Kidney Cancer Treatment Options at The Kidney Cancer Institute

What is Kidney Cancer?

Like any of the body's organs, the kidney can develop cancer. Approximately 32,000 cases of kidney cancer are diagnosed in the United States alone each year, and approximately 11,000 people a year die of kidney cancer in the United States. The disease is more common in men and is most common in the sixth and seventh decades of life.

"Kidney cancer" is not a disease per se, but rather is a group of cancers that arise form different parts of the kidney tubules. Recently, a panel of experts convened a consensus conference in Heidelberg, Germany. The Heidelberg classification was devised based on a number of well-recognized parameters. Kidney cancers were divided into the following subtypes: Common or conventional renal cell carcinoma, papillary renal cell carcinoma, chromophobe renal cell carcinoma, collecting duct carcinoma (including medullary carcinoma), and renal cell carcinoma, which cannot be classified. This expert panel also classified benign kidney growths such as metanephric adenoma, metanephric adenofibroma, and renal oncocytoma. When kidney cancers are classified by the Heidelberg system, there is a significant difference in outcome, with patients having the conventional kidney cancer type having a worse overall prognosis compared to the other kidney cancer types.

Another system used to quantify the aggressiveness of kidney cancer is grading. By looking at the cells that make up a cancer, the cells are divided into low grade tumors which are less aggressive and higher grade tumors which are more aggressive. The Fuhrman classification was originally designed for conventional kidney cancers but is often used to grade all different kidney cancer varieties. Tumors are graded from I to IV with the lower grade tumors being less aggressive. Just as with the different subtypes, different grades have different outcomes.

Another predictive mechanism for kidney cancer is the cancer stage. The most commonly used staging system is the tumor, nodes, metastases system (TNM). Doctors use this system to help understand the extent of each individual patient's disease and to help predict outcomes. Currently used TNM classification system for renal cell carcinoma was instituted in 2002 as is depicted below.

International TNM Staging System for Kidney Cancer
Primary Tumor (T)
T1a = Confined to kidney and less than 4 cm in size
T1b = Confined to the kidney and between 4 and 7cm in size
T2 = Confined to the kidney and greater than 7 cm in size
T3a = Outside renal capsule invading the adrenal, renal sinus or perinephric fat
T3b = Tumor is invading the renal vein
T3c = Tumor is invading the vena cava
T4 = Tumor is outside Gerota’s fascia and is invading adjacent organs

Regional Lymph Nodes (N)
N0 = No regional lymph node metastasis
N1 = Metastasis in a single regional lymph node
N2 = Metastasis in more than one regional lymph node

Distant Metastasis (M)
M0 = No distant metastasis
M1 = Distant metastasis

For advance information on kidney cancer staging click here. If you wish more advanced information including the most updates information available on the biology and epidemiology of kidney cancer, please click here.