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Diagram of the kidney cancer patient's journey. Common Patient Journey - Kidney Cancer Testing Diagnosis Treatment Surveillance Emotional Support Signs & Symptoms Imaging CT Scan MRI Bone Scan Biopsy Types and Grades Renal Cell Papillary Chromophobe Surveillance Imaging Ablation Surgery Lab Tests Physician Visit Immunotherapy Collecting Duct Renal Medullary Treatment by Stage Psychotherapy 1-on-1 Support Online Community Reduce Stress Stages Forward Back ? Narrative

Stages of kidney cancer. Kidney Cancer Staging The staging system most often used for kidney cancer is the American Joint Committee on Cancer (AJCC) TNM system. The TNM system is based on 3 key pieces of information: The size and extent of the main (primary) tumor (T): How large is the tumor? Has it has grown into nearby areas? The spread to nearby lymph nodes (N): Has the cancer spread to nearby lymph nodes? The spread (metastasis) to distant sites (M): Has the cancer spread to other organs such as the bones, brain, or lungs? The stages of kidney cancer range from I (1) through IV (4). The lower the number, the less the cancer has spread. A higher number, such as stage IV, means cancer has spread more. [1] T1 T2 T3 T4 Kidney Purpose The main functions of the kidneys are to clean the blood, balance fluids, remove waste through urine, keep chemicals and electrolytes in balance, make hormones for a stable blood pressure, make red blood cells, and keep our bones strong. [2] © Copyright © Copyright Kidney Cancer Stages Descriptions by American Urological Association and American Cancer Society The "T" in the TNM system is the size of the main (primary) tumor and whether it has grown into nearby areas. © Copyright T1 Tumor Stage I tumors include cancers of any size that are confined to the kidney. Characteristics of T1 tumors: • T1: Tumor 7.0 cm (about 2.8 inches) or less, confined to the kidney • T1a: Tumor 4.0 cm (about 1.6 inches) or less, confined to the kidney • T1b: Tumor 4.0 to 7.0 cm, confined to the kidney © Copyright T2 Tumor Stage II tumors include cancers of any size that are confined to the kidney. Characteristics of T2 tumors: • T2: Tumor greater than 7.0 cm, confined to kidney • T2a: Tumor greater than 7.0 cm and less than 10.0 cm, confined to the kidney • T2b: Tumor greater than 10 cm (about 3.9 inches), confined to the kidney © Copyright T3 Tumor Stage III tumors are either locally invasive (T3) or involve lymph nodes. Characteristics of T3 tumors: The tumor can be any size, but it has not grown outside the kidney. The cancer may have spread to nearby lymph nodes but has not spread to distant lymph nodes or other organs. Tumor grows into major veins (renal vein or the inferior vena cava) or into tissue around the kidney, but not into the adrenal gland and not beyond Gerota’s fascia © Copyright T4 Tumor Stage IV tumors have spread beyond the kidney into organs nearby (T4) or distant (beyond the kidney) metastases. Characteristics of T4 tumors: • The tumor can be any size and may have grown outside the kidney. The tumor may or may not have spread to nearby lymph nodes. The tumor has spread to distant lymph nodes and/or other organs. Tumor reaches beyond Gerota’s fascia (including the adrenal gland). This is not a localized tumor. Kidney Cancer Close Up © Copyright Credits - To the American Urological Association and the American Cancer Society for the descriptions on this page. All of the information is copyright protected. [1] Kidney Cancer Stages American Cancer Society [2] Kidney Cancer Patient Guide American Urological Association (pdf) Kidney Health Basics Urology Care Foundation, American Urological Association (pdf) [3] Kidney Illustrations by iStock See also: Stages of Renal Cell Cancer - Includes Illustrations from the National Cancer Institute

