local anesthesia by an interventional radiologist. Anesthesia is medicine that blocks the awareness of pain. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. A pathologist then analyzes the sample(s) and writes a pathology report describing the results. This report becomes a permanent part of the person’s medical record.

    The pathology report identifies the type of cell involved in the kidney cancer (see the Introduction for a list), which is important in planning treatment. A medical oncologist must have a pathology report before they recommend a systemic therapy plan using medication to treat kidney cancer, particularly metastatic disease. Metastatic kidney cancer is cancer that has spread beyond the kidney to other parts of the body. Systemic therapy involves using medication(s) that affect the entire body. Medical oncologists are doctors who treat cancer using medications. In certain cases, surgeons also may request a renal tumor biopsy to help plan treatment. However, if imaging tests show a solid and growing mass, then surgeons may remove the tumor first and then the pathologist will later provide the definitive tumor type and stage.

    Since every patient's situation is different, the patient should carefully discuss with their doctor whether a biopsy is needed before treatment.

  • Biomarker testing of the tumor. Your doctor may recommend running laboratory tests on a tumor to identify specific genes, proteins, and other factors unique to the tumor. This may also be called molecular testing of the tumor. Results of these tests can help determine your treatment options.

Imaging tests

  • Computed tomography (CT or CAT) scan. A CT scan takes pictures of the inside of the body using x-rays taken from different angles. A computer combines these pictures into a detailed, 3-dimensional image that shows any abnormalities or tumors. A CT scan can be used to measure the tumor’s size. For patients being evaluated for a renal mass, a non-contrast CT scan is done first to evaluate for any non-cancerous types of disorders like a kidney stone or bleeding cyst. Then, contrast medium is injected. Contrast medium is a special dye that provides better detail on the images taken by CT scans. This dye is injected into a patient’s vein. Renal cysts will not take up the contrast medium, but renal tumors will. In addition the contrast will help look for any involvement of cancer in the nearby blood vessels, lymph nodes, or faraway organs like the liver. A non-contrast CT showing fat in a renal tumor suggests it is a benign angiomyolipoma (see Introduction), and nonsurgical treatment options may be recommended. If patients have severe chronic kidney disease or kidney failure, then the contrast medium cannot be safely used. A CT scan of the urinary tract is called a CT urogram. Note that a PET-CT scan is not useful in renal cell carcinoma because the contrast used in most PET scans is excreted through the kidneys and bladder, which limits the ability to see kidney tumors.

  • X-ray. An x-ray is a way to create a picture of the structures inside of the body, using a small amount of radiation.

  • Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can be used to measure the tumor’s size. A special dye called gadolinium is given before the scan to create a clearer picture. This dye is injected into a patient’s vein. Gadolinium is also taken up by cancers and seen more clearly on the final pictures.

  • Cystoscopy and nephro-ureteroscopy. Occasionally, special tests called a cystoscopy and nephro-ureteroscopy may be done for a urothelial cancer of the upper urinary tract or renal pelvis (see Introduction). They are not often used for renal cell carcinoma unless imaging also finds a mass or stone in the bladder. During these procedures, the patient is sedated, while a tiny, lighted tube is inserted into the bladder through the ureter and up into the kidney. Sedation is giving medication to become more relaxed, calm, or sleepy. This procedure can be used to obtain tumor cells for examination under a microscope, to perform a biopsy, and sometimes to completely destroy small tumors.

After diagnostic tests are done, your doctor will review the results with you. If the diagnosis is cancer, these results also help the doctor describe the cancer. This is called staging.

The next section in this guide is StagesIt explains the system doctors use to describe the extent of the disease. Use the menu to choose a different section to read in this guide.

Kidney Cancer - Stages

Approved by the Cancer.Net Editorial Board, 10/2021

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. This is called the stage. Use the menu to see other pages.

What is cancer staging?

Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body.

Doctors use diagnostic tests to find out the cancer's stage, so staging may not be complete until all the tests are finished. Knowing the stage helps the doctor recommend the best kind of treatment, and it can help predict a patient's prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer.

This page provides detailed information about the system used to find the stage of kidney cancer and the stage groups for kidney cancer, such as stage II or stage IV.

TNM staging system

One tool that doctors use to describe the stage is the TNM system. Doctors use the results from diagnostic tests and scans to answer these questions:

  • Tumor (T): How large is the primary tumor? Where is it located?

  • Node (N): Has the tumor spread to the lymph nodes? If so, where and how many?

  • Metastasis (M): Has the cancer spread to other parts of the body? If so, where and how much?

The results are combined to determine the stage of cancer for each person.

There are 5 stages for kidney cancer: stage 0 (zero) and stages I through IV (1 through 4). Stage 0 kidney cancer is extremely rare. The stage provides a common way of describing the cancer so doctors can work together to plan the best treatments.

Here are more details on each part of the TNM system for kidney cancer.

Tumor (T)

Using the TNM system, the "T" plus a letter or number (0 to 4) is used to describe the size and location of the tumor. Tumors are measured in centimeters (cm). One cm is roughly equal to the width of a standard pen or pencil. One inch equals about 2.5 cm.  

Stage may also be divided into smaller groups that help describe the tumor in even more detail. This helps the doctor develop the best treatment plan for each patient. If there is more than 1 tumor, the lowercase letter "m" (which stands for "multiple") is added to the "T" stage category. Specific tumor stage information for kidney cancer is listed below.

TX: The primary tumor cannot be evaluated.

T0 (T zero): No evidence of a primary tumor.

T1: The tumor is found only in the kidney and is 7 cm or smaller at its largest area. There has been much discussion among doctors about whether this classification should only include a tumor that is 5 cm or smaller.

  • T1a: The tumor is found only in the kidney and is 4 cm or smaller at its largest area.

  • T1b: The tumor is found only in the kidney and is between 4 cm and 7 cm at its largest area.

T2: The tumor is found only in the kidney and is larger than 7 cm at its largest area.

  • T2a: The tumor is only in the kidney and is more than 7 cm but not more than 10 cm at its largest area.

  • T2b: The tumor is only in the kidney and is more than 10 cm at its largest area.

T3: The tumor has grown into major veins within the kidney or perinephric tissue, which is the connective, fatty tissue around the kidneys. However, it has not grown into the adrenal gland on the same side of the body as the tumor. The adrenal glands are located on top of each kidney and produce hormones and adrenaline to help control heart rate, blood pressure, and other bodily functions. In addition, the tumor has not spread beyond Gerota's fascia, an envelope of tissue that surrounds the kidney.

