Metastatic Renal Cell Carcinoma

By Dr Ananya Mandal, MD

Metastatic renal cell cancer is cancer that has spread beyond its site of origin in the kidney, to other organs in the body. The cancer first invades the blood vessels or fatty tissue surrounding the kidneys, before affecting nearby lymph nodes and eventually involving lymph nodes in other areas and organs such as the bones, lungs or brain.

In renal cell carcinoma, the risk of metastasis is high since most cases are not detected during the early stages, when the tumor is still small and confined to the kidney. Clinical symptoms of the disease are generally mild and nondescript until the cancer progresses and reaches a more advanced stage. Around 20% to 25% of patients diagnosed have already reached the metastatic phase of disease.

Once renal cell carcinoma has spread to other organs in the body, a patient’s 5-year survival estimate drops to 5-15%. The chances of survival may improve if any detectable cancer is removed from the kidney and any other affected organs, but generally, metastatic renal cell carcinoma cannot be cured and treatment is focused on slowing disease progression and alleviating symptoms.

In many other forms of cancer, patients respond to chemotherapy, but renal cell carcinoma is one of the few cancers that has a poor response to this treatment. The main treatment approaches used instead are described below:

  • Partial or complete nephrectomy, which is surgical removal of the kidney
  • Embolization, which is the deliberate occlusion of a blood vessel to prevent blood flow to a tumor
  • Targeted therapies such as sunitinib and pazopanib
  • Radiotherapy
  • Immunotherapy

Nephrectomy and interleukin-2 therapy is a standard approach in metastatic renal cell carcinoma. The patient response rate is low but a small percentage of people benefit.

Reviewed by , BSc

Further Reading

Last Updated: Sep 17, 2014

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  1. Graeme Hills Graeme Hills United Kingdom says:

    I have metastatic RCC - spread to lymph nodes and left lung.  Just stopped SUNITINIB as it stopped working. Also had a blockage removed from the left lung and just completed radiotherapy course for the lung 'issue'.  Coughing quite a lot and getting very short of breath with very little exertion.. are the symptoms normal after radiotherapy to a lung?  Thanks.. Smile

    • Myron Henderson Myron Henderson United States says:

      I'm sorry to hear that you have complications, I would advise asking your health provider. I too was diagnosed with RCC stage 4 last December. I was somewhat lucky in the fact that I only had metastasis to my sternum and a ribcage. They did have to take my left kidney but all in all radiation seems to be working in controlling my active areas and lucky that I haven't had worst. Best of luck to you and stay strong.

    • Mike Scanlon Mike Scanlon United States says:

      I hope that now a year later finds you well.  You story sounds a bit like mine, I had RCC spread to both my lungs.  Dr's used IL2 and they dissolved away. . though the treatment was pretty devastating. . fast forward 9 years and a new spread to my adrenal.. the point here is that (from what I understand) treatment is moving away from IL2 to just approved Nivolumab. . its a once every other week, IV infusion (takes an hour). . easy to take, higher rate of success and has some durability. . Best of luck.. keep up the fight.

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