Stages, types and grades of kidney cancer
TNM stands for Tumour, Node and Metastasis. It helps your doctor plan your treatment.
T describes the size of the tumour (cancer)
N describes whether the cancer has spread to nearby
M describes whether the cancer has spread to other parts of the body, such as the lungs
Doctors may also use a number staging system for kidney cancer. Stage 1 is the earliest stage and stage 4 is the most advanced.
Read about the number stages of kidney cancer
Kidney cancer stages can be difficult to understand. And you may feel frightened or overwhelmed after being told you have cancer. You might not be able to take in everything your doctor tells you.
It might help to have a family member or friend with you when you see your doctor. They can:
support you
ask questions
take notes for you
Some people may find it helpful to listen back to what has been said. Ask your doctor if you would like to record the conversation and explain why. They will say if they are happy for you to record it or not.
You might also want to talk with your specialist nurse (CNS) about the cancer stage. But you may want to wait until you’ve had a chance to take in what your doctor has said. Your CNS can also arrange for you to see your doctor again if necessary.
The T stage describes the size of the cancer.
There are 4 T stages of kidney cancer. T1 is the smallest and T4 is the largest.
The cancer is 7cm across or smaller and is completely inside the kidney.
T1 is divided into T1a and T1b depending on how big the cancer is:
T1a means the cancer is 4cm across or smaller
T1b means the cancer is between 4 and 7cm across
If the cancer hasn't spread to the lymph nodes or other parts of the body, T1 kidney cancer is the same as number stage 1.
The cancer is more than 7cm across and is completely inside the kidney.
T2 is divided into T2a and T2b:
T2a means the cancer is between 7 and 10cm across
T2b means the cancer is more than 10cm across
If the cancer hasn't spread to the lymph nodes or other parts of the body, T2 kidney cancer is the same as number stage 2.
The cancer has grown into the surrounding tissues or the main blood vessels such as the renal vein. It may also have grown into the large blood vessel that takes blood back to the heart (vena cava).
The cancer has not spread into the adrenal gland or beyond the layer of tissue around the kidney (fascia).
T3 is divided into T3a, T3b, and T3c.
T3a means the cancer has grown into the nearby tissues or the renal vein.
T3b means the cancer has grown into the vena cava but hasn't spread above the .
T3c means the cancer has grown into the vena cava and spread above the diaphragm. Or has grown into the wall of the vena cava.
The diagram below shows stage T3c kidney cancer that has spread above the diaphragm.
The cancer has spread beyond the layer of tissue around the kidney (fascia). It might have spread into the adrenal gland above the kidney.
The diagram below shows stage T4 kidney cancer that has spread outside of the fascia and into the adrenal gland.
The N stage describes whether the cancer has spread to the lymph nodes near the kidney:
N0 means there are no cancer cells in the lymph nodes near the kidney
N1 means there are cancer cells in one or more lymph nodes near the kidney
The diagram below shows stage N1 kidney cancer.
The M stages describe whether the cancer has spread to a different part of the body.
The M stage is split into M0 and M1:
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, such as the lungs or lymph nodes that are further away from the kidney
Cancer that has spread to another part of the body is called advanced or metastatic cancer. Where the cancer has spread to is called a secondary cancer or metastasis.
M1 kidney cancer is the same as number stage 4.
The diagram below shows kidney cancer that has spread to the lung.
Read more about advanced kidney cancer
The stage of the cancer helps your doctor to decide which treatment you need. Treatment also depends on:
the type of cancer (the type of kidney cells the cancer started in)
how much the cancer cells look like normal cells (the grade of the cancer cells)
where the cancer is in your kidney
other health conditions that you have
Treatment may include:
surgery to remove the part of the kidney where the cancer is (partial nephrectomy) or the whole kidney (radical nephrectomy)
freezing therapy (cryotherapy)
microwave ablation (MWA) or radiofrequency ablation (RFA)
blocking the blood supply to the cancer (renal artery embolisation)
targeted cancer drugs or immunotherapy
radiotherapy
Last reviewed: 23 Jan 2024
Next review due: 23 Jan 2027
The kidneys are bean shaped organs near the middle of your back. They filter waste products out of your blood as urine. Kidney cancer develops when abnormal cells in either of the kidneys start to divide and grow in an uncontrolled way.
You should see your GP first if you notice a change that isn't normal for you. They will do some tests and may refer you to a specialist if they think your symptoms could be due to kidney cancer.
Treatments for kidney cancer include surgery, cryotherapy, radiofrequency ablation and radiotherapy. You might have different treatment for advanced kidney cancer.
Advanced kidney cancer means a cancer that started in the kidney has spread to another part of the body. It is also called metastatic kidney cancer. Treatment depends on how many parts of the body the cancer has spread to and how quickly it has spread.
Being diagnosed with kidney cancer may mean you have to make changes to keep your kidneys or remaining kidney healthy. There are people and organisations available to help you cope with being diagnosed with kidney cancer, and to support you in making these changes.
Kidney cancer is cancer that starts in the kidneys. The kidneys filter waste products out of your blood as urine. Kidney cancer develops when abnormal cells in either of the kidneys start to divide and grow in an uncontrolled way.
About Cancer generously supported by Dangoor Education since 2010. Learn more about Dangoor Education
Search our clinical trials database for all cancer trials and studies recruiting in the UK.
Connect with other people affected by cancer and share your experiences.
Questions about cancer? Call freephone 0808 800 40 40 from 9 to 5 - Monday to Friday. Alternatively, you can email us.