Back Sid Sadler Being diagnosed with kidney cancer at 32 years of age wasn't in my "plan," if we want to call it a plan. I'm 34 now, and approaching another round of scans to ensure the cancer removed from my body is gone. December of 2023, I had an episode of hematuria in my urine, and that led to a CT which revealed a 10.5 cm tumor on my left kidney. A slew of appointments made with Vanderbilt led to a plan of a radical nephrectomy removing my tumor and left kidney. February of 2024 the surgery took place. Surprisingly, I recovered well. I had my surgery on a Monday, and I was home that Wednesday afternoon. Eagerly awaiting my pathology results, while also browsing the internet for others in my situation. I didn't find many, but I found a few, and I leaned on those few very hard. With no other evidence of disease, I hoped for a diagnosis of stage two or three, knowing other factors such as grade and type played a big factor in my outlook. The results come back. Stage 2b, grade two Clear Cell Renal Carcinoma. After meeting with my team, a scan schedule was put into place. Hesitant and nervous at first, I learn the rhythm we all learn after cancer enters our lives. Soon thereafter, my wife and I find out she is expecting a baby, and our world goes from one end of the spectrum to another end of emotions. We welcome a beautiful healthy baby girl into the world just short of one year after my surgery. Life is crazy, isn't it? I started as a scared patient, and I still am. However, I'm also equipped with knowledge now, and most importantly perspective. I dove into advocacy, joining the patient family advisory councils at Vanderbilt Ingram Cancer Center, and The Kidney Cancer Association. I was recently invited to join the Board of Directors for The Judy Nicholson Kidney Cancer Foundation. If I could say one thing to you, it's that cancer isn't a period for a lot of us. It's a comma. Once a plan is set in place, things will get better. We have come a long way in treatment for both localized and stage four kidney cancer. I'm confident in my team and the other countless doctors researching this disease. Onward.

Kidney Cancer - Honors The Laurel Wreath represents victory over cancer and honors those who have been impacted by kidney cancer. Individuals listed on this page are recognized and lifted up as a member of the kidney cancer community. Mike Peterson An avid naturalist and outdoorsman, Mike quietly lived life. Soon after retiring, things he enjoyed most created fatigue. A stubborn man, his son finally convinced him to go to the Emergency Department to be evaluated. The doctors discovered a mass in his kidney, liver, and lungs. Stage 4 renal cell carcinoma. Mike passed away quietly on July 1, 2025. The same way he lived. God Bless his memory. Sid Sadler A husband and father, Sid Sadler was diagnosed with kidney cancer in December 2023. Sid was just 32 years of age at the time of the unexpected news that a 10.5 cm mass was growing in his kidney. Since a complete nephrectomy of his left kidney, Sid has been running full speed ahead. Sid set out to learn everything he could about renal cell carcinoma and how he can be a supportive voice for others walking a similar journey. Read More Read More 1 Page 1 Share Your Story Share your kidney cancer story with us. Submit your name, a brief story, and a photo. Name Email Kidney Cancer Story Upload Photo (Max 15MB) Submit

Back Mike Peterson My father, Mike, was an avid naturalist and outdoorsman who could pretty much run circles uphill around people who were half his age. It was hard to keep up with him! He had always been a muscular, yet petite man. He was a quiet, reserved man, who, despite that, loved to joke and show others a slower pace of life. During the last half of 2024, though, he began to notice he didn't have the same strength and energy he had always had. His appetite, which had always been vigorous, was gone now, too. He thought it was all a part of aging, since he had just retired. The fatigue persisted. He would still climb the steep hills around his house in order to chop firewood and manually haul huge logs down to his house via wheelbarrow, but, now it took extreme effort for him to do so. But still, that man was tough as a pine knot to do the things he did. I, along with other concerned loved ones, thought maybe him slowing down and being more reclusive was depression. By March of 2025, he was sleeping excessively, and he had night sweats. Still, he refused to go to the doctor and he still managed to go up into the woods. Back in his 20s and 30s, he had had reoccurring kidney stones that had resulted in multiple surgeries. It made him fear going back to doctors. "They're just looking for something to be wrong with me." When we went out for lunch for Mother's Day, it was clear to me how much weight he had lost. He didn't eat much at all, and he was irritable, which wasn't like him at all. It was obvious to me something was wrong, because he wasn't acting like his normal self. His voice sounded strained, as well. His wife begged him to go to the doctor, and I did too. This battle with trying to convince my dad went back and forth with him until he finally agreed at the end of May to go to the local Emergency Department to get tests. It started out that they found a tumor on his kidney and his oxygen was low. He was immediately told to go to another local hospital that could perform better imaging. He would be admitted to that hospital. Someone asked him how long he had felt sick, and he told them "too long". More findings. He had tumors in his kidneys, liver and lungs. His diagnosis was stage 4 renal cell carcinoma. Other than the loss of appetite and fatigue, he said he hadn't had kidney pain or any other symptoms. He said he'd fight it like a tiger, no matter what the outcome. He and I discussed the facts of his diagnosis, and he wanted me to know that his prognosis wasn't good. He had worked in a long-term health facility for 32 years and he had seen a lot during that time. He and I knew treatments could bring comfort, and we wanted quality of life. I wanted my daddy cured, but, I knew it wouldn't be. He was sent home with oxygen support. His first immunotherapy was set to start on July 1st. On June 30th, he ended up in the Emergency Department again due to confusion, low oxygen, and blood clots that were discovered in his leg and lungs. He told me that morning he was ready to go home. His last words to me were "I love you." He passed away quietly the next morning, on July 1st, the same day he would have begun his immunotherapy. In his own way, on his own terms, he had received his ultimate healing from kidney cancer. I love and miss you, Daddy, every single day.

