Metastatic Renal Cell Carcinoma: What to Expect

Medically Reviewed by Melinda Ratini, DO, MS on January 20, 2022

When you find out you have metastatic renal cell carcinoma, it can be a lot to take in. It may help you to learn more about the condition so you know what to expect.

Renal cell carcinoma is the most common type of kidney cancer. It usually starts as a tumor in one of your kidneys. And like other cancers, it can spread to other parts of your body. That’s when doctors call it metastatic. You might also hear it called stage IV kidney cancer. 

Sometimes, doctors can cure it. More often though, treatment is about slowing the disease down and managing symptoms to help you feel as good as possible.

How Does Kidney Cancer Spread?

As the tumor grows, it spreads into fat or major blood vessels around the kidney. It may also creep into the adrenal gland, which sits right on top of the organ.

From there, it can spread farther through your:

  • Blood. Cancer cells that get into a blood vessel can travel to many body parts through your veins and arteries.
  • Lymph system. This is a network that runs throughout your body, much like your blood vessels. It helps you fight disease. But cancer cells that get into lymph nodes can hitch a ride to other organs.

Kidney cancer most often spreads to the lungs and bones, but it can also go to the brain, liver, ovaries, and testicles.

Because it has no symptoms early on, it can spread before you even know you have it. If you do find it early, but treatment doesn’t get rid of all the cancer cells, it can come back in your kidney or somewhere else.

How Will I Feel?

The symptoms of kidney cancer are different for each person. In most cases, you’ll see blood in your pee. You may feel generally sick, tired, and like you don’t want to eat much. And you may have:

  • A fever that comes and goes
  • A lump in your belly
  • Night sweats, so much that you need to change your clothes or sheets
  • Pain in your back or side that won’t go away
  • Weight loss for no reason

You might also get symptoms where the cancer spreads. If it’s in one of your bones, you might feel pain there. In your lungs, it can give you a cough or trouble breathing.

What Can I Do?

First, work with your doctor to figure out how to best treat it. Even if it can’t be cured, you may be able to slow it down and manage your symptoms with surgery, medicine, and other treatments. 

You can also do a lot on your own to feel better physically and emotionally:

Pace yourself. Cancer, and even some of its treatments, can wipe you out. Try to keep your days simple and save your energy for the important activities. And don’t be shy about resting when you need to.

Speak your symptoms. Your doctor can help with all kinds of common problems from cancer and its treatments, like constipation, upset stomach, and pain. But only if you say something about them. Check in with your doctor often to get the care you need.

Stay active. Exercise lifts your energy and helps you fight off anxiety, depression, and stress. Ask your doctor what’s safe for you to do.

Tend to your body. Along with regular exercise, try to stick to a healthy diet and get the rest you need. If you don’t feel like eating much, a dietitian might be able to help.

Find ways to relax. It’ll keep your mood and energy up. Take time to read a book, go for a walk, call a friend, get a massage, or try some meditation. Or all of the above. Go with what works best for you.

Keep in touch. Your family and friends can help you work through the mix of feelings that cancer can stir up. They can also run errands, keep you company, and boost your spirits. You might also try going to a therapist or joining a support group. Sometimes it’s easier to talk to people who aren’t quite as close to you.

Work with your doctor, and try to stay positive. There are more ways to treat the condition than ever before. Your doctor can help you think about which ones are best for you.

Show Sources


American Cancer Society: “Kidney Cancer,” “Managing Cancer as a Chronic Illness.”

NIH, National Cancer Institute: “Renal Cell Cancer Treatment (PDQ®) -- Patient Version.”

Mayo Clinic: “Kidney Cancer.”

UpToDate: “Patient education: Renal cell carcinoma (kidney cancer) (Beyond the Basics).”

U.S. National Library of Medicine: “Challenges in the long-term management of patients with metastatic renal cell carcinoma treated with targeted therapy: Optimizing surgery, systemic therapy and quality of life.”

Penn Medicine, OncoLink: “All About Kidney Cancer.”

Kidney Cancer Association: “About Kidney Cancer,” “Living with Kidney Cancer.”

Medscape: “Renal Cell Carcinoma.”

Annals of Oncology: “Targeting pulmonary metastases of renal cell carcinoma by inhalation of interleukin-2.”

Journal of Clinical Oncology: “Minor Symptoms Are Suggestive of Metastatic Renal Cell Carcinoma if C-Reactive Protein Remains High After Curative Nephrectomy.”

Cancer Research UK: “Kidney Cancer.”

Kidney Cancer UK: “Understanding Kidney Cancer.”

Macmillan Cancer Support: “Controlling Symptoms and Side Effects.”

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