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TNM stages

See what TNM stages for kidney cancer mean and how they affect your treatment options.

Doctors use a staging system called TNM (Tumour, Node, Metastasis).

  • T describes the size of the tumour
  • N describes whether there are any cancer cells in the lymph nodes
  • M describes whether the cancer has spread to a different part of the body

Doctors may also use a number staging system for kidney cancer. 

T stages

The T stage describes the size of the tumour.

There are 4 stages, T1 to T4.

T0 means there is no evidence of a primary tumour in the kidney.

T1 is divided into T1a and T1b:

  • T1a means the tumour is less than 4cm across, and is completely inside the kidney
  • T1b means the tumour is between 4-7cm acoss, and is completely inside the kidney 

T2 is divided into T2a and T2b:

  • T2a means the tumour is between 7-10cm across, and is completely inside the kidney
  • T2b means the tumour is more than 10cm across, but is still completly inside the kidney

T3 is divided into T3a, T3b, and T3c:

  • T3a means the tumour has grown into nearby tissues or veins, but is still inside the layer of connective tissue called Gerota's fascia
  • T3b means the tumour has grown into the vena cava, but is below the diaphragm (sheet of muscle between the lungs and tummy)
  • T3c means the tumour has grown into the vena cava above the diaphragm (sheet of muscle between the lungs and tummy), or has grown into the wall of the vena cava

T4 means the cancer has spread further than the tissues around the kidney

N stages

The N stage describes whether the cancer has spread to the lymph nodes.

NX means lymph nodes cannot be assessed

N0 means there are no cancer cells in the lymph nodes

N1 means there are cancer cells in one or more lymph nodes

Doctors often call lymph nodes that contain cancer positive lymph nodes.

The lymph nodes nearest to the kidney include the paraaortic, renal hilar and caval lymph nodes.

M stages

The M stages describe whether the cancer has spread to a different part of the body (metastases).

M0 means the cancer has not spread to another part of the body

M1 means the cancer has spread to another part of the body

If your cancer has spread, you have advanced kidney cancer.

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)

Information and help

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