Stages of Renal Cell Carcinoma (RCC)

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How RCC starts and spreads

Cancer cells are abnormal versions of healthy cells. They grow in many ways like these normal cells but do so at abnormal rates with irregular shapes.

Here is how these cells grow and spread:

  • A single RCC cell grows and divides to form 2 cells. These 2 cells form 4. This process repeats, again and again
  • Unlike healthy cells, cancer cells do not respond to your body’s cues telling them to stop growing
  • A tumor can be detected once enough cancer cells are made
  • Some cancer cells may enter the bloodstream, spreading from the kidney to other parts of the body
  • New tumors may arise in other organs. If this happens, the cancer is known as metastatic. But no matter where the cancer spreads, it will still be called RCC, because it started in the kidney

RCC starts in the kidney. It can start as one or more tumors in a single kidney. Less often, tumors form in both kidneys at the same time.

How doctors measure RCC

There are 4 stages of RCC. To determine the cancer’s stage, doctors will measure the tumor size. If you don’t know the size or stage of your
tumor, ask your doctor. The images below are examples of different tumor sizes.

STAGE
DEFINITION
Stage I
Tumor is found only in the kidney and is 7 centimeters or smaller.
Stage II
Tumor is found only in the kidney and is larger than 7 centimeters.
Stage III
Cancer may be found in the kidney, one nearby lymph node, an adrenal gland, the tissue around the kidney, or the main blood vessels of the kidneys.
Stage IV
Cancer has spread beyond the kidney and may be found in multiple nearby lymph nodes or other organs, such as the intestines, pancreas, or lungs.
Recurrent RCC
Recurrent RCC is cancer that has returned after it has been treated—coming back in the kidney and/or in other parts of the body after the first treatment.

Looking for more
information and support?

There are many places you can go for help, both online and off.
Visit the Cancer Resources section to find a list of organizations
and resources devoted to helping people just like you.

 

On the next page, learn about the various treatments available to people with RCC. Ask your doctor why he or she chose SUTENT for your treatment.

SUTENT is used to treat advanced kidney cancer (advanced renal cell carcinoma or RCC).

*SUTENT is used to treat GIST (gastrointestinal stromal tumor). This is a rare cancer of the stomach, bowel, or esophagus. SUTENT is used when the medicine Gleevec® (imatinib mesylate) did not stop the cancer from growing or when you cannot take Gleevec.

SUTENT is used to treat a type of pancreatic cancer known as pancreatic neuroendocrine tumors (pancreatic NET), that has progressed and cannot be treated with surgery.

IMPORTANT SAFETY INFORMATION

SUTENT can cause serious liver problems, including death.

Tell your healthcare provider right away if you develop any of the following signs and symptoms of liver problems during treatment with SUTENT:

  • Itching
  • Yellow eyes or skin
  • Dark urine
  • Pain or discomfort in the right upper stomach area

Your healthcare provider should do blood tests to check your liver function before you start taking SUTENT and during treatment.

Pregnancy and breastfeeding:

  • SUTENT may harm an unborn baby. You should not become pregnant while taking SUTENT. Tell your healthcare provider right away if you become pregnant while taking SUTENT
  • Do not breastfeed while taking SUTENT

Tell your healthcare provider about all the medicines you take, including prescription medicines and nonprescription medicines, vitamins, and herbal supplements. Using SUTENT with certain other medicines can cause serious side effects. You may have an increased risk of severe jaw bone problems (osteonecrosis) if you take SUTENT and a bisphosphonate medicine (Actonel, Aredia, Boniva, Didronel, Fosamax, Reclast, Skelid, or Zometa). Talk with your healthcare provider before starting any new medicines.

Tell all of your healthcare providers and dentists that you are taking SUTENT. They should talk to the healthcare provider who prescribed SUTENT for you, before you have any surgery, or medical or dental procedure.

SUTENT may cause serious side effects, including:

  • Serious liver problems, including death
  • Heart problems—Heart problems may include heart failure and heart muscle problems (cardiomyopathy) that can lead to death. Tell your healthcare provider if you feel very tired, are short of breath, or have swollen feet and ankles
  • Abnormal heart rhythm changes—Your healthcare provider may do electrocardiograms and blood tests to watch for these problems during your treatment with SUTENT. Tell your healthcare provider if you feel dizzy, faint, or have abnormal heartbeats
  • High blood pressure—Your healthcare provider may check your blood pressure during treatment with SUTENT. Your healthcare provider may prescribe medicine for you to treat high blood pressure, if needed
  • Bleeding sometimes leading to death—Tell your healthcare provider right away if you have any of these symptoms or a serious bleeding problem:
    • Painful, swollen stomach (abdomen)
    • Bloody urine
    • Vomiting blood
    • Headache or change in your mental status
    • Black, sticky stools
    Your healthcare provider can tell you other symptoms to watch for.
  • Jaw-bone problems (osteonecrosis)—Severe jaw bone problems may happen. Your healthcare provider should examine your mouth before you start SUTENT. Your healthcare provider may tell you to see your dentist before you start SUTENT
  • Tumor lysis syndrome (TLS)—TLS is caused by the fast breakdown of cancer cells and may lead to death. TLS may cause you to have nausea, shortness of breath, irregular heartbeat, clouding of urine and tiredness associated with abnormal laboratory test results (high potassium, uric acid and phosphorus levels and low calcium levels in the blood) that can lead to changes in kidney function and acute kidney failure. Your healthcare provider may do blood tests to check you for TLS
  • Hormone problems, including thyroid and adrenal gland problems—Your healthcare provider may do tests to check your thyroid and adrenal gland function during SUTENT treatment. Tell your doctor if you have any of the following signs and symptoms:
    • Tiredness that worsens and does not go away
    • Heat intolerance
    • Loss of appetite
    • Feeling nervous or agitated, tremors
    • Nausea or vomiting
    • Sweating
    • Diarrhea
    • Irregular menstrual periods or no menstrual periods
    • Fast heart rate
    • Headache
    • Weight gain or weight loss
    • Hair loss
    • Feeling depressed