  • T3a: The tumor has spread to the large vein leading out of the kidney, called the renal vein, or the branches of the renal vein; the fat surrounding and/or inside the kidney; or the pelvis and calyces of the kidney, which collect urine before sending it to the bladder. The tumor has not grown beyond Gerota's fascia.

  • T3b: The tumor has grown into the large vein that drains into the heart, called the inferior vena cava, below the diaphragm. The diaphragm is the muscle under the lungs that helps breathing.

  • T3c: The tumor has spread to the vena cava above the diaphragm and into the right atrium of the heart or to the walls of the vena cava.

T4: The tumor has spread to areas beyond Gerota's fascia and extends into an adjacent organ, including the adrenal gland, liver, intestines, spleen, or pancreas.

Node (N)

The “N” in the TNM staging system stands for lymph nodes. These small, bean-shaped organs help fight infection. Lymph nodes near the kidneys are called regional lymph nodes. Lymph nodes in other parts of the body are called distant lymph nodes.

NX: The regional lymph nodes cannot be evaluated.

N0 (N zero): The cancer has not spread to the regional lymph nodes.

N1: The cancer has spread to regional lymph nodes.

Metastasis (M)

The "M" in the TNM system describes whether the cancer has spread to other parts of the body, called metastasis. Common areas where kidney cancer may spread include the bones, liver, lungs, brain, and distant lymph nodes.

M0 (M zero): The disease has not metastasized.

M1: The cancer has spread to other parts of the body beyond the kidney area.

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Stage groups for kidney cancer

Doctors assign the stage of the cancer by combining the T, N, and M classifications (see above).

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 (T1, N0, M0).

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 (T2, N0, M0).

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 (T1 or T2, N1, M0).

  • 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 (T3, any N, M0).

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 (any T, any N, M1).

Recurrent: Recurrent cancer is cancer that has come back after treatment. It may be found in the kidney area or in another part of the body. If the cancer does return, there will be another round of tests to learn about the extent of the recurrence. These tests and scans are often similar to those done at the time of the original diagnosis.

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Used with permission of the American College of Surgeons, Chicago, Illinois. The original and primary source for this information is the AJCC Cancer Staging Manual, Eighth Edition (2017), published by Springer International Publishing.

Prognostic factors

It is important for doctors to learn as much as possible about the tumor. This information can help them predict if the cancer will grow and spread or how effective treatment will be. This information includes:

  • Cell type, such as clear cell, papillary, chromophobe, or another type (see Introduction)

  • Grade, which describes how similar the cancer cells are to healthy cells

  • Personal information, such as the person’s activity level and body weight

  • Presence or absence of fevers, sweats, and other symptoms

  • Laboratory test findings, such as red blood cell counts, white blood cell counts, and calcium levels in the blood

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Information about the cancer’s stage will help the doctor recommend a specific treatment plan. The next section in this guide is Types of Treatment. Use the menu to choose a different section to read in this guide.

Kidney Cancer - Types of Treatment

Approved by the Cancer.Net Editorial Board, 10/2021

ON THIS PAGE: You will learn about the different types of treatments doctors use to treat people with kidney cancer. Use the menu to see other pages.

This section explains the types of treatments, also known as therapies, that are the standard of care for kidney cancer. “Standard of care” means the best treatments known. When making treatment plan decisions, you are encouraged to discuss with your doctor whether clinical trials are an option. A clinical trial is a research study that tests a new approach to treatment. Doctors learn through clinical trials whether a new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. Clinical trials are an option for all stages of cancer. Your doctor can help you consider all your treatment options. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.

How kidney cancer is treated

In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary teamFor kidney cancer, the health care team usually includes these specialists:

  • Urologist. A doctor who specializes in the genitourinary tract, which includes the kidneys, bladder, genitals, prostate, and testicles.

  • Urologic oncologist. A urologist who specializes in treating cancers of the urinary tract.

  • Medical oncologist. A doctor trained to treat cancer with systemic treatments using medications.

  • Radiation oncologist. A doctor trained to treat cancer with radiation therapy. This doctor will be part of the team if radiation therapy is recommended.

Cancer care teams include a variety of other health care professionals, such as physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

Treatment options and recommendations depend on several factors, including the cell type and stage of cancer, possible side effects, and the patient’s preferences and overall health. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Talk with your doctor about the goals of each treatment and what you can expect while receiving treatment. These types of talks are called “shared decision-making.” Shared decision-making is when you and your doctors work together to choose treatments that fit the goals of your care. Shared decision-making is particularly important for kidney cancer because there are different treatment options. Learn more about making treatment decisions.

Kidney cancer is most often treated with surgery, targeted therapy, immunotherapy, or a combination of these treatments. Radiation therapy and chemotherapy are occasionally used. People with kidney cancer that has spread, called metastatic cancer (see below), often receive multiple lines of therapies. This means treatments are given one after another.

The common types of treatments used for kidney cancer are described below. Your care plan also includes treatment for symptoms and side effects, an important part of cancer care.

Active surveillance

Sometimes, the doctor may recommend closely monitoring the tumor with regular diagnostic tests and clinic appointments. This is called "active surveillance." Active surveillance may be recommended in older adults and people who have a small renal tumor and other serious medical conditions, such as heart disease, chronic kidney disease, or severe lung disease. Younger people who have small kidney masses (smaller than 5 cm) may also be recommended to undergo active surveillance due to the low likelihood of the tumor spreading. Active surveillance may also be used for some people with kidney cancer as long as they are otherwise well and have few or no symptoms, even if the cancer has spread to other parts of the body. Systemic therapies (see "Therapies using medication," below) can be started if it looks like the disease is getting worse.

Active surveillance is not the same as "watchful waiting" for kidney cancer. While active surveillance uses interval diagnostic scans, watchful waiting involves regular appointments to review symptoms, but patients do not have regular diagnostic tests, such as biopsy or imaging scans. The doctor simply watches for symptoms. If symptoms suggest that action is needed, then a new treatment plan is considered.

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Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. If the cancer has not spread beyond the kidneys, surgery to remove the tumor may be the only treatment needed. Surgery to remove the tumor may mean removing part or all of the kidney, as well as possibly nearby tissue and lymph nodes.

