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Number stages

See what the number stages of kidney cancer mean and how they affect your treatment options.

There are 4 main stages in the number stage system - stage 1 to stage 4.

Doctors might also use the TNM staging system.

Stage 1

The cancer is less than 7cm across and is completely inside the kidney.

Diagram showing stage 1 kidney cancer - the cancer is less than 7cm across and completely inside the kidney

In the TNM staging system, stage 1 is the same as:

    • T1, N0, M0

    Stage 2

    The cancer is more than 7cm across but is still completely inside the kidney.

    Diagram showing stage 2 kidney cancer - the cancer is more than 7cm across but still completely inside the kidney

    In the TNM staging system, stage 2 is the same as:

    • T2, N0, M0

    Stage 3

    The cancer has grown into surrounding tissues or a major vein nearby. 

    The cancer is still inside the layer of connective tissue called Gerota's fascia.

    There might or might not be any cancer cells in the lymph nodes, but the cancer has not spread to another part of the body.

    Diagram showing stage 3 kidney cancer where the tumour has grown into a vein or adrenal gland

    In the TNM staging system, stage 3 is the same as one of the following:

    • T1, N1, M0
    • T2, N1, M0
    • T3, any N, M0

    Stage 4

    Stage 4 means one of the following:

    • the cancer has grown into surrounding tissues outside the connective tissue called Gerota's fascia, or into the adrenal gland. It may or may not have spread to the lymph nodes or other parts of the body. Or, 
    • the cancer has spread to another part of the body
    Diagram showing stage 4 kidney cancer tumour and secondary cancer in the lung

    In the TNM staging system, stage 4 is the same as one of the following:

    • T4, any N, M0
    • any T, any N, M1

    Treatment

    The stage of your cancer helps your doctor to decide which treatment you need. Treatment also depends on:

    • your type of cancer (the type of cells the cancer started in)
    • where the cancer is 
    • other health conditions that you have

    If your cancer hasn't spread to other parts of your body

    Surgery is the main treatment. 

    If your cancer is smaller than 3cm and you are older or unwell, your doctor might suggest you have no treatment at first. They will monitor you closely. They might call this active surveillance. 

    If you can't have surgery you might have:

    • freezing therapy (cryotherapy)
    • radio wave treatment (RFA)
    • radiotherapy
    • blocking the blood supply to the cancer (arterial embolisation)

    If your cancer has spread away from the kidney (advanced cancer)

    You might have surgery to remove your kidney if you are well enough to recover from the operation. The surgeon might also remove cancer that has spread (secondary cancer). 

    You might have targeted cancer drugs to stop or slow the growth of the cancer. 

    Other possible treatments include:

    • radiotherapy
    • freezing therapy (cryotherapy)
    • radio wave treatment (RFA)
    • blocking the blood supply to the cancer (arterial embolisation)
    Last reviewed: 
    13 Jan 2016
    • EAU Guidelines on Renal Cell Carcinoma: 2014 Update
      B Ljungberga and others
      European Urology, 2015, Volume 67, Issue 5, Pages 913–924

    • Renal Cell Carcinoma: ESMO Clinical Practice Guidelines
      European Society of Medical Oncology, 2016

    • TNM Classification of Malignant Tumours (7th Edition)
      L H Sobin (Editor) and others.
      Wiley-Blackwell, 2009

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