Kidney Cancer – Types & Stages

Radiation Oncology in Orange County, CA

No matter who you are or what you’re up against, a cancer diagnosis can be one of life’s most difficult challenges – but it’s never one you have to face alone. Orange County CyberKnife is a premier radiation oncology center serving the Orange County, CA area, and we’re proud to stand with our patients in the fight against cancer. Offering a variety of world-class cancer treatments like the revolutionary CyberKnife system, we are committed to helping our patients overcome virtually any form of cancerous condition – including kidney cancer.

Types & Stages of Kidney Cancer

Kidney Cancer Treatment - Cyberknife OCKidney cancer, or renal cell carcinoma, is staged using the TNM system, as most cancers are. This system uses three variables to determine the size of the tumor and the extent to which it has spread: T, standing for Tumor, describes the size of the primary tumor itself; N, standing for Node, delineates whether or not the cancer has spread to nearby lymph nodes; and M, standing for Metastasis, tells if the cancer has spread to distant regions of the body. If there’s more than one tumor present, the lowercase letter “m” is added to the T variable, standing for “multiple.”

Using the TNM system, the “T” plus a letter or number (0 to 4) is used to describe the size and location of the tumor. Some stages are also divided into smaller groups that help describe the tumor in even more detail. This helps the doctor develop the best treatment plan for each patient. If there is more than one tumor, the lowercase letter “m” (multiple) is added to the “T” stage category. Specific tumor stage information for kidney cancer is listed below.

Each variable comes with its own levels of grade and stage, which run as follows:


  • TX: We cannot evaluate the primary tumor.
  • T1: The tumor is less than 7cm in diameter and has not yet spread beyond the kidney. All subgroups of the T1 stage have not spread beyond the kidney, but different variables are used to size the tumor:
    • T1a: Tumors less than 4cm across.
    • T1b: Tumors between 4cm and 7cm across.
  • T2: These tumors are larger than 7cm across but have not yet spread beyond the kidney.
    • T2a: Between 7cm and 10cm across.
    • T2b: Larger than 10cm across.
  • T3: These tumors have grown into major veins within the kidney or infected the perinephric tissue, which is the fatty connective tissue surrounding the kidneys. That said, the tumor has not infected the adrenal gland near the kidney. These glands produce adrenaline, which helps control heart rate, blood pressure, and a number of other vital bodily functions. T3 tumors also have yet to spread beyond Gerota’s fascia, which is an envelope of tissue surrounding the kidney.
    • T3a: While the tumor has not grown beyond Gerota’s fascia, it has spread to either the largest vein leading out of the kidney (the renal vein), the muscular branches of the renal vein, or the fat inside or surrounding the kidney.
    • T3b: These tumors have spread to the large vein that drains into the heart, which is called the inferior vena cava, but only below the diaphragm.
    • T3c: These tumors have spread into the vena cava above the diaphragm, and often into the right atrium of the heart or the walls of the vena cava.
  • T4: In this case, the tumor has spread beyond Gerota’s fascia and extends into the adrenal gland near the kidney.


The “N” staging variable describes whether or not the cancer has spread to the lymph nodes, which are tiny, bean-shaped organs that function in the immune system. The tumor may spread to regional lymph nodes, which are near the kidney, or distant lymph nodes, which are in other parts of the body. N classifications are fairly simple:

  • NX: Cannot evaluate the regional lymph nodes.
  • N0: The tumor hasn’t spread to any lymph nodes.
  • N1: The tumor has spread to nearby (regional) lymph nodes.


Finally, the “M” variable describes metastasis, in which the tumor spreads to distant organs and lymph nodes in the body. Kidney cancer has a high risk of spreading to the bones, lungs, brain, liver, and distant lymph nodes.

  • M0: The tumor has not metastasized.
  • M1: The tumor has spread to distant parts of the body.

Stages of Kidney Cancer

Renal Cell Carcinoma (RCC)Your cancer doctor will assess the T, N, and M classifications of your cancer to determine its overall stage. Kidney cancer stages are as follows:

  • Stage I – T1, N0, M0: These tumors are less than 7cm across and have not spread to lymph nodes, distant tissues, or beyond the kidney.
  • Stage II – T2, N0, M0: While larger than 7cm, these tumors have not spread to lymph nodes or beyond the kidney.
  • Stage III: Stage III tumors are either one of two situations:
    • T1/T2, N1, M0: A tumor of any size that has yet to spread beyond the kidney, but has spread to regional lymph nodes.
    • T3, Any N, M0: A tumor that hasn’t spread to distant parts of the body and may or may not have infected regional lymph nodes, but has grown into the major veins or perinephric tissue.
  • Stage IV: Stage IV tumors may be either of the following situations:
    • T4, Any N, M0: The tumor has spread beyond Gerota’s fascia, into the adrenal gland, and possibly to regional lymph nodes, but not yet to distant parts of the body.
    • Any T, Any N, M1: The cancer has spread to any organ besides the kidney – including the lungs, bones, brain, liver, or any other structure.

Contact Your Orange County Radiation Oncology Center Today

Kidney cancer can prove to be a serious condition, but with early detection and prompt treatment, the outlook is often positive – and even in serious cases, OC CyberKnife can help. We use some of the most advanced, state-of-the-art cancer fighting technology in the world, and we are committed to doing everything we can to help our patients succeed and thrive. Call us today at 714.962.7100 to learn more about how we can help you beat cancer no matter what you’re up against, and feel free to schedule your consultation or second opinion by reaching out to us at our contact page. We can’t wait to hear from you.