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Active surveillance of kidney cancer before or after a nephrectomy is critical. Surveillance Clear cell, renal cell carcinoma (ccRCC) patient's that have a partial or radical nephrectomy are usually followed up under a surveillance program based on their individual case. General guidelines, such as those outlined by Dr. Brad Leibovich, Mayo Clinic, serve as recommendations for physicians to follow patients who have had a nephrectomy, monitoring the patient for any recurrence of renal cancer. Dr. Leibovich and his team developed the Progression-Free Survival Score to classify patient's as low, medium, and high risk for recurrence. Active Surveillance Follow Up for Kidney Cancer Predicting Outcomes in RCC Prognostic Models Patient Classification* The Leibovich Model recommends imaging / follow up for all patient classifications at 3 months post-surgery to check for recurrence as well as establish a new baseline for the patient for comparison against future imaging / testing. The higher the risk a patient is for recurrence, the more frequent are the intervals for ongoing testing. Stage I and II (Low Risk) 3 months post op CT or MRI with contrast of abdomen Chest x-ray Basic Metabolic Panel (BMP) then, Annually for 5 years after surgery (same testing as above) then, > 5 years Renal ultrasound Chest x-ray at clinical discretion Stage III (Intermediate Risk) 3 months post op CT or MRI with contrast of abdomen/pelvis Chest x-ray or CT Basic Metabolic Panel (BMP) then, 6 month intervals for 3 years (same testing as above) then, >3 years - Annually (same testing as above) then, > 5 years - Patient Specific Based on individual patient's case / history Stage IV (High Risk) 3 months post op CT or MRI with contrast of abdomen/pelvis Chest x-ray or CT Basic Metabolic Panel (BMP) then, 4 month intervals for 2 years (same testing as above) then, >2 years at 6 month intervals (years 3 to 5 after surgery) (same testing as above) then, > 5 years - Annually (same testing as above) *Based on published Mayo Clinic risk score (Leibovich BC, Cancer 2003;97:1663-1671) National Comprehensive Cancer Network Kidney Cancer Guidelines The National Comprehensive Cancer Network (NCCN) is a not-for-profit alliance of 33 leading cancer centers devoted to patient care, research, and education. The NCCN develops resources that present valuable information to stakeholders in health care. Part of their mission is creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. One of the guidelines is the recommended treatment for patients with kidney cancer. The most recent Kidney Cancer Treatment Guidelines (March 2025) can be viewed on the NCCN website in pdf format. These guidelines are detailed and extensive. Well worth your time and attention if you want to understand the details of the management and treatment guidelines for kidney cancer at all stages. An important note is that the guidelines are just that - guidelines. No single follow-up plan is appropriate (fits) all patients. Management should be individualized based on each patient's unique medical condition and other contributing factors.

