Living with Metastatic Renal Cell Carcinoma: Survivorship Needs in the Combination Therapy Era

Prior to the development of new cancer technologies, metastatic Renal Cell Carcinoma (mRCC) had a poor prognosis. Fortunately, advances in treatment are allowing a growing population of patients to live with advanced or mRCC. While quality of life has been an area of investigation in this population as treatments advance, relatively little is known about the specific survivorship needs experienced by these patients in the modern treatment era. Using the five survivorship domains defined by the National Cancer Institute, this narrative review explores the literature addressing the survivorship needs of patients living with mRCC. Significant physical, mental, emotional, social and financial effects of mRCC are herein discussed. By comparing literature from the pre-combination treatment period to the modern era, this narrative review of the published literature highlights the significant gaps in our survivorship knowledge for this unique and expanding population. Specifically, this review identifies gaps in understanding of symptom burden, psychological impact, financial effects, and the particular impact of immune-checkpoint inhibitor based combination therapies. Here, we highlight these areas for further research with the hope of finding strategies to alleviate the effects of mRCC and improve the quality of life of patients living with metastatic disease.