Understanding Your Stage 3 Clear Cell Renal Cell Carcinoma Diagnosis

Being diagnosed with stage 3 clear cell renal cell carcinoma (ccRCC) can feel overwhelming, but it is important to know that this stage is considered locally advanced, meaning it is often still treatable with a curative intent.

This overview is designed to help you understand your diagnosis and prepare for meaningful discussions with your oncology team.

Overview: What is stage 3 ccRCC?

Clear cell renal cell carcinoma is the most common form of kidney cancer, accounting for about 80% of cases. In Stage 3, the cancer has grown beyond the kidney but has not yet spread to distant organs like the lungs or bones.

• T3 Stage: The tumor may have grown into major veins (like the renal vein or vena cava) or into the fatty tissue surrounding the kidney.
• N1 Stage (if applicable): The cancer may have reached nearby lymph nodes.
• Prognosis: While Stage 3 carries a higher risk of recurrence than earlier stages, many patients achieve long-term remission following surgery.

Diagnosis: How it is confirmed

Your medical team uses a "multimodal" approach to staging, which involves looking at the tumor’s size, location, and aggressiveness.

• Imaging: Contrast-enhanced CT scans or MRIs of the abdomen and pelvis are the gold standard for seeing if the cancer has invaded nearby blood vessels.
• Pathology & Grading: After the tumor is removed or biopsied, a pathologist assigns a Fuhrman or ISUP Grade (1–4). This tells your doctor how "angry" the cells look under a microscope; higher grades may indicate a faster-growing tumor.
• Blood Work: Tests like Creatinine (to check kidney function) and Calcium levels help assess your overall health and the cancer's impact on your body.

Treatment options

Treatment for Stage 3 ccRCC typically involves a combination of "local" therapy (to remove the primary tumor) and sometimes "systemic" therapy (to prevent the cancer from returning).

Treatment for kidney cancer may involve several approaches depending on disease stage and individual risk. One option is radical nephrectomy, which involves surgical removal of the entire kidney along with surrounding fat and, in some cases, nearby lymph nodes, with the goal of removing all visible cancer. Following surgery, some patients may receive adjuvant therapy, typically immunotherapy such as pembrolizumab given for approximately one year, to eliminate any remaining microscopic cancer cells and reduce the risk of recurrence.

Clinical trials may also be an option, offering access to newer drugs or novel treatment combinations that are not yet widely available, with the aim of providing more advanced or targeted therapeutic options.

“The collective work demonstrated in [ongoing research], shows that clinical trials are being developed to improve upon already effective treatments. This means that these trials are increasingly likely to both advance our knowledge and directly benefit patients,” Dr. Eric Jonasch, emphasized in an interview with CURE. “The value of this approach is increasing by expanding access to more patients, which allows us to gather a more representative study population.”

He is a professor in the Department of Genitourinary Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, in Houston. He also serves as director of the von Hippel Lindau Center at MD Anderson Cancer Center and is vice chair of the National Comprehensive Cancer Network Kidney Cancer Guidelines.

Side Effects: What to Expect

Since Stage 3 treatment often involves both surgery and immunotherapy, you may experience different types of side effects.

• Post-Surgical: Fatigue, pain at the incision site, and changes in kidney function (monitored via blood tests).
• Immunotherapy (Immune-Related Adverse Events): Because immunotherapy "wakes up" your immune system, it can sometimes cause the body to attack healthy tissues.
• Common: Skin rash, itching, and fatigue.
• Serious: Inflammation of the lungs (cough/shortness of breath), colon (diarrhea), or hormone glands (thyroid issues).

Pro Tip: Always report new symptoms to your oncologist immediately. Early management of immunotherapy side effects often involves steroids and can prevent long-term complications.

Conclusion & Next Steps

Your journey with Stage 3 ccRCC is a marathon, not a sprint. Success depends on a partnership between you and your care team. Your next step should be a focused "Planning Session" with your oncologist.

Questions to ask your oncologist:

1. What was the specific grade of my tumor in the pathology report?
2. Am I a candidate for adjuvant immunotherapy to reduce my risk of recurrence?
3. How will we monitor my remaining kidney's health moving forward?
4. What is the schedule for follow-up scans over the next five years?

Editor's note: This article is for informational purposes only and is not a substitute for professional medical advice, as your own experience will be unique. Use this article to guide discussions with your oncologist. Content was generated with AI, reviewed by a human editor, but not independently verified by a medical professional.

Reference

1. “Expanding Clinical Trial Access for Patients With Kidney Cancer,” by. Dr. Eric Jonasch. CURE; Aug. 15, 2026. https://www.curetoday.com/view/expanding-clinical-trial-access-for-patients-with-kidney-cancer 

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