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General information regarding kidney cancer, chronic kidney disease, kidney stones, diet. Kidney Cancer - Testing and Diagnosis The Basics Kidney Overview What is Kidney Cancer? General Information about RCC Kidney Cancer Patient Guide (UCF) Your Kidneys and Kidney Cancer Tests for Kidney Cancer Types - Illustrations Types and Grades Just Diagnosed Toolkit - KCA What is a Renal Mass? Video What You Need to Know Biopsy Overview of Kidney Biopsies Kidney Biopsy Explained Kidney Biopsy Indications - youtube Kidney Biopsy Basics 4 Things to Know What to Know - Kidney Biopsy Kidney Biopsy Details More Info Stages Kidney Cancer Stages Kidney Cancer Staging Staging Illustrated Journey by Stage Case Example Pediatrics von Hippel-Lindau disease (VHL) Wilms Cancer Foundation Specifics Kidney External Structure Anatomy of the Kidney Kidney Cancer Explained - EAU Anatomy Basics Image by Adobe Stock, July 14, 2023 Kidney Anatomy, Wikipedia Illustration by A. Hoofring, 2007 To play, press and hold the enter key. To stop, release the enter key.

KidneyCouch resource library for kidney cancer and chronic kidney disease. Kidney Cancer Example ccRCC Stage T3a, Grade 3 These images are from my personal journey with Clear Cell Renal Cell Carcinoma. I was diagnosed in January 2023 and had a radical nephrectomy in February 2023. jeff kallis CT Scan Images The CT scan on January 25, 2023 confirmed that I had a kidney stone) and pinpointed where the stone was located. I did have a 6 mm kidney stone from my left kidney, lodged in the ureter at the entrance of the bladder and refusing to move further. In addition, something more sinister was identified. A 5 cm mass in my other (right) kidney. Thank God for that kidney stone. I had no symptoms from the kidney mass itself, in the right kidney. CT scans and MRI's do a lot of slicing and dicing of body parts, and keeps them together in the end. Kidney Stone Kidney Tumor Pathology - Kidney This is my right kidney that was removed during my radical nephrectomy. The highlighted area is the kidney mass. The pathologist at Mayo Clinic, Dr. John Cheville, diagnosed the mass as Stage T3a, Grade 3, with renal vein invasion. The mass was a higher stage and grade and was more invasive than what could be seen with imaging alone. The time from when I was first tested for symptoms (January 20, 2023) until the tumor was removed from my kidney (February 15, 2023) was 27 days. That's one of many benefits from being seen at an integrated medical practice (Mayo Clinic Rochester) that specializes in kidney cancer. Profoundly grateful for the care and compassion I have received.

Discover tailored one-on-one mentoring for kidney health and disease support. Connect with experienced mentors now at KidneyCouch. One-on-One Support for patients and family members KidneyCouch and Imerman Angels are committed to providing patients and family members with the resources and connections so that no one walks alone as they deal with a kidney cancer diagnosis. One-on-One support is at the heart of the mission of Imerman Angels. KidneyCouch is proud to partner with Imerman Angels to ensure that patients and family members with kidney cancer have access to one-on-one support. Whether you are a patient who is newly diagnosed with kidney cancer; are in the early stages of treatment; need a shoulder to lean on in dealing with cancer; or you are a family member and need support, Imerman Angels has a network of mentors that would love to connect with you. Individuals with kidney cancer who would like to receive one-on-one support will undergo a personalized matching process and be paired up with someone who has a similar diagnosis and experiences. Our hope is that peer-to-peer exchanges will facilitate positive relationships between individuals affected by kidney cancer so that they may share emotional support, encouragement, and information. Also, if you are a kidney cancer patient and would like to become an Imerman Mentor Angel, Imerman Angels would love to visit with you about joining their mentor angels team. How to Partner with Imerman Angels Find a Mentor If you are interested in finding a one-on-one support mentor, you will be asked to fill out an initial registration application and select the type of mentor you would like to be matched up with. Imerman Angels will match you and a mentor according to age, gender, cancer type and experience; so you know you are talking to someone who truly understands what you’re going through, in a supportive and empathetic environment. Any information shared will be kept confidential between Imerman Angels and the assigned mentor. Become a Mentor If you are a kidney cancer patient and would like to become a mentor, you must complete a profile detailing your cancer experiences. After initial screening and training, Imerman Angels will add your name to the list of mentors in their database network and contact you when someone with your shared experiences registers to request a one-on-0ne support mentor. This a great opportunity to "give back" to the kidney cancer community by helping others navigate the cancer journey. Find A Mentor Angel Become A Mentor Angel About Imerman Angels Imerman Angels was created on the belief that no one should have to face cancer alone and without the necessary support. Their mission is to provide personalized connections that enable one-on-one support among cancer patients, survivors, caregivers and previvors. Through their unique matching process, Imerman Angels partners anyone, any age, anywhere, and any cancer type seeking support from someone with a similar diagnosis and experiences—a “Mentor Angel.” Get in touch with the Imerman Angels to connect you with a one-on-one mentor: https://imermanangels.org/find-mentor-angel/ Imerman Angels - Contact Information https://imermanangels.org/contact/

