What Does Stage 4 Kidney Cancer Mean?

Stage 4 kidney cancer is the most advanced stage. It means the cancer has either:

  • Spread to distant organs such as the lungs, bones, liver, or brain, or
  • Extensively invaded surrounding tissues and multiple lymph nodes near the kidney.

This stage is also referred to as metastatic kidney cancer when distant spread is involved.

At stage 4, symptoms are often more pronounced and may include:

  • Blood in the urine
  • Pain or pressure in the side or lower back
  • A lump or swelling in the abdomen
  • Fatigue
  • Unexplained weight loss
  • Persistent cough or bone pain, if the cancer has spread

Diagnosis is confirmed through imaging tests such as CT scans, MRIs, or bone scans, which help determine the extent of spread. A biopsy may also be performed to confirm the cancer type, especially when it has spread to distant sites.

Treatment for Stage 4 Kidney Cancer

Stage 4 is generally not curable, but it is often treatable. The main goals are to:

  • Slow the growth of cancer
  • Reduce symptoms
  • Prolong survival
  • Improve quality of life
  • Treatment may include:
  • Immunotherapy (e.g. nivolumab, pembrolizumab)
  • Targeted therapy (e.g. cabozantinib, lenvatinib)
  • Combination therapy
  • Surgery (in selected cases, such as removing the kidney to reduce tumor burden)
  • Palliative care to manage symptoms

Some patients respond very well to modern treatments and live for many years with stable disease. Regular monitoring with scans is important to track the response to treatment and adjust the plan as needed.

While stage 4 is serious, advances in kidney cancer therapy have significantly improved survival and outcomes compared to the past.

Looking for more questions?

Visit our Kidney Cancer Questions page for all other topics explained in plain language.

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