Cancer Staging, Prognosis, and Life Expectancy
If you’ve been diagnosed with kidney cancer, your doctor will go through a staging process. Staging is a way to describe a cancer in terms of location and how far it has spread. Staging also helps doctors determine treatments.
Staging allows doctors to predict a patient’s chance of recovery (prognosis). Outlooks are often talked about in terms of survival rates. For example, a five-year survival rate refers to what percentage of people lived at least five more years after a cancer diagnosis.
Knowing survival rates by stage can help you understand prognosis based on the kidney cancer’s progression.
How Is Kidney Cancer Staged?
One method doctors use to stage kidney cancer is called the TNM system. T refers to the size of the primary tumor and if it has invaded surrounding tissue. N communicates how far the cancer has spread to lymph nodes. M indicates whether the cancer has metastasized, or spread into other organs or more distant lymph nodes.
Kidney cancer also can be assigned a stage number of one through four (I-IV). These stages identify cancers with a similar prognosis and so are treated in a similar manner. The lower the stage number, the better the patient’s chance of recovery.
Stage 1 is the least aggressive stage and has the highest five-year survival rate. According to the TNM system, the cancerous tumor is relatively small in the first stage, so it receives a designation of T1. The tumor only appears in one kidney and there’s no evidence that it has spread to lymph nodes or other organs, so it receives N0 and M0 designations.
In stage 1, the cancerous kidney will probably be removed, but follow-up therapy might not be necessary. The chances for recovery are good. The five-year survival rate for stage 1 kidney cancer is 81 percent, according to the American Cancer Society and the National Cancer Data Base.
Stage 2 is more serious than stage 1. In this stage, the tumor is a little larger, but only appears in the kidney. Now it’s considered T2. But, like stage 1, there’s no evidence that it has spread to nearby lymph nodes or other organs, so it’s also considered N0 and M0.
As in stage 1, a stage 2 cancerous kidney will probably be removed, and follow-up therapy might not be necessary. The patient’s chances are still good, but not quite as good as in stage 1. The five-year survival rate for stage 2 kidney cancer is 74 percent, according to the American Cancer Society and the National Cancer Data Base.
The TMN system describes two scenarios for stage 3 kidney cancer. In the first scenario, the tumor has grown into a major vein and nearby tissue, but has not reached nearby lymph nodes. This is referred to as T3, N0, M0.
In the second scenario, the tumor can be any size and may appear outside the kidney. In this case, cancer cells also have invaded nearby lymph nodes, but have not gone further. It’s considered, T1-T3, N1, M0.
In either case, treatment will be aggressive. If the cancer has reached the lymph nodes, they may be surgically removed. The five-year survival rate for stage 3 kidney cancer is 53 percent, according to theAmerican Cancer Society and the National Cancer Data Base.
Stage 4 kidney cancer also can be classified in two ways. In the first, the tumor has grown larger and reached tissue beyond the kidney. It may or may not have spread to nearby lymph nodes, but it still hasn’t metastasized. In this case, the designation is T4, any N, M0.
In the second, the tumor can be any size, may be in lymph nodes, and has metastasized to other organs or further lymph nodes: any T, any N, M1.
The five-year survival rate in this stage drops to eight percent, according tothe American Cancer Society and the National Cancer Data Base.
Factors Affecting Prognosis
Researchers have found that certain factors may lower survival rates in stage 3 or 4 kidney cancer. These include:
- a high blood lactate dehydrogenase (LDH) level (indicates cell damage)
- a high blood calcium level
- low red blood cell count
Other factors that affect prognosis are:
- if the cancer has spread to two or more distant sites
- if it’s been less than a year from the time of diagnosis to the need for systemic treatment
- type of treatment
If you have symptoms of kidney cancer or are considering treatment, starting your regimen as soon as possible can help your chances for survival. According to recent numbers from theAmerican Cancer Society, the five-year relative survival rate for kidney cancer diagnosed in stage 1 or 2 is 92 percent.
Five-year survival rate statistics are determined by observing large numbers of people. But each cancer case is unique, and the numbers can’t be used to predict outlooks for individuals. If you have kidney cancer and want to understand your life expectancy, speak with your doctor.