KidneyCouch is proud to partner with Smart Patients, an online community for patients and families affected by kidney cancer and chronic kidney disease. The Smart Patients kidney community's online support complements KidneyCouch's belief that accessing valuable resources, stories, and articles can make a difference in your journey. You are not alone. Sunlight through the trees. You are surrounded by others who would love to connect and support you. Go To KidneyCouch Community on Smart Patients About Smart Patients Smart Patients is an online community for patients and families affected by a variety of illnesses. Connect with others and learn at your own pace about scientific developments related to your condition, share your questions and concerns with other members, and use what you learn in the context of your own life. With the right tools, you and other patients can do the same. Communities At Smart Patients, they have over 100 communities covering oncology, autoimmune diseases (like Sjögren’s and lupus), neurodegenerative diseases and their symptoms (like Parkinson’s, Alzheimer’s and dementia). They also have several communities where caregivers share tips for coping while caring for a child, parent or spouse. Smart Patients Community Home Kidney Cancer Conversations At Smart Patients, they believe patients are the most underutilized resource in healthcare. They’ve watched patients become experts in their conditions — and see that their knowledge improves the care they receive. Go To Conversations Strength in Unity Smart Patients Partners Smart Patients - Contact Information Website https://www.smartpatients.com/site Email Info@smartpatients.com

