Where Is Your Kidneys Located In The Body Picture – Making educated treatment decisions begins with determining the stage, or progression, of a particular disease. The stage of kidney cancer is one of the most important factors in evaluating treatment options.

After a diagnosis of kidney cancer, the patient’s care team gives a stage to the cancer. The stage is a measure of how far the cancer has spread in the body. There are four basic stages of kidney cancer, and they are given the numbers 1, 2, 3 and 4. Stage 1 is the earliest stage and stage 4 is the most advanced. This process helps the patient and his or her care team decide on the best treatment options.

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Kidney cancer, also known as renal cell cancer, starts inside the kidney, where the blood is filtered. Cancer that starts in the renal pelvis, where urine collects, is technically in the kidney, but it is a separate type of cancer called transitional cell cancer. There is another type of cancer found in the kidney that is not considered kidney cancer called Wilms tumor. These cancers have different stages than kidney cancer.

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Many early kidney cancers are suspected after a urine sample tests positive for blood, or an imaging test of the abdomen—computed tomography (CT) scan, magnetic resonance imaging (MRI) scan ultrasound ( MRI) — reveals a problem. In some cases, kidney cancer can be diagnosed with imaging tests alone.

If surgery is recommended to confirm a diagnosis, the kidney will be examined by a pathologist. If surgery is not recommended, a long needle can be placed in the kidney to retrieve the cells. This sample is called a needle biopsy. As an added part of staging, an X-ray bone scan of the chest may be recommended to see if the kidney cancer has spread to other parts of the body.

To assess the location, size and spread of the cancer, the care team will use the TNM staging system, developed by the American Joint Committee on Cancer (AJCC). TNM refers to tumor, node and metastasis, which are important factors in determining the severity of cancer. The patient-specific combination of TNM and other markers helps the care team determine the stage of the cancer.

The cancer has not spread outside the kidney and is not larger than 7 cm. Under the TNM system, kidney cancer stage 1 is T1, N0, M0.

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The cancer has not spread outside the kidney but is larger than 7 cm. Using the TNM system, stage 2 kidney cancer is T2, N0, M0.

The cancer can be of any size, but has spread to nearby sites outside of the kidney. Using the TNM system, stage 3 kidney cancer is T3, N0, M0 or T1-T3, N1, M0.

Cancer has spread away from the kidney to distant sites or organs. The most common places kidney cancer spreads, or metastasizes, to include distant lymph nodes, the lungs, bones, liver and brain. TNM classification for stage 4 kidney cancer T4, any N, M0 or any T, any N, M1.

The American Cancer Society (ACS) describes the stages of kidney cancer in more detail using the AJCC’s TNM system. In this system, T stands for tumor, N for lymph nodes and M for metastasis.

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Once the care team gathers details about the type and stage of the tumor, they can evaluate available treatment options and develop information to share with the patient about his or her prognosis. Typically, the care team considers the following factors as part of this process:

Your multidisciplinary team will work with you to develop a personalized plan to treat your kidney cancer in a way that fits your individual needs and goals.

The best treatment for kidney cancer depends on the stage, along with the patient’s general health. The most common options include:

Stage 1 Kidney cancer treatment: At this stage, surgery to remove the part of the kidney with the tumor may be the most appropriate option. This surgery is called a partial nephrectomy.

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Stage 2 Kidney cancer treatment: At this stage, the entire kidney can be removed. This surgery is called a radical nephrectomy.

Stage 3 Kidney cancer treatment: Some cancers may involve a radical nephrectomy to remove the affected kidney, nearby lymph nodes and cancer cells, as well as the adrenal gland and fatty tissue.

Stage 4 Kidney cancer treatment: At this advanced stage, other treatment options separate from surgery—such as targeted therapy or immunotherapy—may be recommended.

Staging the cancer not only helps the care team determine a treatment plan—it also helps predict a potential prognosis. This is done by calculating the percentage of people with kidney cancer who live five years after diagnosis compared to people who do not have that type of cancer. It is important to remember that this is only a statistic based on all people with kidney cancer several years in the past, so individual statistics may vary.

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The ACS estimates that approximately 81,800 new cases of kidney cancer may be diagnosed in 2023 in the United States. Survival numbers predict that 77 percent of these people will live at least five years compared to those who do not have kidney cancer. However, the stage of the cancer makes a difference. If the cancer has not grown outside the kidney, the relative survival rate for five years is 93 percent. For stage 4 kidney cancer, the five-year relative survival rate is much lower.

It is important to know that even with more advanced cancer, the relative five-year survival rate is based on the last five years and does not include new advances in clinical trials. A nephrostomy allows urine (pee) to drain from the kidney if it is present. blockage in the urinary system.

A nephrostomy is a tube that allows urine to drain from the kidney through an opening in the skin at the back.

A thin, flexible tube passes through the opening and into the kidney. This is called a nephrostomy tube or catheter. The urine drains through the tube into a bag outside your body. The bag has a tap so you can empty it. You can still pass some urine normally even when you have a nephrostomy.

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The kidneys are at the back of the body, one on each side, just below the rib cage. The kidneys are bean shaped. They are just above the level of the belly button. The kidneys filter your blood to get rid of waste products, and turn them into urine (pee).

Urine travels from each kidney through a fine tube called a ureter to the bladder, where it is stored. The bladder is located in the lower part of the belly (abdomen). This area is called the pelvis.

When you are ready to urinate, you leave your bladder through a tube called the urethra. The urethra opens in front of the vagina, or at the tip of the penis.

You may need a nephrostomy if the cancer, or cancer treatment, affects one or both ureters. If a ureter is blocked, urine (pee) cannot pass from the kidney to the bladder. This causes urine to build up in the kidneys. When this happens, the kidneys can slowly stop working.

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You may need 1 or 2 nephrostomy tubes, depending on whether one or both ureters are blocked. If you have only 1 tube, this is called a unilateral nephrostomy. If you have tubes in both ureters, this is called bilateral nephrostomies.

Cancers that start in the lower abdomen (pelvis) are most likely to block the ureters. These include cancer of the:

Sometimes, cancer that started in another part of the body spreads to the pelvis and forms a tumor. This can block 1 or both ureters. You will usually have a scan to find out exactly where the blockage is.

Your doctor will explain how long you are likely to have a nephrostomy tube. They can remove it if the cancer treatment clears the blockage. Sometimes, the doctor places a tube called a stent in the ureter. The stent keeps the ureter open so it is no longer blocked. This means that the nephrostomy tube can be removed.

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If cancer treatment or a stent does not clear the blockage, the nephrostomy tube is left in. The doctor changes it every 3 to 4 months, to stop it from blocking. Replacing a nephrostomy tube is a very quick procedure.

You usually have a local anesthetic for nephrostomy insertion. Most people stay in hospital only for a short time. A doctor usually performs the procedure in the x-ray (radiology) department. The doctor, called a radiologist, uses x-rays and ultrasound scans to help them place the nephrostomy tube in the kidney. It can take 30 to 60 minutes.

Your doctor or nurse will place a fine tube called a cannula into a vein in your arm. They may use this to give you:

You lie on your stomach on an x-ray table. When you are comfortable, the doctor will inject some local anesthetic into the skin on the back.

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When the area is numb, the doctor gently places a fine needle through the skin and into the kidney. Then they put a guide wire through the needle. The doctor uses the guide wire to place the nephrostomy tube into the kidney. They use stitches or dressings to hold the tube in place.

The nephrostomy tube may also have a locking system. This coils inside the kidney to keep the tube inside

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