Types of surgery used for kidney cancer include the following procedures:

  • Radical nephrectomy. Surgery to remove the tumor, the entire kidney, and surrounding tissue is called a radical nephrectomy. If nearby tissue and surrounding lymph nodes are also affected by the disease, a radical nephrectomy and lymph node dissection is performed. During a lymph node dissection, the lymph nodes affected by the cancer are removed. If the cancer has spread to the adrenal gland or nearby blood vessels, the surgeon may remove the adrenal gland during a procedure called an adrenalectomy, as well as parts of the blood vessels. A radical nephrectomy is usually recommended to treat a large tumor when there is not much healthy tissue remaining. Sometimes the renal tumor will grow directly inside the renal vein and enter the vena cava on its way to the heart. If this happens, complex cardiovascular surgical techniques are needed.

  • Partial nephrectomy. A partial nephrectomy is the surgical removal of the tumor. This type of surgery preserves kidney function and lowers the risk of developing chronic kidney disease after surgery. Research has shown that partial nephrectomy is effective for T1 tumors whenever surgery is possible. Newer approaches that use a smaller surgical incision, or cut, are associated with fewer side effects and a faster recovery.

  • Laparoscopic and robotic surgery (minimally invasive surgery). During laparoscopic surgery, the surgeon makes several small cuts in the abdomen, rather than the one larger cut used during a traditional surgical procedure. The surgeon then inserts telescoping equipment into these small keyhole incisions to completely remove the kidney or perform a partial nephrectomy. Sometimes, the surgeon may use robotic instruments to perform the operation. This surgery may take longer but may be less painful. Laparoscopic and robotic approaches require specialized training. It is important to discuss the potential benefits and risks of these types of surgery with your surgical team and to be certain that the team has experience with the procedure.

  • Cytoreductive nephrectomy. A cytoreductive nephrectomy is the surgical removal of the primary kidney tumor along with the whole kidney in cases where disease has spread beyond the kidney. This may be recommended after diagnosis or after other systemic treatments have already been started. There is growing evidence that in metastatic disease, starting systemic treatments first is helpful. There are ongoing clinical trials evaluating the when is the best time for cytoreductive nephrectomy after treatment with immunotherapy (see below).

  • Metastasectomy. Metastasectomy is the surgical removal of a single site of disease, such as lung, pancreas, liver, or other site, with the goal of curing the cancer. This surgery is generally recommended for people who will benefit from having a single site of kidney cancer removed.

Before any type of surgery, talk with your health care team about the possible side effects from the specific surgery you will have. Learn more about the basics of cancer surgery.

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Non-surgical tumor treatments

Sometimes surgery is not recommended because of characteristics of the tumor or the patient’s overall health. Every patient should have a thorough conversation with their doctor about their diagnosis and risk factors to see if these treatments are appropriate and safe for them. The following procedures may be recommended:

  • Radiofrequency ablation. During radiofrequency ablation (RFA), a needle is inserted into the tumor to destroy the cancer with an electric current. The procedure is performed by an interventional radiologist or urologist. The patient is sedated and given local anesthesia to numb the area. In the past, RFA has only been used for people who were too sick to have surgery. Today, most patients who are too sick for surgery are monitored with active surveillance instead (see above), and patients who have locally advanced disease may also be recommended to have systemic treatments (see below).

  • Cryoablation. During cryoablation, also called cryotherapy or cryosurgery, a metal probe is inserted through a small incision into cancerous tissue to freeze the cancer cells. A computed tomography (CT) scan and ultrasound are used to guide the probe. Cryoablation requires general anesthesia for several hours and is performed by an interventional radiologist. Some surgeons combine this technique with laparoscopy to treat the tumor, but there is not much long-term research evidence to prove that it is effective.

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Therapies using medication

The treatment plan may include medications to destroy cancer cells. Medication may be given through the bloodstream to reach cancer cells throughout the body. When a drug is given this way, it is called systemic therapy. Medication may also be given locally, which is when the medication is applied directly to the cancer or kept in a single part of the body.

This treatment is generally prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication.

Medications are often given through an intravenous (IV) tube placed into a vein using a needle or as a pill or capsule that is swallowed (orally). If you are given oral medications, be sure to ask your health care team about how to safely store and handle them.

The types of medications used for kidney cancer include:

  • Targeted therapy

  • Immunotherapy

  • Chemotherapy

Each of these types of therapies is discussed below in more detail. A person may receive 1 type of medication at a time or a combination of medications given at the same time. They can also be given as part of a treatment plan that includes surgery and/or radiation therapy.

The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications.

It is also important to let your doctor know if you are taking any other prescription or over-the-counter medications or supplements. Herbs, supplements, and other drugs can interact with cancer medications, causing unwanted side effects or reduced effectiveness. Learn more about your prescriptions by using searchable drug databases.

Targeted therapy

Targeted therapy is a treatment that targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This type of treatment blocks the growth and spread of cancer cells and limits damage to healthy cells.

Not all tumors have the same targets. Research studies continue to find out more about specific molecular targets and new treatments directed at them. Learn more about the basics of targeted treatments.

Targeted therapies for kidney cancer are described below.

Anti-angiogenesis therapy. This type of treatment focuses on stopping angiogenesis, which is the process of making new blood vessels. Most clear cell kidney cancers have mutations of the VHL gene, which causes the cancer to make too much of a certain protein, known as vascular endothelial growth factor (VEGF). VEGF controls the formation of new blood vessels and can be blocked with certain drugs. Because a tumor needs the nutrients delivered by blood vessels to grow and spread, the goal of anti-angiogenesis therapies is to “starve” the tumor. There are 2 ways to block VEGF, with small molecule inhibitors of the VEGF receptors (VEGFR) or with antibodies directed against these receptors.

  • Bevacizumab (Avastin). Bevacizumab is an antibody that has been shown to slow tumor growth for people with metastatic renal cell carcinoma. Bevacizumab combined with interferon (see “Immunotherapy,” below) slows tumor growth and spread. There are 2 similar drugs, called bevacizumab-awwb (Mvasi) and bevacizumab-bvzr (Zirabev), that have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of metastatic kidney cancer. These are called biosimilars, and they are similar in their action to the original bevacizumab antibody.

