Is Kidney Cancer Curable? Understanding the Odds
Medically reviewed by Doru Paul, MD
There are several types of kidney (renal) cancer. Each type is potentially curable if it's found and treated early, before the cancer has a chance to spread.
Kidney cancer is categorized in stages from 1 through 4. The lower the stage, the more likely the cancer is to be successfully treated and cured.
This article will discuss the curability of kidney cancer by stage. It will also provide information about treatments that may be used to treat kidney cancer, including recent breakthroughs in research.
Photo composite by Lecia Landis for Verywell Health; Getty Images
Kidney Cancer Stage and Curability
If you have stage 1 kidney cancer, the tumor has not spread from the kidney and is less than 7 centimeters (cm), or approximately 2.7 inches, large. Stage 1 kidney cancer may be cured through surgical removal of the tumor and part of the kidney (partial nephrectomy).
In stage 2 kidney cancer, the tumor has grown larger than 7 cm but is still confined to the kidney. This stage of kidney cancer may be cured surgically, typically with a radical nephrectomy (removal of the entire kidney).
Once kidney cancer has reached stage 3, local spread has occurred to the regional lymph nodes. Sometimes, the tumor gets larger and grows outside the kidney, but in order to be classified as stage 3, the lymph nodes need to be involved. Stage 3 kidney cancer can sometimes be cured, provided that the cancer is found and removed completely.
If you have stage 4 kidney cancer, cancer has metastasized (spread) to the adrenal glands (located on top of the kidneys) or distant lymph nodes or organs. Stage 4 kidney cancer is treatable but is not typically considered curable.
Kidney cancer that is cured can return years later. The more time that passes without a recurrence, the less likely this will occur. Medical testing and regular checkups will help ensure that any potential recurrence is caught early and treated.
Treatment to Cure Kidney Cancer
Multiple factors will be considered when your treatment options for kidney cancer are being planned. They include:
Type and stage of cancer
Level of tumor aggressiveness
Your age and overall health
Your risk level for recurrence
Stages 1 to 3
Surgical removal of all or part of the kidney is the preferred treatment for kidney cancer in stages 1, 2, and 3. The removal of nearby lymph nodes may also be recommended, especially if they have become enlarged.
If any cancer cells have spread into large veins located near the kidneys, the veins may be opened surgically so that the cells can be removed from inside.
After undergoing surgical treatment, you may be given immunotherapy for an extended period of time.
If you aren't healthy enough to withstand surgery, alternative, localized treatments may be recommended for you to consider instead. These include:
Cryotherapy (cryoablation): During this treatment, extremely cold gasses are inserted directly into the tumor through a hollow needle, destroying it.
Radiofrequency ablation: This minimally invasive procedure uses radiofrequency waves to kill cancer cells.
Radiation therapy (radiotherapy): This localized treatment uses high doses of radiation to shrink tumors and to kill or damage cancer cells.
Stage 4
Kidney cancer that has advanced to stage 4 requires treatment that targets the spread of cancer cells to other organs or distant lymph nodes.
Surgical removal of the kidney and other areas of localized tumors may or may not be recommended. Localized radiation of the kidney may be used instead of, or in addition to, surgery.
If the spread is extensive, combinations of targeted therapy drugs and/or immunotherapy drugs may be used as systemic (overall bodily) treatments. Immunotherapy helps the body’s immune system fight or slow the spread of tumors. These therapies find and fight cancer cells wherever they exist in the body.
If you're diagnosed with stage 4 kidney cancer, you may be understandably concerned about your survival rate. Please keep in mind that cancer at this stage is not always "terminal."
The five-year relative survival rate for kidney cancer that has metastasized is 15%. This number is likely to be lower than you would hope.
However, it is based on the experiences of people who were diagnosed at least five years ago. This statistic does not take new treatments or breakthroughs into account. Everyone's experience is different, and new treatments are often on the horizon.
Other Influencing Factors
Aggressive forms of kidney cancer may be more challenging to treat and cure than other types. Hereditary leiomyomatosis and renal cell carcinoma (HLRCC) is thought to be one of the most aggressive types of kidney cancer. HLRCC is not the same condition as renal cell carcinoma (RCC). A lack of the enzyme fumarate hydratase earmarks HLRCC.
In addition to staging, tumor grade may influence how challenging your cancer is to cure. Kidney cancer tumors may be low grade or high grade. High-grade tumors are more aggressive and grow more quickly than low-grade tumors.
A 2015 report contrasted early surveillance studies of tumor growth in older people with kidney cancer compared to those with kidney cancer with an average age of 64. The younger group had clinically significant tumors that were treated immediately upon diagnosis.
The surveillance studies of the older subjects indicated that tumor growth averaged 0.3 cm annually. The younger group showed tumor growth of 2.13 cm annually, on average. According to this report, younger people may have faster tumor growth than older people. However, it should be noted that the younger group was small, at only 46 people.
The type of kidney cancer you have may determine how aggressive your tumors will be. However, any type of kidney cancer tumor may grow or metastasize. Catching and treating the cancer early is the best way to combat this.
The most common type of kidney cancer is renal cell carcinoma (RCC). RCC is further broken down into several subtypes. Some subtypes, such as chromophobe renal cell carcinoma and papillary renal cell carcinoma, are sometimes low-grade tumors.
Other RCC subtypes, such as renal medullary carcinoma and collecting duct carcinoma, are categorized by very aggressive, high-grade tumors. Both of these subtypes are rare.
International Metastatic Renal Cell Carcinoma Database Consortium (IMDC)
If you have stage 3 or stage 4 cancer, your healthcare provider may predict your prognosis and risk level for recurrence by utilizing the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) system, which will determine the type of treatment used.
The IMDC uses these six predictors to assess your score:
Your ability to carry out daily life skills, as assessed on the Karnofsky performance status scale
Amount of time between diagnosis and metastatic cancer treatment
Blood calcium level to measure if there is too much calcium in the blood
Red blood cell count, which measures the blood cells that carry oxygen throughout the body
Platelet count, which measures the blood cells active in blood-clotting
Neutrophil level, which measures this type of white blood cell that fights infections
Research Advancements in Curing Kidney Cancer
Research into kidney cancer's causes, origins, and treatments has been robust over the last few decades. National Institutes of Health (NIH) data indicate that 75% of people with kidney cancer are alive five years after diagnosis. But more progress can be made.
Some noteworthy advancements in kidney cancer research include:
An early detection liquid biopsy (blood or urine) test that detects DNA shed by small tumors
Targeted therapy treatments for clear cell kidney cancer (the most common type of RCC)
Immunotherapy treatments for advanced kidney cancer
Clinical trials for kidney cancer remain ongoing. A clinical trial tests a new procedure or medication compared to standard treatment. If you're interested in participating in a clinical trial, talk to your healthcare provider about which trial may be most beneficial for you. A list links approximately 150 actively recruiting, NIH-approved clinical trials.
Summary
When caught early, kidney cancer is often curable. Stage 3 and stage 4 cancers may be more challenging to treat but cure or long-term remission is still possible, even at those stages.
The type and stage of cancer you have, as well as your tumor grade, will have an impact on your potential cure rate. Talk to your healthcare provider about treatments that make sense for you and about lifestyle changes that may enhance your recovery.
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