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PRESS RELEASES 1 / Partnership Announcement with Smart Patients February 13, 2026 FOR IMMEDIATE RELEASE: KidneyCouch Supports Patients and their Families with an Online Kidney Cancer Community KidneyCouch partners with Smart Patients to create a new online kidney cancer community that will make it easier for patients and families to support and learn from one another. ROCHESTER, MN, February 13, 2026: Today, KidneyCouch is proud to announce a new partnership with Smart Patients, an online peer-to-peer support forum for patients and their families, which allows KidneyCouch to extend its ability to help those impacted by kidney cancer by adding virtual social and emotional support to their outreach programs. Patients and families affected by kidney cancer can join the Smart Patients kidney cancer or chronic kidney disease community for free to share, interact, and learn from each other in a safe, supportive environment. Patients are invited to join the kidney cancer community through the following link: KidneyCouch Smart Patients Community. Individuals can join the community by securely sharing their email addresses and setting up a free personal account. Once the account is confirmed participants will have access to information, and resources, and be able to participate in community conversations on topics of interest. About KidneyCouch KidneyCouch is dedicated to providing a supportive and informative space for kidney cancer patients and those who are also dealing with chronic kidney disease (CKD). It provides resources, stories, and articles to its community members. About Smart Patients: Smart Patients is an online community where patients and caregivers affected by serious illnesses learn from each other. Members share personal experiences, ask and answer questions, and gain knowledge in an ad-free, private space that helps them make better-informed decisions about their care. The platform hosts more than 100 disease-specific communities and is free to join. Learn more at KidneyCouch Smart Patients Community. Contact: Kristi Lynden kristi@smartpatients.com Smart Patient Social Media Handles: Facebook (@smartpatientscommunity) Instagram and Threads (@smart_patients_community) LinkedIn (@Smart Patients) Bluesky (@smartpatients.bsky.social) 2 / Affiliate Partnership Announcement with the Kidney Cancer Association October 20, 2025 KCA Welcomes New Affiliate Partner KidneyCouch Kidney Cancer Association The Kidney Cancer Association (KCA) welcomes KidneyCouch as a new Affiliate Partner. KidneyCouch is committed to offering support and information to individuals battling kidney cancer and/or chronic kidney disease (CKD) with a goal to create a community that fosters connection, understanding, and empowerment for patients and their loved ones. Founder Jeff Kallis, 64, was diagnosed with stage 3 clear cell renal cell carcinoma (RCC) in 2023 and has since written a book about his journey, has been featured in multiple news stories, and created KidneyCouch to increase awareness, education, and support for patients and family members dealing with kidney cancer and chronic kidney disease. His personal mission has always been to connect with and support fellow patients so that no one has to walk this journey alone. For more information about Kallis’s full story, visit KidneyCouch – About. Jeff Kallis’ kidney cancer prompted questions. He wanted to help others find answers. “KidneyCouch is proud to create this affiliation with the Kidney Cancer Association,” Kallis said. “There is strength in unity and there is no better partner than the KCA in creating awareness, education, and finding a cure for kidney cancer.” “It’s gratifying to see how Jeff has used his personal experience to create a welcoming space for meaningful connection,” said Gretchen E. Vaughan, KCA’s President and CEO. “With our shared values, we are looking forward to working together!” The KCA’s Affiliate Partners help expand the support available for people impacted by kidney cancer and allows for strategic collaborations that will advance research, advocacy, and education. KidneyCouch joins seven existing KCA Affiliate Partner organizations: the Chris “CJ” Johnson Foundation, the Chromophobe and Oncocytic Tumor Alliance, HLRCC Foundation, Elevate Childhood Research and Advocacy, Joey’s Wings Foundation, the Judy Nicholson Kidney Cancer Foundation, and the Wilms Cancer Foundation. Media Contact: Radha Chitale Senior Director of Communications 847.332.1051 ext. 113 | rchitale@www.kidneycancer.org 3 / Partnership Announcement with Imerman Angels August 15, 2025 KidneyCouch is pleased to announce that it has formed a partnership with Imerman Angels. Imerman Angels matches a cancer patient with another cancer patient with similar stories and experiences. In addition to the support I received from my wife Cindy, our sons, family, and friends, it would have been very helpful to have a personal connection with someone who had the same diagnosis and story as mine. There are people out there who want to be available to help others navigate their cancer journey – relating to you on a level that others cannot. Now, I want to “give back” to other people diagnosed with kidney cancer and need some emotional / social support as they ride this roller coaster. In July, I became a certified Imerman Angels Mentor Angel to do just that. No one needs to navigate the unknowns alone. Imerman Angles intentionally matches cancer patients according to age, gender, type of cancer, and experience; so, you know you are talking to someone who truly understands what you’re going through, in a supportive and caring connection. Imerman Angels provides this connection free of charge to anyone seeking support, connection and community. If you know of anyone who is dealing with cancer and would like or benefit from a one-on-one connection, please reach out to Imerman Angels at https://imermanangels.org/. If you are cancer survivor and would like to become a Mentor Angel, reach out to Imerman Angels at https://imermanangels.org/give-support/. To learn more about Imerman Angels, visit these links: KidneyCouch / Imerman Angels Partnership: https://www.kidneycouch.com/imermanangels Imerman Angels Resource / Partner Page: https://imermanangels.org/resources/ Imerman Angels – Home Page https://imermanangels.org/

Kidney cancer and chronic kidney disease resource library. Contact Us Feel free to reach out with any questions, feedback, requests to add a resource to this site, or comments. Email jeff@kidneycouch.com Social Media First Name Last Name Email Message Send Thanks for submitting! Thank You for sitting around the couch with us.