  • Tyrosine kinase inhibitors (TKIs). Axitinib (Inlyta), cabozantinib (Cabometyx), pazopanib (Votrient), lenvatinib (Lenvima), sorafenib (Nexavar), sunitinib (Sutent), and tivozanib (Fotivda) are TKIs that block VEGF receptors. They may be used to treat clear cell kidney cancer. Common side effects of TKIs may include diarrhea, high blood pressure, and tenderness and sensitivity in the hands and feet. Of these approved treatments, pazopanib, sunitinib, or cabozantinib are often used as first-line treatments. Axitinib or cabozantinib maybe be used as first-line treatments combined with immunotherapies (see below). After first-line treatment, axitinib, cabozantinib, lenvatinib, and tivozanib may be recommended, if they have not already been used.

mTOR inhibitors. Everolimus (Afinitor) and temsirolimus (Torisel) are drugs that target a certain protein that helps kidney cancer cells grow, called mTOR. Studies show that these drugs slow kidney cancer growth. Everolimus may be prescribed in combination with lenvatinib or bevacizumab.

HIF2a inhibitor. Belzutifan (Welireg) is a drug that targets hypoxia-inducible factor-2 alpha (HIF2a), which is a protein that can support the growth of blood vessels and cancer cells. Belzutifan can be used to treat kidney cancer in people with von Hippel-Lindau syndrome.

Combined therapies. In 2019, the FDA approved 2 combination treatments for the first treatment for advanced renal cell carcinoma. The first combination includes axitinib and pembrolizumab (Keytruda), which is an immune checkpoint inhibitor (see "Immunotherapy," below). The second combination uses axitinib and avelumab (Bavencio), which is another immune checkpoint inhibitor. Axitinib is an anti-angiogenesis therapy. Both pembrolizumab and avelumab target the PD-1 pathway to activate the immune system to attack cancer cells.

In 2021, the FDA approved 2 more combination treatments for the first treatment of advanced renal cell carcinoma: cabozantinib (an anti-angiogenesis therapy) with nivolumab (an immune checkpoint inhibitor blocking the PD-1 pathway) and lenvatinib (also an anti-angiogenesis therapy) with pembrolizumab. These treatment combinations work regardless of whether the tumor expresses the PD-L1 protein.

While all of these combination treatments were approved based on superior outcomes compared to sunitinib, none of the combinations have been compared directly to each other. Therefore, the doctor will help select the most appropriate treatment option for each patient based on their unique situation.

Talk with your doctor about possible side effects for each specific medication and how they can be managed.

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Immunotherapy uses the body's natural defenses to fight cancer by improving your immune system’s ability to attack cancer cells.

Interleukin-2 (IL-2, Proleukin). IL-2 is a type of immunotherapy that has been used to treat later-stage kidney cancer. IL-2 is a cytokine, which is a protein produced by white blood cells, and is important in immune system function, including the destruction of tumor cells.

High-dose IL-2 can cause severe side effects, such as low blood pressure, excess fluid in the lungs, kidney damage, heart attack, bleeding, chills, and fever. Patients may need to stay in the hospital for up to 10 days during treatment. However, some symptoms may be reversible. Only centers with expertise in high-dose IL-2 treatment for kidney cancer should recommend IL-2. High-dose IL-2 can cure a small percentage of people with metastatic kidney cancer. Some centers use low-dose IL-2 because it has fewer side effects, but it is not as effective.

Alpha-interferon. Alpha-interferon is used to treat kidney cancer that has spread. Interferon appears to change the proteins on the surface of cancer cells and slow their growth. Although it has not proven to be as beneficial as IL-2, alpha-interferon has been shown to lengthen lives when compared with an older treatment called megestrol acetate (Megace).

Immune checkpoint inhibitors. A type of immunotherapy called immune checkpoint inhibitors is being studied in kidney cancer. The FDA has approved the following treatments using immune checkpoint inhibitors for the treatment of kidney cancer:

  • Nivolumab (Opdivo) and ipilimumab (Yervoy) for certain patients with advanced renal cell carcinoma that has not been previously treated.

  • Nivolumab in combination with cabozantinib (see “Anti-angiogenesis therapy,” above) as a first-line treatment for advanced renal cell carcinoma.

  • Avelumab (Bavencio) plus axitinib (see "Targeted Therapy," above) as a first-line treatment for people with advanced renal cell carcinoma.

  • Pembrolizumab (Keytruda) plus axitinib as a first-line treatment for people with advanced renal cell carcinoma.

  • Pembrolizumab plus lenvatinib (see "Targeted Therapy," above) as a first-line treatment for people with advanced renal cell carcinoma.

  • Pembrolizumab alone for renal cell carcinoma with an increased risk of recurrence after nephrectomy or after surgical removal of sites of metastasis.

The approvals for advanced renal cell carcinoma were based on large clinical trials showing the benefit of the immunotherapy combinations compared to sunitinib in people with advanced or metastatic kidney cancer. Additional research had previously shown that nivolumab given as a single drug through the vein every 2 weeks also helped certain people who had previously received anti-angiogenesis treatments live longer than patients treated with the targeted therapy everolimus. The approval for pembrolizumab following surgery was based on a large clinical trial that showed improvement in time to recurrence for people who had received surgery for the primary kidney tumor or all sites of distant spread. There are several ongoing clinical trials investigating immune checkpoint inhibitors for the treatment of kidney cancer (see Latest Research). 

Different types of immunotherapy can cause different side effects. Common side effects include skin reactions, flu-like symptoms, diarrhea, and weight changes. Talk with your doctor about possible side effects for the immunotherapy recommended for you. Learn more about the basics of immunotherapy.

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Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells.

A chemotherapy regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. A patient may receive 1 drug at a time or a combination of different drugs given at the same time.

Although chemotherapy is useful for treating many types of cancer, most cases of kidney cancer are resistant to chemotherapy. Researchers continue to study new drugs and new combinations of drugs. For some patients, the combination of gemcitabine (Gemzar) with capecitabine (Xeloda) or fluorouracil (5-FU) will temporarily shrink a tumor.

It is important to remember that transitional cell carcinoma, also called urothelial carcinoma, and Wilms tumor are much more likely to be successfully treated with chemotherapy.

The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away after treatment is finished.

Learn more about the basics of chemotherapy.

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Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist.

