Kidney Cancer Causes And Stages

Kidney Cancer Causes And Stages
Last year, more than 1.3 million new cancers were diagnosed in the United States. According to the American Cancer Society, more than 50,000 of these individuals were diagnosed with kidney cancer. But there is hope: More than 200,000 kidney cancer survivors are living in the United States right now. Recent advances in diagnosis, surgical procedures, and treatment options will allow even more patients to live with the disease, continuing to maintain their normal schedules and lifestyles.

This marks the beginning of an important new era for kidney cancer patients, with the recent approval by the Food and Drug Administration (FDA) of new drugs to treat their advanced disease. These drugs target cancer cells in different ways than current drugs used to treat kidney cancer, and will have a very positive impact for many patients. Continued research efforts will improve our understanding of the disease even more and increase the options available to fight kidney cancer.

Each person diagnosed with kidney cancer goes through the shock of being told they have the disease. It is a difficult experience. Feelings of shock, loneliness, alienation, fear, frustration, anger, and hurt are natural parts of any life-threatening illness. It is okay to have these feelings, to cry, and to be upset.


1.  Genetic Causes 

Genetic factors have been linked to an increased risk of developing kidney cancer. A hereditary disorder called von Hippel-Lindau (VHL) disease is associated with a high risk of developing kidney cancer, for example. Scientists have isolated the gene responsible for VHL disease, and this discovery offers exciting future possibilities for improved diagnosis and treatment of some kidney cancers. 

Another genetic mutation is thought to be responsible for tuberous sclerosis, a disease characterized by small tumors of the blood vessels that results in numerous bumps on the skin, mental retardation, seizures, and cysts in the kidneys, liver, and pancreas. 

In some cases, tuberous sclerosis has been associated with renal cell carcinoma. Birt Hogg Dube Syndrome (BHD) is another disorder associated with kidney cancer that is characterized by the presence of multiple small bumps (nodules) on the skin covering the nose, cheeks, forehead, ears, and neck. For more information about these genetic factors, as well as HLRCC and HPRCC, please click here.

2. External Factors

Some external factors, such as smoking and obesity, have been related to a higher incidence of kidney cancer. In an attempt to answer the question “Why me?” some people want to determine such factors as a cause for their cancer. Although it is important for people to know what factors or behaviors are associated with an increased risk of kidney cancer, blaming yourself for past behavior is neither helpful nor healing. The fact that a person’s behavior included a risk factor such as smoking doesn’t necessarily mean the factor caused the cancer.


Knowing survival rates by stage can help you understand your outlook based on the kidney cancer’s progression, but each person’s situation is unique. Survival rates are affected by how well you respond to treatment along with other factors. That means someone with a later stage cancer may live a longer life than a person who’s been diagnosed with an earlier stage cancer, or vice versa.

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 is used to identify 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.

For example, if you are told your cancer is T1, N0, M0, that means that you have a small tumor in one kidney, but that it hasn’t spread to your lymph nodes or organs.

TNM designation
main tumor can’t be measured
no main tumor identified
main tumor is only in one kidney and is less than 7 cm, or a little less than 3 inches, across
main tumor is only in one kidney and larger than 7 cm
main tumor has grown into a major vein and nearby tissue
main tumor has reached tissue beyond the kidney
tumor in lymph nodes can’t be measured
no evidence that tumor has spread to the lymph nodes
N1 - N3
tumor has spread to nearby lymph nodes; the higher the number, the more lymph nodes that are affected
spread of cancer (metastasis) can’t be measured
tumor has not spread to other organs
tumor has spread to other organs

Kidney cancer also can be assigned a stage number of 1 through 4. These stages identify cancers with a similar outlook, and so are treated in a similar way. As a general guide, the lower the stage number, the better your chance of recovery, but everyone’s situation is unique.

kidney cancer stages
Kidney Cancer Image
Stage 1

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.

Stage 2

Stage 2 is more serious than stage 1. In this stage, the tumor is larger than 7 centimeters across 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.

Stage 3

The TNM 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.

Stage 4

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.

Cancer is called recurrent when it come backs after treatment. Recurrence can be local (in or near the same place it started) or distant (spread to organs such as the lungs or bone). Treatment of kidney cancer that comes back (recurs) after initial treatment depends on where it recurs and what treatments have been used, as well as a person’s health and wishes for further treatment.

For cancers that recur after initial surgery, further surgery might be an option. Otherwise, treatment with targeted therapies or immunotherapy will probably be recommended. Clinical trials of new treatments are an option as well.

For cancers that progress (continue to grow or spread) during treatment with targeted therapy or cytokine therapy, another type of targeted therapy or immunotherapy may be helpful. If these don’t work, chemotherapy may be tried, especially in people with non-clear cell types of renal cell cancer. Clinical trials may be a good option in this situation for those who want to continue treatment.

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