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A patient whose kidney cancer is confined to the kidney and has not spread into the lymph nodes or to other organs of the body, statistically stands the best chance of long-term survival. Some patients in this category will have their kidney and primary tumour removed by surgery and will never have any recurrence of the disease. In that sense they may be deemed ‘cured’. However, as with all cancers, there can never be complete certainty that cancer cells, carried through the lymphatic system and the blood, will not form into secondary tumours (metastases). Regular check-ups are essential for all kidney cancer patients, including those, who after surgery, are apparently free of disease.
According to medical statistics, patients in whom the disease has spread beyond the kidney are less likely to do well. If the disease has spread to one or more organs it is vitally important to have access to treatment that can stabilise or even eliminate secondary tumours. Some patients with secondary tumours respond well to further treatment (which is usually in the form of targeted therapy); others do not respond or respond only temporarily. We do not fully understand the reasons for this variation. One explanation is that kidney cancer cells vary in their level of aggressiveness from patient to patient. This relates mainly to the degree of abnormality of the cells, i.e. how different they are from normal cells. The higher the ‘grade’ of the kidney cancer cells, the more aggressive they are and the more likely they are to spread quickly. Some patients with secondary tumours live with their disease for a long time. A small proportion are ‘cured’ by treatment in the sense that their secondary tumours disappear completely. However even in these cases a recurrence can never be ruled out.