Radiation therapy is not effective as a primary treatment for kidney cancer. It is very rarely used alone to treat kidney cancer but can be used to increase the effects of systemic treatments. Radiation therapy is used mostly if a patient cannot have surgery and usually on areas where the cancer has spread and not on the primary kidney tumor. Most often, radiation therapy is used when the cancer has spread. This is done to help ease symptoms, such as bone pain or swelling in the brain.

Learn more about the basics of radiation therapy.

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Physical, emotional, and social effects of cancer

Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.

Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as surgery or radiation therapy.

Before treatment begins, talk with your doctor about the goals of each treatment in the recommended treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative care options. Many patients also benefit from talking with a social worker and participating in support groups. Ask your doctor about these resources, too.

During treatment, your health care team may ask you to answer questions about your symptoms and side effects and to describe each problem. Be sure to tell the health care team if you are experiencing a problem. This helps the health care team treat any symptoms and side effects as quickly as possible. It can also help prevent more serious problems in the future.

Learn more about the importance of tracking side effects in another part of this guide. Learn more about palliative care in a separate section of this website.

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Metastatic kidney cancer (updated 06/2022)

If cancer spreads to another part in the body from where it started, doctors call it metastatic cancer. 

Metastatic kidney cancer most commonly spreads to the lungs, but it can also spread to the lymph nodes, bones, liver, brain, skin, and other areas in the body. This is a systemic disease that usually requires treatment with systemic therapy, such as targeted therapy or immunotherapy.

For certain patients with metastatic kidney cancer who meet very specific criteria, active surveillance may be recommended.

Currently, the most effective treatments for metastatic kidney cancer include combinations of immune checkpoint inhibitors that activate the immune system to attack cancer cells or an immune checkpoint inhibitor combined with a TKI. However, in some cases, an immune checkpoint inhibitor or a TKI may be given alone. These drugs have been shown to lengthen life when compared with standard treatment. Sometimes, doctors may ask a surgeon to remove the kidney with the tumor in an operation called a cytoreductive nephrectomy (see above). The goal of this surgery is to help people live longer and can also treat pain or bleeding. Cytoreductive surgery may be recommended for certain patients before starting systemic treatment. For kidney cancer that has spread to a limited number of locations, such as a single spot in the lung, surgery may be able to completely remove the cancer. This operation is called a metastasectomy (see above), and it can help some people delay or avoid the need for systemic therapy using medications. Other localized treatment options for distant tumors include RFA, cryoablation, and radiation therapy. If the cancer has spread to many areas beyond the kidney, it is more difficult to treat with local treatments and systemic therapy may be given instead. If the cancer has spread to the bones, the cancer may be treated with radiation therapy, and medications to prevent bone loss or fractures should be recommended. If the cancer has spread to the brain, the tumors may be treated with radiation therapy, surgery, or both. If the cancer has spread, it is a good idea to talk with doctors who have a lot of experience in treating it. Doctors can have different opinions about the best standard treatment plan, and the best treatment for you requires a collaborative approach. Clinical trials might also be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan. Palliative care is also important to help relieve symptoms and side effects.

For many people, a diagnosis of metastatic cancer is very stressful and difficult. You and your family are encouraged to talk about how you feel with doctors, nurses, social workers, or other members of your health care team. It may also be helpful to talk with other patients, such as through a support group or other peer support program, or to meet with a mental health professional who has specific training in cancer.

This information is based on the ASCO guideline, "Management of Metastatic Clear Cell Renal Cell Carcinoma." Please note that this link takes you to another ASCO website.

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Remission and the chance of recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having “no evidence of disease” or NED.

A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.

If the cancer returns after the original treatment, it is called recurrent cancer. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence). If you have had a partial nephrectomy already, a new tumor may form in the same kidney. The recurrent tumor can be removed with another partial nephrectomy or with a radical nephrectomy (see "Surgery," above).

If there is a recurrence, a new cycle of testing will begin to learn as much as possible about it. After this testing is done, you and your doctor will talk about the treatment options. Often the treatment plan will include the treatments described above, such as surgery, targeted therapy, or immunotherapy, but they may be used in a different combination or given at a different pace. Your doctor may also suggest clinical trials that are studying newly developed systemic therapies or new combinations of these medications. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.

People with recurrent cancer sometimes experience emotions such as disbelief or fear. You are encouraged to talk with your health care team about these feelings and ask about support services to help you cope. Learn more about dealing with cancer recurrence.

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If treatment does not work

Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and for some people, advanced cancer is difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.

People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

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The next section in this guide is About Clinical TrialsIt offers more information about research studies that are focused on finding better ways to care for people with cancer. Use the menu to choose a different section to read in this guide.

Kidney Cancer - About Clinical Trials

Approved by the Cancer.Net Editorial Board, 10/2021

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are studied to see how well they work. Use the menu to see other pages.

What are clinical trials?

Doctors and scientists are always looking for better ways to care for people with kidney cancer. To make scientific advances, doctors create research studies involving volunteers, called clinical trials. Every drug that is now approved by the U.S. Food and Drug Administration (FDA) was tested in clinical trials.

Clinical trials are used for all types and stages of kidney cancer. Many focus on new treatments to learn if a new treatment is safe, effective, and possibly better than the existing treatments. These types of studies evaluate new drugs, different combinations of treatments, new approaches to radiation therapy or surgery, and new methods of treatment.

People who participate in clinical trials can be some of the first to get a treatment before it is available to the public. However, there are some risks with a clinical trial, including possible side effects and the chance that the new treatment may not work. People are encouraged to talk with their health care team about the pros and cons of joining a specific study.

Some clinical trials study new ways to relieve symptoms and side effects during treatment. Others study ways to manage the late effects that may happen a long time after treatment. Talk with your doctor about clinical trials for symptoms and side effects.

Deciding to join a clinical trial

People decide to participate in clinical trials for many reasons. For some, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Others volunteer for clinical trials because they know that these studies are a way to contribute to the progress in treating kidney cancer. Even if they do not benefit directly from the clinical trial, their participation may benefit future people with kidney cancer.

Insurance coverage and the costs of clinical trials differ by location and by study. In some programs, some of the expenses from participating in the clinical trial are reimbursed. In others, they are not. It is important to talk with the research team and your insurance company first to learn if and how your treatment in a clinical trial will be covered. Learn more about health insurance coverage of clinical trials.

