What You Need to Know About Stage 4 Kidney Cancer

What You Need to Know About Stage 4 Kidney Cancer

What Is Stage 4 Kidney Cancer?

Stage 4 kidney cancer means cancer cells have metastasized to the lymph nodes and/or other organs.

The adrenal gland is the first place that cancer spreads, as this gland is attached to the kidney. Cancer may also spread into nearby lymph nodes near the kidney or elsewhere in the body.

Renal cell carcinoma (RCC) is the most common type of kidney cancer, affecting up to 90 percent of the people with kidney cancer, this according to the American Cancer Society. Up to 25 percent of new diagnoses of RCC are cases where the cancer has already metastasized.

What Is Metastasis?

Metastasis is the medical term for cancer that has spread to another part of the body. Other names for metastasis are advanced stage cancer, metastatic cancer or stage 4 cancer.

Metastasis develop when cancer cells break away from the main tumor and enter your bloodstream or lymphatic system. Any cancer can metastasize, but the more aggressive cancer, the more likely this will happen. Metastasis to the bones, brain, liver, lungs and lymph nodes are most common. Doctors give the same name to the metastasis that they give to original cancer.

When kidney cancer spreads, it is called metastatic renal cell carcinoma. When kidney cancer is in an early stage, most people do not notice symptoms, but symptoms are noticeable when the disease has metastasized.

Signs that your cancer may have metastasized include:

  • Pain on one size of the lower back
  • Lump on the back or side
  • Weight loss and loss of appetite
  • Blood in urine
  • Extreme fatigue
  • Fever and night sweats
  • Ankle swelling

Diagnosis of stage 4 kidney cancer involves a physical exam, a review of medical history, imaging and lab testing.


What Does This Mean for You?

If you have been diagnosed with stage 4 kidney cancer, cancer has grown outside the kidney and/or has spread to other parts of the body, either the lymph nodes or other organs.

Your treatment options at this stage will depend on how extensive the cancer is and your overall health. Even at Stage 4, surgery is still an option if you are in otherwise good health.

The tumor can still be removed if the cancer has only spread to one other area. Surgery involves removal of the kidney and the metastasis.

Even if surgery isn’t an option, your doctor can recommend targeted therapies.

And clinical trials are also an option, especially when other treatments don’t work. Clinical trials include new combinations of targeted therapies, immunotherapy, and other new treatments.

Embolization and radiation therapy are options for you, but they are considered palliative. This means they are designed to relieve symptoms and improve your life’s quality.


Radical nephrectomy is a surgical procedure that involves removing the entire kidney, affected adrenal gland and any involved lymph nodes or major blood vessels. Studies shown radical nephrectomy improves survival for stage 4 kidney cancer.

Some patients are lucky enough to experience long-term survival after surgical removal of metastatic cancer if metastasis are singular. One study shows that up to 50 percent of people with a single metastasis have survived 5 or more years, this according to a report from the Journal of Clinical Oncology.

An alternative to surgery is arterial embolization which can also be used before surgery to make the operation easier. This procedure involves an injection of a gelation like materials through a catheter to clog the main kidney blood vessel to shrink the cancer by depriving it of oxygen-carrying blood it needs to survive.

Systemic Therapy

Examples of systemic therapies are immunotherapy, targeted therapy, and chemotherapy. When these treatments are done after surgery, they significantly reduce the chances of a cancer reoccurrence.

These treatments are also used during surgery on cancer cells doctors are unable to remove.   In addition to reducing reoccurrence, these treatments may also help prolong survival and improve quality of life.

Immunotherapy works by stimulating the immune system to fight cancer. Unfortunately, these drugs can have some serious side effects and are effective for small percentages of people.

Targeted therapies are designed to treat only cancer cells and cause minimal damage to healthy cells. These therapies are known for fewer side effects and improved outcomes.

Chemotherapy is administered either through a vein or a pill. Because kidney cancer has been known to be resistant to chemotherapy, chemotherapy drugs are in combination with other treatments.

Participation in Clinical Trials

You may be able to gain access to a clinical trial which may give you additional treatment options. If you are interested in a clinical trial, speak with your doctor about which ones could benefit you.

Clinical trials offer new targeted therapies, combination therapies and vaccines for treating kidney cancer. Unfortunately, not enough people participate in these.

Living with Stage 4 Kidney Cancer

In advanced stage cancer, palliative treatments help you live longer and live comfortably, even if you cannot be cured.

Kidney cancer pain management will also help you to continue to have a good quality of life. These medications shouldn’t interfere with your cancer treatment and controlling pain will keep you active and allow you to continue the daily activity.

You may live with cancer for many years, and your doctor will treat it similarly to a chronic illness. Just like people with diabetes or lupus, you will need treatment.

Make sure you follow your treatment plan, so it works as well as possible. You will also need support to manage all the challenges that come along with living with advanced stage cancer.


National Institutes of Health (Management of Renal Cell Carcinoma With Solitary Metastasis)

American Cancer Society (Treatment Choices by Stage for Kidney Cancer)

American Cancer Society (Survival Rates for Kidney Cancer by Stage)

National Cancer Institute (Metastatic Cancer)

American Cancer Society (What Is Kidney Cancer?)

University of New Mexico Comprehensive Cancer Center (Stage IV Renal Cancer)

National Institutes of Health (Radical Nephrectomy Plus Interferon-Alfa-Based Immunotherapy Compared With Interferon Alfa Alone In Metastatic Renal-Cell Carcinoma: A Randomised Trial)

Journal of Clinical Oncology (Resection of Metastatic Renal Cell Carcinoma)

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