Number stages of kidney cancer

The stage of a cancer tells you how big it is and how far it has spread. It helps your doctor decide which treatment you need.

Doctors use a number staging system for kidney cancer. Stage 1 is the earliest stage of cancer and stage 4 is the most advanced.

Doctors might also use the TNM staging system. TNM stands for Tumour, Node and Metastasis. It shows:

• T - the size of the tumour (cancer)
• N - whether the cancer has spread to nearby lymph nodes
• M - whether the cancer has spread to other parts of the body, such as the lungs

Stage 1 kidney cancer

The cancer is 7cm across or smaller and is completely inside the kidney.

In the TNM staging system, stage 1 is the same as:

• T1, N0, M0

Stage 2 kidney cancer

The cancer is more than 7cm across but is still completely inside the kidney.

In the TNM staging system, stage 2 is the same as:

• T2, N0, M0

Stage 3 kidney cancer

The cancer may be within the kidney but has grown into the tissue around the kidney (fascia). Or it has grown into the main blood vessels such as the renal vein or vena cava. The vena cava is the vein that carries blood back to the heart. The cancer may have spread to nearby lymph nodes.

Stage 3 kidney cancer is also called locally advanced kidney cancer.

The diagram below shows stage 3 kidney cancer that has grown into the renal vein. It has also spread to one of the nearby lymph nodes.

In the TNM staging system, stage 3 is the same as one of the following:

• T1, N1, M0

• T2, N1, M0

• T3, any N, M0

Stage 4 kidney cancer

Stage 4 means one of the following:

• the cancer has grown outside the fascia around the kidney, or into the adrenal gland. It may have spread to nearby lymph nodes
• the cancer has spread to another part of the body, such as the lungs.

This is called advanced or metastatic kidney cancer. Where the cancer has spread to other areas of the body, these cancers can be called secondary cancers.

The diagram below shows stage 4 kidney cancer that has spread to the lungs.

In the TNM staging system, stage 4 is the same as one of the following:

• T4, any N, M0

• any T, any N, M1

Treatment for kidney cancer

The stage of the cancer helps your doctor to decide which treatment you need. Treatment also depends on:

• the type of cancer (the type of kidney cells the cancer started in)
• how much the cancer cells look like normal cells (the grade of the cancer cells)
• where the cancer is in your kidney
• other health conditions that you have

Treatment may include:

• surgery to remove the part of the kidney where the cancer is (partial nephrectomy) or the whole kidney (radical nephrectomy)
• freezing therapy (cryotherapy)
• microwave ablation (MWA) or radiofrequency ablation (RFA)
• blocking the blood supply to the cancer (renal artery embolisation)
• targeted cancer drugs or immunotherapy
• radiotherapy