Sometimes people have concerns that, in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” When used, placebos are usually combined with standard treatment in most cancer clinical trials. Study participants will always be told when a placebo is used in a study. Find out more about placebos in cancer clinical trialsIn many current kidney cancer trials, new treatments are compared against the standard of care, or what the patient would have received if they were not starting a trial. It is important to discuss any clinical trial treatment with the doctor in charge of enrolling patients.

Patient safety and informed consent

To join a clinical trial, people must participate in a process known as informed consent. During informed consent, the doctor should:

  • Describe all of the standard treatment options, so that the person understands how the new treatment differs from the standard treatment.

  • List all of the risks of the new treatment, which may or may not be different than the risks of standard treatment.

  • Explain what will be required of each person in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

  • Describe the purposes of the clinical trial and what researchers are trying to learn.

Clinical trials also have certain rules called “eligibility criteria” that help structure the research and keep patients safe. You and the research team will carefully review these criteria together. You will need to meet all of the eligibility criteria in order to participate in a clinical trial. Learn more about eligibility criteria in clinical trials.

People who participate in a clinical trial may stop participating at any time for personal or medical reasons. These reasons may include serious side effects or the possibility that the new treatment is not working. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that people participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if they choose to leave the clinical trial before it ends.

Finding a clinical trial

Research through clinical trials is ongoing for all types of cancer. For specific topics being studied for kidney cancer, learn more in the Latest Research section.

Cancer.Net offers a lot of information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

PRE-ACT, Preparatory Education About Clinical Trials

In addition, you can find a free video-based educational program about cancer clinical trials in another section of this website.

The next section in this guide is Latest ResearchIt explains areas of scientific research for kidney cancer. Use the menu to choose a different section to read in this guide.

Kidney Cancer - Latest Research

Approved by the Cancer.Net Editorial Board, 10/2021

ON THIS PAGE: You will read about the scientific research being done to learn more about kidney cancer and how to treat it. Use the menu to see other pages.

Doctors are working to learn more about kidney cancer, ways to prevent it, how to best treat it, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the best diagnostic and treatment options for you.

Because most types of kidney cancer do not respond well to traditional chemotherapy, medication research for kidney cancer focuses on using immunotherapy and targeted therapy (see Types of Treatment).

  • Targeted therapy. Several recently discovered drugs that affect the process of blood vessel development and/or cancer cell growth are being tested as targeted therapies for kidney cancer. The results from these clinical trials show that these types of drugs may be effective treatments for kidney cancer, and this is an area of rapid scientific change.

    Many targeted therapies and immunotherapies are being studied for use as adjuvant therapies, which are treatments given after the main treatment(s) to lower the risk of recurrence and to get rid of any remaining cancer cells. One targeted therapy, sunitinib, slowed the cancer from coming back in patients with localized kidney cancer at high risk for recurrence after having a nephrectomy. Other studies have not shown this effect, so using this type of targeted therapy as adjuvant treatment still needs to be studied.

  • Cancer vaccines. Cancer vaccines are treatments that help a person’s immune system fight cancer. Doctors are testing the use of several cancer vaccines to treat kidney cancer and to prevent recurrence for people with later-stage renal cell carcinoma. One vaccine is made from a person's tumor and given after surgery, while others are made from proteins found on the surface of kidney cancer cells or blood vessel cells found in the tumor. There is currently no cancer vaccine that is approved for kidney cancer.

  • Modified cytokines. Interleukin (IL)-2 is a proven treatment for metastatic kidney cancer but has serious side effects (see "Immunotherapy" in Types of Treatment). There is a new treatment that chemically modifies IL-2 (bempegaldesleukin), and it is associated with less frequent serious side effects. Clinical trials continue to study this treatment for kidney cancer.

  • Immune checkpoint inhibitors. This type of immunotherapy works by taking the brakes off the immune system so it is better able to destroy the cancer. These drugs use antibodies directed at specific molecules found on the surface of immune cells, such as PD-1 and CTLA-4. These drugs appear to work in kidney cancer, and many more clinical trials are currently ongoing. 

  • Palliative care/supportive care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current kidney cancer treatments to improve comfort and quality of life for patients.

Looking for More About the Latest Research?

If you would like more information about the latest areas of research in kidney cancer, explore these related items that will take you outside of this guide:

The next section in this guide is Coping with TreatmentIt offers some guidance on how to cope with the physical, emotional, social, and financial changes that cancer and its treatment can bring. Use the menu to choose a different section to read in this guide.

Kidney Cancer - Coping with Treatment

Approved by the Cancer.Net Editorial Board, 10/2021

ON THIS PAGE: You will learn more about coping with the physical, emotional, social, and financial effects of cancer and its treatment. Use the menu to see other pages.

Every cancer treatment can cause side effects or changes to your body and how you feel. For many reasons, people do not experience the same side effects even when they are given the same treatment for the same type of cancer. This can make it hard to predict how you will feel during treatment.

As you prepare to start cancer treatment, it is normal to fear treatment-related side effectsIt may help to know that your health care team will work to prevent and relieve side effects. This part of cancer treatment is called palliative care or supportive care. It is an important part of your treatment plan, regardless of your age or the stage of disease.

Coping with physical side effects

Common physical side effects from each treatment option for kidney cancer are described in the Types of Treatment section. Learn more about side effects of cancer and its treatment, along with ways to prevent or control themChanges to your physical health depend on several factors, including the cancer’s stage, the length and dose of treatment, and your general health.

Talk with your health care team regularly about how you are feeling. It is important to let them know about any new side effects or changes in existing side effects. If they know how you are feeling, they can find ways to relieve or manage your side effects to help you feel more comfortable and potentially keep any side effects from worsening.

You may find it helpful to keep track of your side effects so it is easier to explain any changes with your health care team. Learn more about why tracking side effects is helpful.

Sometimes, physical side effects can last after treatment ends. Doctors call these long-term side effects. They call side effects that occur months or years after treatment late effects. Treating long-term side effects and late effects is an important part of survivorship care. Learn more by reading the Follow-up Care section of this guide or talking with your doctor.

Coping with emotional and social effects

You can have emotional and social effects after a cancer diagnosis. This may include dealing with a variety of emotions, such as sadness, anxiety, or anger, or managing your stress level. Sometimes, people find it difficult to express how they feel to their loved ones. Some have found that talking to an oncology social worker, counselor, or member of the clergy can help them develop more effective ways of coping and talking about cancer.

You can also find coping strategies for emotional and social effects in a separate section of this website. This section includes many resources for finding support and information to meet your needs.

