Hi, Thanks for writing in. Review of medical literature says that the survival for any treated renal cell cancer patient with progressing, recurring, or relapsing disease is difficult, regardless of cell type or stage. Almost all patients with stage IV renal cell cancer are incurable. The question and selection of further treatment depends on many factors, including previous treatment and site of recurrence, as well as individual patient considerations. Carefully selected patients may benefit from surgical resection of localized metastatic disease, particularly if they have had a prolonged, disease free interval since their primary therapy. Chemotherapy and radiation are main treatment options if there is no possibility of surgery to be done due to spread of disease to the lung and extend his survival. Please do not worry.