 

Common side effects of SUTENT include:

  • The medicine in SUTENT is yellow, and it may make your skin look yellow. Your skin and hair may get lighter in color
  • Tiredness
  • Weakness
  • Fever
  • Gastrointestinal symptoms, including diarrhea, nausea, vomiting, mouth sores, upset stomach, abdominal pain, and constipation. Talk with your healthcare provider about ways to handle these problems
  • Rash or other skin changes, including drier, thicker, or cracking skin
  • Blisters or a rash on the palms of your hands and soles of your feet
  • Taste changes
  • Loss of appetite
  • Pain or swelling in your arms or legs
  • Cough
  • Shortness of breath
  • Bleeding, such as nosebleeds or bleeding from cuts

Call your healthcare provider if you have any swelling or bleeding during treatment with SUTENT.

Gleevec is a registered trademark of Novartis AG.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or
call 1-800-FDA-1088.

Please see patient Medication Guide and full Prescribing Information, including Boxed Warning regarding serious liver problems.

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Adrenal gland
One of a pair of small glands; one sits on top of each kidney. The adrenal glands produce hormones that help control heart rate, blood pressure, the way the body uses food, and other vital functions.
Angiogenesis (an-jee-o-JEN-ih-sis)
The growth of new blood vessels from existing ones. Tumors use this process to receive nutrients from the bloodstream and to metastasize.
Cardiomyopathy (kahr-dee-oh-my-OP-uh-thee)
A disease that weakens and enlarges your heart muscle and makes it harder for your heart to pump blood and deliver it to the rest of your body.
Chemotherapy
Cancer cells grow and multiply like normal cells, but often much more quickly. Chemotherapy uses drugs to stop these cells from multiplying. However, chemotherapy can also harm healthy cells.
Digestive system
A collection of organs that break down food into simpler components, which your body uses to make energy and repair cells.
Functional pancreatic NET
A type of tumor in the pancreas that overproduces hormones.
Gastrointestinal (GASS-tro-in-TESS-tin-nul)
Relating to your stomach and intestines.
Gastrointestinal stromal tumor (GIST)
(GASS-tro-in-TESS-tin-nul STRO-mul TOO-mor)
GIST is a cancer that occurs in the digestive system. It can grow at all levels of the gastrointestinal tract (though most often in the stomach and small intestine).
Hand-foot syndrome (hand-foot-SIN-drome)
Dryness, thickening, or cracking of the skin on the palms of the hands and soles of the feet. It can sometimes include blisters or a rash.
Hypertension (hy-per-TEN-shun)
A disease of the arteries involving constant high blood pressure.
Intravenous therapy (IV)
Treatment given directly into a vein.
IFNα (Interferon alfa)
A medicine prescribed to prevent tumor cells or viruses from growing. A clinical study has proven that SUTENT is more effective than interferon alfa (IFNα) in the treatment of RCC.
Kidney
One of a pair of organs that removes waste products from the blood. In the process, they make urine to help carry waste out of the body. One is on the left side of the abdomen. The other is on the right side.
Lymph node
Located throughout the body, lymph nodes filter lymph fluid. They store special cells that can trap cancer cells or bacteria that are traveling through the body in the lymph.
Metastasis (muh-TAHS-tuh-sis)
The spread of cancer from one part of the body to another through the lymphatic system or bloodstream.
Nonfunctional pancreatic NET
A type of tumor in the pancreas that does not overproduce hormones.
Pancreas
A 6-inch long organ that stretches across the back of the abdomen. It makes pancreatic juices, which help digest food in the small intestine. The pancreas also makes insulin, which controls the amount of sugar in the blood.
Pancreatic neuroendocrine tumor (Pancreatic NET)
An uncommon tumor that starts in the hormone-producing cells of the pancreas.
Progression-free survival
The length of time during and after treatment in which a patient is living with a disease that does not get worse. Progression-free survival may be used in a clinical study or trial to help find out how well a new treatment works.
Proliferation (pro-liff-er-AY-shun)
When cells divide and multiply quickly. Tumors form when cancer cells proliferate.
Renal cell carcinoma (RCC) (REE-null SELL kar-sin-O-muh)
The most common form of cancer that starts in the kidneys.
Stroma
The tissue that supports an organ.
Tumor (TOO-mor)
A mass of cancer cells.
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The SUTENT Co-payment Card is not health insurance. For a complete list of participating pharmacies, please call the First Resource program at 1-877-744-5675. There are no membership fees to participate. Estimated savings vary and depend on the amount of SUTENT purchased and the pharmacy where purchased.

Average patient savings is $5000.

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