There are patient advocacy groups that can provide further support to patients and their loved ones. Find a list of kidney cancer advocacy groups in another section of this website. 

Coping with the costs of cancer care

Cancer treatment can be expensive. It may be a source of stress and anxiety for people with cancer and their families. In addition to treatment costs, many people find they have extra, unplanned expenses related to their care. For some people, the high cost of medical care stops them from following or completing their cancer treatment plan. This can put their health at risk and may lead to higher costs in the future. Patients and their families are encouraged to talk about financial concerns with a member of their health care team. Learn more about managing financial considerations in a separate part of this website.

Coping with barriers to care

Some groups of people experience different rates of new cancer cases and experience different outcomes from their cancer diagnosis. These differences are called “cancer disparities.” Disparities are caused in part by real-world barriers to quality medical care and social determinants of health, such as where a person lives and whether they have access to food and health care. Cancer disparities more often negatively affect racial and ethnic minorities, people with fewer financial resources, sexual and gender minorities (LGBTQ+), adolescent and young adult populations, older adults, and people who live in rural areas or other underserved communities.

If you are having difficulty getting the care you need, talk with a member of your health care team or explore other resources that help support medically underserved people.

Talking with your health care team about side effects

Before starting treatment, talk with your doctor about possible side effects. Ask:

  • Which side effects are most likely?

  • When are they likely to happen?

  • What can we do to prevent or relieve them?

  • When and who should we call about side effects?

Be sure to tell your health care team about any side effects that happen during treatment and afterward, too. Tell them even if you do not think the side effects are serious. This discussion should include physical, emotional, social, and financial effects of cancer.

Caring for a loved one with cancer

Family members and friends often play an important role in taking care of a person with kidney cancer. This is called being a caregiver. Caregivers can provide physical, practical, and emotional support to the patient, even if they live far away. Being a caregiver can also be stressful and emotionally challenging. One of the most important tasks for caregivers is caring for themselves.

Caregivers may have a range of responsibilities on a daily or as-needed basis, including:

  • Providing support and encouragement

  • Talking with the health care team

  • Giving medications

  • Helping manage symptoms and side effects

  • Coordinating medical appointments

  • Providing a ride to and from appointments

  • Assisting with meals

  • Helping with household chores

  • Handling insurance and billing issues

A caregiving plan can help caregivers stay organized and help identify opportunities to delegate tasks to others. It may be helpful to ask the health care team how much care will be needed at home and with daily tasks during and after treatment. Use this 1-page fact sheet to help make a caregiving action plan. This free fact sheet is available as a PDF, so it is easy to print.

Learn more about caregiving or read the ASCO Answers Guide to Caring for a Loved One With Cancer in English or Spanish.

Looking for More on How to Track Side Effects?

Cancer.Net Mobile app symptom tracker

Cancer.Net offers several resources to help you keep track of your symptoms and side effects. Please note that these links will take you to other sections of Cancer.Net:

  • Cancer.Net Mobile: The free Cancer.Net mobile app allows you to securely record the time and severity of symptoms and side effects.

  • ASCO Answers Managing Pain: Get this 32-page booklet about the importance of pain relief that includes a pain tracking sheet to help patients record how pain affects them. The free booklet is available as a PDF, so it is easy to print.

  • ASCO Answers Fact Sheets: Read 1-page fact sheets on anxiety and depression, constipationdiarrhea, rash, and immunotherapy side effects that provide a tracking sheet to record details about the side effect. These free fact sheets are available as a PDF, so they are easy to print, fill out, and give to your health care team.

The next section in this guide is Follow-up CareIt explains the importance of checkups after cancer treatment is finished. Use the menu to choose a different section to read in this guide.

Kidney Cancer - Follow-Up Care

Approved by the Cancer.Net Editorial Board, 10/2021

ON THIS PAGE: You will read about your medical care after cancer treatment is completed and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with cancer does not end when active treatment has finished. Your health care team will continue to check that the cancer has not come back, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations, medical tests, or both. Doctors want to keep track of your recovery in the months and years ahead. Your follow-up care will depend on the type of tumor, stage, and symptoms.

Cancer rehabilitation may be recommended, and this could mean any of a wide range of services, such as physical therapy, occupational therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent as possible. Learn more about cancer rehabilitation.

Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence, which means that the cancer has come back. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will ask specific questions about your health. Some people may have blood tests or imaging tests done as part of regular follow-up care, but testing recommendations depend on several factors, including the type and stage of cancer first diagnosed and the types of treatment given. Interval scans (CT and/or ultrasound) may be recommended depending on several factors, including the initial characteristics of the cancer diagnosis. It is important to continue to receive routine follow-up appointments when scans are recommended.

The anticipation before having a follow-up test or waiting for test results may add stress to you or a family member. This is sometimes called “scanxiety.” Learn more about how to cope with this type of stress.

Managing long-term and late side effects

Most people expect to have side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. Other side effects called late effects may develop months or even years after treatment has ended. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on your diagnosis, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may have certain physical examinations, scans, or blood tests to help find and manage them.

Because people treated for kidney cancer often have a single kidney, their kidney function will have to be monitored for the rest of their lives. There are few long-term side effects of surgery, although some people may have chronic pain from the surgical scar. Also, people treated for kidney cancer have a slightly higher risk of developing colon cancer and prostate cancer. Talk with your doctor about this increased risk.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help keep track of the cancer treatment you received and develop a survivorship care plan when treatment is completed.

This is also a good time to talk with your doctor about who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their primary care doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.

If a health care professional who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with them and with all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is SurvivorshipIt describes how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to choose a different section to read in this guide.

Kidney Cancer - Survivorship

Approved by the Cancer.Net Editorial Board, 10/2021

ON THIS PAGE: You will read about how to with challenges in everyday life after a cancer diagnosis. Use the menu to see other pages.

What is survivorship?

The word “survivorship” is complicated because it means different things to different people. Common definitions include:

  • Having no signs of cancer after finishing treatment.

  • Living with, through, and beyond cancer. According to this definition, cancer survivorship begins at diagnosis and continues during treatment and through the rest of a person's life.

For some, even the term “survivorship” does not feel right, and they prefer to use different language to describe and define their experience. Sometimes extended treatment will be used for months or years to manage or control cancer. Living with cancer indefinitely is not easy, and the health care team can help you manage the challenges that come with it. Everyone has to find their own path to name and navigate the changes and challenges that are the results of their cancer diagnosis and treatment.

