If you or a loved one has been diagnosed with kidney cancer, such as renal cell carcinoma (RCC), one of the first questions is often “What happens next?” Your cancer care team can look at several key details to help predict how the cancer might grow or change. This is called your prognosis — a general idea of what to expect going forward. Factors they consider include your:

• Cancer stage and grade
• Subtype of RCC
• Symptoms
• Age and overall health
• History of any relapse after surgery

No two people with RCC are exactly alike. This article will explain how different factors can affect your prognosis with RCC.

What Is a Survival Rate?

Survival rate is a measurement that refers to the percentage of people with RCC who are still alive after a certain period. The most common way doctors measure survival rate is with the five-year relative survival. This statistic compares how many people are alive five years after their cancer diagnosis to people in the general population, which helps show how cancer affects a person’s survival.

In the U.S., the National Cancer Institute (NCI) tracks cancer statistics through the Surveillance, Epidemiology, and End Results (SEER) database. This database looks at survival statistics from the past several years to estimate survival rates based on a person’s stage of kidney cancer.

Keep in mind that survival rates don’t tell the whole story of your prognosis. The data used to predict kidney cancer survival rates is based on studies that are several years old. Even the most recent data is based on people who were treated at least five years ago.

Survival Rate by Renal Carcinoma Stage

RCC survival rates depend on the stage, or how far the cancer has spread. Kidney cancer stages are divided into the following SEER stages, based on how far the cancer has spread:

• Localized — Cancer that’s only found in the kidney
• Regional — Cancer that has spread outside the kidney to nearby lymph nodes or other surrounding tissues
• Distant — Cancer that has metastasized (spread to distant parts of the body, such as the lungs, liver, or bones)

The five-year survival rate for all SEER stages of kidney cancer combined is 78 percent. This means that, according to the data, 78 percent of people with kidney cancer are still alive after five years.

Broken down by stage, the five-year relative survival rates are:

• Localized — 93 percent
• Regional — 75 percent
• Distant or metastatic— 18 percent

This means that 93 percent of people with localized kidney cancer, 75 percent of people with regional kidney cancer, and 18 percent of people with distant kidney cancer were found to be alive after five years.

What Factors Affect Renal Cell Carcinoma Prognosis?

The stage of your RCC is an important factor for figuring out your prognosis, but it’s not the only thing that matters. Your healthcare provider will take into account other details about yourself and your health.

Age

RCC is more common in older adults. However, younger people with RCC typically have better outcomes compared to older adults. Younger adults are more likely to have symptoms of a kidney tumor before diagnosis. Although younger people may have more symptoms, they are also less likely to have aggressive types of kidney cancer, which can lead to a better prognosis.

Your overall health can also affect your outlook regarding kidney cancer. Older adults are more likely to have other health conditions that can complicate cancer treatment. Health conditions in older adults that may predict a poor outlook include:

• Dementia
• Heart disease
• Kidney disease

In some cases, other health conditions in older adults may affect their life expectancy more than RCC.

Type of Renal Cell Carcinoma

Researchers don’t fully understand how the type of RCC affects your outlook. Some large studies have found no significant difference in the outlooks for people with different types of RCC, including clear cell RCC, papillary RCC, and chromophobe RCC.

However, other studies show that some types of RCC may be associated with worse outcomes, including:

• Clear cell RCC
• Collecting duct RCC
• Medullary carcinoma
• Renal sarcoma

Grade of Renal Cell Carcinoma

Cancer grade helps describe how quickly the cancer may grow and how likely it is to metastasize. RCC is graded from grades 1 to 4 — grade 1 is the lowest, and grade 4 is the highest. In low-grade RCC, cancer cells look more like normal kidney cells, usually grow more slowly, and are less likely to spread. People with low-grade cancers often have a better prognosis.

High-grade cancer cells in RCC look less like normal kidney cells. High-grade cancers are more likely to grow quickly and spread to distant parts of the body. Understanding the grade of your RCC gives your cancer care team valuable information about your prognosis.

Signs and Symptoms of Renal Cell Carcinoma

Having symptoms of RCC, such as blood in the urine, pain on the sides or lower back, or a lump on your sides or stomach, is often associated with a worse outlook as compared to people who don’t have any symptoms before their diagnosis.

Other signs and symptoms of RCC associated with a poor outlook include:

• Fever
• Weight loss
• Anemia (low red blood cell count)
• Hypercalcemia (high calcium levels in the blood)
• Thrombocytosis (high platelets in the blood)

Renal Cell Carcinoma Treatment

Surgical removal of part (partial nephrectomy) or all (radical nephrectomy) of the kidney with cancer is the main treatment for most people with RCC. In early-stage RCC, this is often the only treatment needed. However, if the cancer comes back after treatment, systemic (whole-body) treatment may be needed, such as immunotherapy or targeted therapy.

If you need systemic therapy less than a year after being diagnosed and surgically treated for RCC, you may have a worse prognosis.

Clinical trials for new RCC treatments measure the effect of the treatment on survival. Effective treatments can help improve the length of time people live after diagnosis and how long the cancer stays the same without getting worse.

Smoking

In addition to being a risk factor for developing kidney cancer, people who smoke cigarettes or have smoked in the past may have a worse outlook. In a 2023 study, people who smoked cigarettes had a 30 percent higher risk of dying compared to those who never smoked. If you smoke, quitting smoking may improve your prognosis.

Risk Groups for Advanced Kidney Cancer

If you have stage 4 RCC, your cancer care team can assign you a risk group that can help predict how the cancer may behave and which treatment options may work best.

There are two systems commonly used to describe risk groups for stage 4 RCC — the Memorial Sloan Kettering Cancer Center (MSKCC) model and the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) criteria. Both systems consider several factors:

• Hypercalcemia (high blood calcium levels)
• Anemia
• Needing systemic treatment less than one year from your diagnosis and surgery
• How well you can perform daily activities

Along with these factors, the MSKCC system also looks at whether you have high lactate dehydrogenase (LDH) levels in your blood. LDH is a substance that helps cells make energy, and high levels can be a sign of cancer. The IMDC system also looks at a person’s neutrophil and platelet counts.

Each system assigns a risk group based on the number of factors you have:

• Low-risk — No factors
• Intermediate-risk — One or two factors
• High-risk — Three or more factors

Talk to Your Cancer Care Team About Your Prognosis

Your prognosis with kidney cancer is influenced by many different factors. Survival rates can help you understand your likely outcome, but these statistics may not reflect your situation.

Your cancer care team can give you the most accurate outlook. They can help you understand how different treatment options may affect your life expectancy and quality of life with kidney cancer. Don’t hesitate to ask questions or ask for things to be explained in simple terms. Open communication with your care team can help you feel more informed, supported, and confident as you move forward with care.

Find Your Team

On MyKidneyCancerTeam, the social network for people living with kidney cancer and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with kidney cancer.

Have you discussed your prognosis with your cancer care team? Share your experience in the comments below, or start a conversation by posting on your Activities page.