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Understanding Your Grade and Stage of Kidney Cancer

7 October 2009 686 views 2 Comments protect ur eyes
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After the initial shock of the diagnosis, try and push your emotions aside so you can get answers about your kidney cancer, its treatment, and prognosis. One of the most important things you need to know about your kidney cancer before treatment, is GRADE and STAGE of your kidney cancer. Your doctor can tell you the grade and stage of your kidney cancer after giving a kidney biopsy and other tests to you. So, what are the grade and stage?

In a word, the GRADE of cancer is what the cancer cells look like under a microscope. STAGE is the size of the tumor and how far it has spread.

Your treatment plan and prognosis depends on the stage and grade of your kidney cancer and other factors such as your general health and age. (Treatment choices) This is why knowing your grade and stage of kidney cancer is so important.

Grades of Kidney Cancer

The grade of your cancer is the terminology doctors use to describe how the cancer cells look. The grade refers to how the part of the cell where DNA is stored, called the nucleus, looks compared to normal kidney cells’ nuclei. The most widely used and most predictive grading system for renal cell cancer is the “Fuhrman Nuclear Grade”. Your pathology report should use the Fuhrman Grade. Fuhrman grade is on a scale of I through IV, where grade I carries the best prognosis and grade IV the worst. Grading will help your doctor predict how fast the cancer may grow and spread. The lower the number, the closer the cancer cells look like normal cells and the better the prognosis. That’s because these cancers tend to grow and spread slowly. At the other extreme, cancers with a grade 4 look very different from normal kidney cells. They have a worse prognosis.

 

Stages of Kidney Cancer

Although the cell type and grade are sometimes helpful in predicting a prognosis, the cancer’s stage is by far the best predictor of survival.

The stage of your cancer is the terminology doctors use to communicate the size of a tumor and where and how deeply it has spread. When you are diagnosed with kidney cancer, the doctor needs to know the type of kidney cancer you have (clear cell (65%), papillary (15%), chromophobe cell (10%), oncocytoma (5%) or unclassified(5%) ) and the stage the cancer is in.

The TNM System is a standard system for describing the extent of a cancer’s growth. The International Union Against Cancer and the American Joint Committee on Cancer developed this system. Here’s what the letters stand for in the TNM System:

  • T indicates the size of the main (primary) tumor and whether it has grown into nearby areas.
  • N describes the extent of spread to nearby (regional) lymph nodes. Lymph nodes are small bean-shaped collections of immune system cells that are important in fighting infections.
  • M indicates whether the cancer has spread (metastasized) to other organs of the body. (The most common sites of spread are to the lungs, bones, liver and distant lymph nodes.)
kidney cancer T3a

T3a

Numerical values, from X to 3, are assigned to the T, N, and M categories. Once the T, N, and M categories have been assigned, this information is put together in what is called stage grouping. Stage grouping is used to determine your overall disease stage. It is expressed in Roman numerals from I (the earliest stage) to IV (the most advanced stage). Here are the 4 stages of kidney cancer.

Stage I. The cancer is found only in the kidney, and it is 7 centimeters or less in diameter.

Stage II. The cancer is found only in the kidney, and the tumor is greater than 7 centimeters in diameter.

Stage III. In this stage, one of the following is true.

  • Cancer is in the kidney and in one nearby lymph node. (Lymph nodes are small bean-shaped structures that are found throughout the body. They produce and store infection-fighting cells.)
  • Cancer is in an adrenal gland or in the layer of fatty tissue around the kidney. (The adrenal gland, which is attached to the top of the kidney, produces certain hormones.) It may also be in one nearby lymph node.
  • Cancer is in the main blood vessels of the kidney or the large vein that the kidneys drain into, known as the vena cava. It may also be in one nearby lymph node.

Stage IV. In this stage, one of the following is true.

  • The cancer has spread outside the connective tissue covering of the kidney, known as Gerota’s Fascia.
  • The cancer has spread to 2 or more nearby lymph nodes.
  • The cancer has spread to other organs, such as the bowel, pancreas, or lungs. It may also be found in nearby lymph nodes.

A simplified stage chart

Renal cell carcinoma treatment choices by stage

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2 Comments »

  • Polprav said:

    Hello from Russia!
    Can I quote a post in your blog with the link to you?

    [Reply]

    kenny1983uk Reply:

    Yes,you can.

    [Reply]

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