Survivors may experience a mixture of feelings, including joy, concern, relief, guilt, and fear. Some people say they appreciate life more after a cancer diagnosis and have gained a greater acceptance of themselves. Others become very anxious about their health and uncertain about coping with everyday life. Feelings of fear and anxiety may still occur as time passes, but these emotions should not be a constant part of your daily life. If they persist, be sure to talk with a member of your health care team.

Survivors may feel some stress when their frequent visits to the health care team end after completing treatment. Often, relationships built with the cancer care team provide a sense of security during treatment, and people miss this source of support. This may be especially true when new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexual health and fertility concerns, and financial and workplace issues.

Every survivor has individual concerns and challenges. With any challenge, a good first step is being able to recognize your fears and talk about them. Effective coping requires:

  • Understanding the challenge you are facing

  • Thinking through solutions

  • Asking for and allowing the support of others

  • Feeling comfortable with the course of action you choose

Many survivors find it helpful to join an in-person support group or an online community of survivors. This allows you to talk with people who have had similar first-hand experiences. Other options for finding support include talking with a friend or member of your health care team, individual counseling, or asking for assistance at the learning resource center of the place where you received treatment.

A new perspective on your health

For many people, survivorship serves as a strong motivator to make lifestyle changes.

People recovering from kidney cancer are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, exercising regularly, and managing stress. Regular physical activity can help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about making healthy lifestyle choices.

It is important to have recommended medical checkups and tests (see Follow-up Care) to take care of your health.

Talk with your health care team to develop a survivorship care plan that is best for your needs.

Changing role of caregivers

Family members and friends may also go through periods of transition. A caregiver plays a very important role in supporting a person diagnosed with cancer, providing physical, emotional, and practical care on a daily or as-needed basis. Many caregivers become focused on providing this support, especially if the treatment period lasts for many months or longer.

However, as treatment is completed, the caregiver's role often changes. Eventually, the need for caregiving related to the cancer diagnosis will become much less or come to an end. Caregivers can learn more about adjusting to life after caregiving.

Looking for More Survivorship Resources?

For more information about cancer survivorship, explore these related items. Please note that these links will take you to other sections of Cancer.Net:

  • ASCO Answers Cancer Survivorship Guide: Get this 48-page booklet that helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms. The free booklet is available as a PDF, so it is easy to print.

  • Survivorship Resources: Cancer.Net offers information and resources to help survivors cope, including specific sections for children, teens and young adults, and people over age 65. There is also a main section on survivorship for people of all ages.

The next section offers Questions to Ask the Health Care Team to help start conversations with your cancer care team. Use the menu to choose a different section to read in this guide.

Kidney Cancer - Questions to Ask the Health Care Team

Approved by the Cancer.Net Editorial Board, 10/2021

ON THIS PAGE: You will find some questions to ask your doctor or other members of the health care team, to help you better understand your diagnosis, treatment plan, and overall care. Use the menu to see other pages.

Cancer.Net Mobile app question tracker

Talking often with the health care team is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment, or download Cancer.Net’s free mobile app for a digital list and other interactive tools to manage your care. It may also be helpful to ask a family member or friend to come with you to appointments to help take notes.

Questions to ask after getting a diagnosis

  • What type of kidney cancer do I have?

  • What type of cell makes up the tumor?

  • Can you explain my pathology report (laboratory test results) to me?

  • What is the stage of the cancer? What does this mean?

  • What is my prognosis?

Questions to ask about choosing a treatment and managing side effects

  • What are my treatment options?

  • What clinical trials are available for me? Where are they located, and how do I find out more about them?

  • What treatment plan do you recommend? Why?

  • What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?

  • What are the possible side effects of each treatment, both in the short term and long term?

  • Who will be part of my health care team, and what does each member do?

  • Who will be leading my overall treatment?

  • How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?

  • Could this treatment affect my sex life? If so, how and for how long?

  • Could this treatment affect my ability to become pregnant or have children in the future? If so, should I talk with a fertility specialist before cancer treatment begins?

  • If I’m worried about managing the costs of cancer care, who can help me?

  • What support services are available to me? To my family?

  • If I have questions or problems, who should I call?

Questions to ask about having surgery

  • What type of surgery will I have? Will lymph nodes be removed?

  • Can I have a partial nephrectomy? If not, why?

  • If I first receive a type of treatment other than surgery, can surgery be done later, if necessary?

  • Who will be doing the surgery? How experienced is this surgeon with this type of cancer?

  • How long will the operation take?

  • How long will I be in the hospital?

  • Can you describe what my recovery from surgery will be like?

  • Who should I contact about any side effects I experience? And how soon?

  • What are the possible long-term effects of having this surgery?

  • Will I need treatment after surgery? What type of treatment?

Questions to ask about having therapies using medication

  • Will targeted therapy and/or immunotherapy be included in my treatment plan?

  • What is the goal of this treatment?

  • Does this center have expertise in using high-dose IL-2, if it is recommended for me? If not, what is the nearest center with that expertise?

  • How long will it take to give this treatment?

  • Will I receive this treatment at a hospital or clinic? Or will I take it at home?

  • What side effects can I expect during treatment?

  • Who should I contact about any side effects I experience? And how soon?

  • What are the possible long-term or late effects of having this treatment?

  • What can be done to prevent or relieve the side effects?

  • How can I keep myself as healthy as possible during treatment?

Questions to ask about planning follow-up care

  • What is the chance that the cancer will come back? Should I watch for specific signs or symptoms?

  • What long-term side effects or late effects are possible based on the cancer treatment I received?

  • What follow-up tests will I need, and how often will those tests be needed?

  • How do I get a treatment summary and survivorship care plan to keep in my personal records?

  • Who will be leading my follow-up care?

  • What survivorship support services are available to me? To my family?

The next section in this guide is Additional ResourcesIt offers more resources on this website that may be helpful to you. Use the menu to choose a different section to read in this guide.

Kidney Cancer - Additional Resources

Approved by the Cancer.Net Editorial Board, 10/2021

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Kidney Cancer. Use the menu to go back and see other pages.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond.

Here are a few links to help you explore other parts of Cancer.Net:

This is the end of Cancer.Net’s Guide to Kidney Cancer. Use the menu to choose a different section to read in this guide.