The cancer spreads locally into the flank and then metastasises further afield, especially to the bones, lungs and also the brain and liver. 25% of patients present with metastatic disease. Symptoms of these metastatic sites of spread depend on the exact localisation of the spread – e.g. bone pain in the spine, pressure symptoms from brain metastases, coughing up blood from lung metastatic spread etc.
The staging therefore includes chest x-ray or CT scanning of the lungs as well as scanning of the abdomen. A whole body bone scan is also a part of the routine work-up.After CT scanning of the body and bone scan, the clnican should know whether the cancer has spread from the kidney.
