What Is Metastatic Renal Cell Carcinoma?

Metastatic renal cell carcinoma (mRCC) is kidney cancer that has spread beyond the kidney to other parts of the body. “Metastatic” means the cancer cells have moved through the bloodstream or lymphatic system and formed tumors in distant organs. This is considered stage 4 kidney cancer.

Where Can It Spread?

Common sites of metastasis include:

• Lungs
• Bones
• Liver
• Lymph nodes
• Brain

In some cases, the cancer may be found in more than one area at the same time.

How Does It Happen?

After developing in the kidney, cancer cells can break away from the original tumor and travel to other parts of the body. Some patients are diagnosed with metastatic disease from the start (called de novo mRCC), while others develop metastases months or years after initial treatment.

Symptoms of Metastatic RCC

Symptoms vary based on where the cancer has spread. These may include:

• Chronic cough or chest pain (lungs)
• Bone pain or fractures (bones)
• Fatigue, weight loss, or fevers
• Neurological symptoms like headaches or vision changes (brain)

However, some patients may not have symptoms, and the disease is found on imaging during routine follow-up.

How Is It Treated?

Although metastatic RCC cannot usually be cured, many patients live for years with proper treatment. Options include:

• Immunotherapy: drugs like nivolumab or pembrolizumab
• Targeted therapy: drugs like cabozantinib or lenvatinib
• Combination therapy: using both types together
• Palliative surgery or radiation: for symptom control

Clinical trials are also available and may offer newer treatments.

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