Metastatic renal cell carcinoma is a type of kidney cancer that has spread to the lungs, spine, lymphatic system, or other parts of the body. The rate at which it spreads can vary, but treatment can often help manage it.

Renal cell carcinoma accounts for 90% of all kidney cancers. It occurs when cancer cells form in the tubules of the kidney. Tubules are tiny tubes in your kidney that help filter waste products from your blood in order to make urine.

One in three people with renal cell carcinoma receive a diagnosis at the metastatic stage.

People who receive a diagnosis of metastatic — or stage 4 — renal cell carcinoma have a 12% chance of living at least another 5 years, compared with those who don’t have this condition.

Around 4% of cases of renal cell cancer run in families, which suggests a genetic link. The other 96% are sporadic, or not accounted for by genetics.

Here, find out what to expect with metastatic renal cell carcinoma and the treatment options available.

Renal cell carcinoma can spread from a mass of cancer cells or tumor to other parts of your body. This process is called metastasis.

It occurs in one of three ways:

  • Cancer cells spread into the tissue around the tumor in your kidney.
  • The cancer moves from your kidney into your lymph system, which has vessels throughout the body.
  • Kidney cancer cells enter the bloodstream and move to another organ or location in your body.

At stage 4, which is metastatic kidney cancer, one or all of the following may occur:

  • Cancer spreads beyond the layer of fatty tissue around the kidney, possibly:
    • into the adrenal gland above the kidney
    • to nearby lymph nodes
  • Cancer spreads to more distant parts of the body, such as the:
    • bones
    • liver
    • lungs
    • brain
    • adrenal glands
    • distant lymph nodes
  • Cancer comes back after treatment, either in the kidney or another part of the body.

When renal cell carcinoma is in its early stages, there may be no obvious symptoms. Noticeable symptoms may not occur until metastasis happens.

However, over half of all cases are discovered by chance, for instance, during a scan for another condition.

When they occur, symptoms may include:

  • blood in the urine
  • pain on one side of the lower back
  • lump or fullness in the back or side
  • weight loss
  • fatigue
  • fever
  • night sweats
  • a general feeling of being unwell
  • high blood pressure

The symptoms of metastatic renal cell carcinoma will depend on where the cancer has spread, but some common symptoms are:

  • weight loss
  • pain
  • breathing problems or shortness or breath
  • weakness
  • fatigue

A doctor may do tests if a person has symptoms that could indicate kidney cancer. Tests can also be useful as part of a follow-up during or after kidney cancer treatment.

Lab tests

The following tests may help show if a person has renal cell carcinoma or metastatic kidney cancer:

  • Urinalysis can give clues about kidney health and may, in some cases, help show if cancer has spread.
  • A complete blood count assesses levels of red and white blood cell levels. Unusual results may be a sign of cancer.
  • A biopsy involves using a needle to take a tissue sample from a possible tumor.


Imaging tests can help diagnose and stage renal cell carcinoma.

  • MRI and CT scans can show the location and size of a tumor.
  • Chest X-rays and bone scans may show if the cancer has spread to other parts of your body.
  • Imaging tests can provide clues about how well treatment is working.

Treatment options for metastatic renal cell carcinoma may include surgery, immunotherapy, or chemotherapy.

Treatment options for stage 4 or metastatic kidney cancer include:

  • immunotherapy which uses drugs that boost the immune system to fight cancer
  • chemotherapy, which uses strong drugs to kill cancer cells throughout the body but can also damage other cells
  • targeted therapy, which aims to destroy cancer cells specifically
  • surgery to remove an affected kidney, known as nephrectomy
  • regular screening as follow-up, to monitor the progress of symptoms
  • treatment for cancer in other areas, such as radiation therapy to the brain, if necessary
  • palliative care in the later stages, such as pain relief to help a person feel more comfortable

A doctor may recommend one or more options, depending on individual factors.

The precise treatment plan will take into consideration the subtype of renal cell cancer, where cancer has spread, and other factors.

The chance of living another 5 years or longer with renal cell carcinoma varies depending on the stage and other factors.

Research suggests the following rates, based on past statistics:

Stage5-year relative survival rate
Stage 1: Localized (in the kidney, where it started)93%
Stage 2–3: Regional (local lymph nodes affected)72.5%
Stage 4: Metastatic (spread to distant organs)12%

A study published in 2019 looked at data for 5,670 people in eight countries who underwent surgery known as resection for kidney cancer. Of these, 86.1% survived another 5 years and 69.3% survived at least 10 years more.

Factors affecting an individual’s chance of surviving longer include:

  • their age at diagnosis
  • the extent of cancer
  • how aggressive a tumor is
  • structural features that may cause it to grow more quickly
  • whether the tumor has invaded or moved beyond the fat around the kidney
  • individual genetic features

Survival rates are statistics relating to people who have previously had kidney cancer. They can offer a rough guide, but they can’t predict individual outcomes.

What is metastatic renal cell carcinoma?

Renal cell carcinoma is a type of kidney cancer. Metastatic renal cell carcinoma is stage 4 kidney cancer. It has spread to other organs in the body.

What is the survival rate for metastatic renal cell carcinoma?

Statistics suggest that a person with metastatic renal cell carcinoma has a 12% chance of living at least another 5 years after a diagnosis, but this will depend on many factors. As screening and treatment options progress, the chance of living longer than 5 years with kidney cancer is increasing all the time.

Is metastatic renal cell carcinoma curable?

Metastatic renal cell cancer is not usually curable, but treatment can prolong a person’s life. Compared with the 1990s, when most people did not survive beyond one year with this condition, more recent studies suggest the average survival time is 4 years or more, and there is a 12% chance of living another 5 years or longer.

Where does renal cell carcinoma usually metastasize to?

Renal cell carcinoma may spread first to nearby lymph nodes or through the fatty tissue around the kidney to the adrenal gland just above it.

It may also spread to the:

  • bones
  • liver
  • lungs
  • brain

Renal cell carcinoma is the most common type of kidney cancer. Around one third of people receive a diagnosis at the stage of metastasis, also known as stage 4, when cancer has spread to more distant parts of the body.

The symptoms will depend on the area the cancer spreads to, but pain, fatigue, and blood in the urine are common symptoms.

Various treatment options are available that can prolong a person’s life and help them feel more comfortable. As screening and treatment options progress, so does the chance of living longer with metastatic kidney disease.