Metastatic renal cell carcinoma, or stage IV renal cell carcinoma, is diagnosed when the cancer has spread outside the kidney to lymph nodes or distant organs, according to the National Cancer Institute. Although this stage of cancer cannot be cured, there are various treatments to manage the cancer and relieve any symptoms it is causing, which can improve quality of life.
Surgery
If the main tumor is removable and the cancer has only metastasized to one place, like the lungs, surgery may be done to resect the main tumor and part or all of the metastases, according to the American Cancer Society. This can only be done if the patient is in otherwise good health, as it would be too risky if not. Sometimes treatment with targeted therapies to shrink the tumor or the metastases is done prior to surgery to make the removal easier. If there are extensive metastases, but the main tumor is contained and able to be removed, removing the kidney may be done, followed by targeted therapy or cytokine therapy, notes the American Cancer Society.
Targeted Therapies
According to the National Cancer Institute, targeted therapies are another treatment option for Stage IV renal cell carcinoma. These are medications that seek and destroy cancer cells while minimizing harm to normal, healthy cells. The American Cancer Society lists several drugs in this category for renal cell cancer, including sorafenib (brand name Nexavar), sunitinib (brand name Sutent) and temsirolimus (Torisel). These drugs help slow down and stop cancer growth by blocking cellular enzymes necessary for cell growth, or by stopping new blood vessels from forming, which starves cancer cells.
Radiation Therapy
The use of high-energy rays, similar to X-rays, aimed at a cancerous area may be used to kill cancer cells or slow the growth of disease. For metastatic renal cell carcinoma, this treatment is typically used as a palliative measure to relieve pain or any other symptoms that the cancer may be causing.
Biologic Therapy
Biologic therapy is described by the National Cancer Institute as medication that uses the immune system of the patient to help fight cancer; another term for this treatment is immunotherapy or biotherapy. This may or may not be combined with other treatment modalities, especially targeted therapy or surgery. Cytokines are proteins that help activate the immune system, according to the American Cancer Society, and are the main kinds of biologic therapy drugs used in treating renal cell carcinoma. The two most commonly used drugs include interleukin-2 (IL-2) and interferon-alpha. These drugs can have serious side effects, so they are sparingly used in metastatic renal cell carcinoma, and only in patients who are in good overall health otherwise.
