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CRashster's picture
Posts: 239
Joined: Mar 2017

How bad is Furhman grade 4 and does that even matter 2 years after neph?

icemantoo's picture
Posts: 3317
Joined: Jan 2010

The question is whether it matters enough to be a concern. Ask the doctor. Size is the most relevant concern. 




CRashster's picture
Posts: 239
Joined: Mar 2017

my next scan is in June, I’ll ask then. I’m just looking at my old paperwork and never noticed that before.

Steph85's picture
Posts: 166
Joined: Feb 2018

I was stage 1 grade 2 for my tumor. If a tumor were to grow back, would it still be grade 2? Or could it change to a higher grade? I've seen on here even small tumors can be grade 4. I just always associated grade 4 with large tumors. If you have a liver met, would that be the same grade as the primary tumor? I've been curious and thought it might be dumb questions.. But, screw it, I'm asking anyway.



CRashster's picture
Posts: 239
Joined: Mar 2017

so many questions!

Hd67xlch's picture
Posts: 152
Joined: Apr 2016

meastsized to a lung they changed the grade from 2 to 4 on my pathology report after my 1st lung surgery    The cells had changed they said.  I just  had a 7mm nodule removed three days ago but have not got the report yet so size doesn’t seem to matter if has metastasized. Good luck

Posts: 61
Joined: May 2018

When I got my pathology report back after my nephrectomy last April, I learned that the cancer was Grade 4 with sarcomatoid and rhabdoid features. Grade 4 doesn't necessarily mean the cancer is worse than a lower grade, however, it does shed some light on the cellular makeup of the cancer.  Grade 4 is very unpredictable as the cells have a high level of mutation. Grade 4 also often times has sarcomatoid features which is another indicator of the potential aggressiveness of the cancer. There is a lot of information out there about this - usually I don't like what I find. My cancer didn't take long to metastasize and the tumors grew rapidly. My oncologist believes this aggressive nature has more to do with the sarcomatoid features, however, he is concerned with the high grade as the cells will mutate quickly which will potentially limit the length of time a treatment is effective. 

Mighty Frog's picture
Mighty Frog
Posts: 152
Joined: Jul 2017

Furhman grade 4 indicate the cancer was a aggressive one and need to be vigilant from time to time. I suggestion to be continue checkup even after 5 years mark.   

Allochka's picture
Posts: 946
Joined: Nov 2014


grade is important as well, not only the size. It indicates how abnormal cancer cells are. Grade 4 cancer cells are more aggressive, so more vigilant follow-up is recommended.

And yes, a very small cancer can be grade 4 (just caught very early), and a big one - just grade 2, most probably growing slowly in the kidney for a long time already.


donna_lee's picture
Posts: 999
Joined: Feb 2009

If you again find that cancer is there, it would increase the Stage #, from a 1, even up to a 4.  The Stage 1 just tells us that it was a very small turmor that had not invaded vessels in the kidney or metastasized to another organ.

My Dr's knew going in that it was already at a 4 because they saw 1-2 masses in my liver.

Do a web search for "Cancer and/or Kidney Cancer Staging" to get some basic definitions.

good wishes,


Posts: 67
Joined: Jul 2013

I can't see your subtype. I just know that Furman, grading system isn't used for Chromophobe anymore.

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