After a person is diagnosed with cancer, what comes next is the staging process. This procedure helps determine as to which body parts and how far the cancer has spread and the chances of recovery and survival rate. Only after this stage is when a doctor can determine the course of treatment. Kidney cancer ranges from stages (1) I to (4) IV, and the doctors further use the TNM system, defined by the American Joint Committee on Cancer (AJCC).

T (tumor) – identifies with the size of the tumor and whether it has invaded the surrounding tissues

N (node) – determines if cancer has spread to the lymph nodes

M (metastasis) – establishes whether cancer has spread to other body parts

Stage 1
This is the least aggressive stage, where the tumor is sized at 7cm or less and is limited to just one kidney. Designated as T1, this stage has the highest five-year survival rate.

Treatment
The two surgery options of this stage are partial nephrectomy and radical nephrectomy.

Partial nephrectomy: In an attempt to retain the kidney, only the tumor and the healthy tissue around it are removed. This treatment option brings about no change in your lifestyle.

Radical nephrectomy: This surgery is only opted when partial nephrectomy is not an option for the patient’s recovery. This procedure involves removing the entire kidney, the attached ureter, and the fat layer around it. In rare cases, the adrenal gland is also removed.

Stage 2
In this stage, the tumor is larger than 7 cm but is retained to the kidney. Designated as T2, this stage won’t see the tumor spread in lymph nodes or other parts of the body.

Treatment
The two surgery options for this stage are similar to that of stage 1. And in case your body can’t handle a surgery, or you have just one functional kidney, ablation therapy would be the next best option. This therapy involves using electrical energy and heat to destroy the tumour.

Stage 3
The third stage is differentiated based on the invasion of cancer into the lymph nodes. For instance, when the tumor grows into the vein and the tissues around the kidney but hasn’t invaded lymph nodes, it’s diagnosed as T3. And the other scenario is when the tumor appears outside the kidney and has invaded the lymph nodes. This scenario, as per the AJCC system, is termed as T1-T3, N1, M0.

Treatment
Both scenarios demand radical nephrectomy, wherein the lymph nodes and the adrenal gland are removed.

Stage 4
The first scenario designated as T4, any N, M0 is when cancer has spread to the tissue beyond the kidney, and the second type — any T, any N, M1 is when cancer has spread across organs.

Treatment
Cytoreductive nephrectomy surgery is performed to remove the kidney and as much of cancer as possible. The surgery is then followed by targeted therapy to limit any harm caused to other healthy cells and retain the cancer spread.