Kidney cancer, also known as renal cancer, begins in the kidneys, which are a pair of bean-shaped organs located on either side of the spine, just below the rib cage. These organs play a role in filtering waste products from the blood and producing urine. Understanding the stage of kidney cancer is important for determining treatment and anticipating the disease’s course. Staging helps categorize the cancer’s spread, guiding personalized care.
Defining Stage 3 Kidney Cancer
Cancer staging is a standardized system that describes the size of a tumor and how far it has spread from its original site. For kidney cancer, the most common system used is the TNM staging system, which assesses three components: T for tumor, N for lymph nodes, and M for metastasis.
Stage 3 kidney cancer indicates that the tumor has grown beyond the kidney itself, but has not yet spread to distant parts of the body. For the T (tumor) component, this means the tumor has extended into major veins connected to the kidney, such as the renal vein or even the vena cava. It may also involve the tumor growing into the fat surrounding the kidney, but without reaching the adrenal gland or beyond the kidney’s surrounding fascia.
The N (lymph node) component for Stage 3 kidney cancer means that cancer cells have spread to nearby lymph nodes, but this involvement is limited to regional lymph nodes, not distant ones. It may involve one nearby lymph node. The M (metastasis) component means there is no distant spread of the cancer to other organs or lymph nodes.
Therefore, a diagnosis of Stage 3 kidney cancer corresponds to specific combinations within the TNM system, such as a T3 tumor with no lymph node involvement or distant metastasis (T3, N0, M0). It can also include cases where the tumor is of any T-stage (T1, T2, or T3) but has spread to a regional lymph node, with no distant metastasis (T1-T3, N1, M0).
Identifying Stage 3 Kidney Cancer
Identifying Stage 3 kidney cancer may begin when individuals experience certain symptoms. When symptoms do occur, they can include blood in the urine, known as hematuria. Other possible indicators are a persistent dull ache or pain in the side, abdomen, or lower back, or a noticeable lump or mass in the side or lower back area.
Diagnostic procedures confirm the diagnosis and determine the cancer’s stage. Imaging tests are used, with CT scans and MRI scans providing detailed images to assess tumor size, extent, and spread. An ultrasound may also be used to visualize kidney masses.
A biopsy is performed to confirm the presence of cancer cells and determine the specific type of kidney cancer. Blood tests, such as a complete blood count (CBC) and basic or complete metabolic panel (CMP), provide information about overall health, organ function, and potential signs of disease like anemia or high calcium levels. Urinalysis is also conducted to check for blood or protein in the urine.
Treatment Options for Stage 3 Kidney Cancer
Treatment for Stage 3 kidney cancer typically involves a multi-modal approach, with surgery as a primary intervention. A radical nephrectomy, which involves the removal of the entire affected kidney, surrounding lymph nodes, and sometimes the adrenal gland and fatty tissue, is a common surgical procedure for Stage 3 disease. In some instances, if feasible, a partial nephrectomy may be considered to remove only the cancerous part of the kidney while preserving the rest of the organ.
Following surgery, or in cases where surgery is not possible, systemic therapies such as targeted therapy and immunotherapy play a significant role. Targeted therapies work by specifically attacking cancer cells based on their unique characteristics, often by blocking proteins that help them grow or form new blood vessels that feed the tumor. Examples of targeted drugs include sunitinib, axitinib, and cabozantinib, which are often taken as pills.
Immunotherapy utilizes the body’s own immune system to fight cancer cells. These treatments can help the immune system recognize and destroy cancer cells by blocking “checkpoint” proteins that cancer cells use to evade immune detection. Pembrolizumab is an immunotherapy drug that may be given after surgery to reduce the chance of recurrence. Radiation therapy is less commonly used as a primary treatment for kidney cancer but may be employed for palliative care to alleviate symptoms or in specific circumstances before or after surgery for more extensive tumors.
Outlook and Ongoing Care
The outlook for individuals diagnosed with Stage 3 kidney cancer can vary based on several factors, including the patient’s overall health, the specific characteristics of the cancer, and how well they respond to treatment. While the five-year survival rate for Stage 3 kidney cancer can range, some statistics indicate it is around 75%.
Following initial treatment, ongoing care is a crucial aspect of managing Stage 3 kidney cancer. This includes regular follow-up appointments and monitoring to detect any signs of recurrence or new cancer development. These follow-up measures may involve continued imaging scans and blood tests to track the patient’s health status.
Lifestyle considerations after treatment can also contribute to overall well-being. Maintaining a healthy diet, engaging in regular physical activity as advised by medical professionals, and avoiding smoking are generally recommended. These practices can support recovery and potentially influence long-term health outcomes.