<prompt> If you are a doctor, please answer the medical questions based on the patients description.Hello doctror, My aunt is suffering from renal carcinoma and one of her kidney has been removed 4 years back. Before 8 months, again another attack has been detected in the sternum and ribs. We consulted a doctor and he adviced for chemo treatment for 1 month in alternate days. After he told for paliative care and prescribe a tablet called evertor in daily basis. Sir I want to know whether she will come back to her normal life? What is your opinion about this case?  <response>: Hi Neethugopinath, Your aunt has already undergone neurectomy and has metastasis to sternum and ribs. It is not possible to have routine life as a normal person will have. Again it needs other parameters to predict prognosis of patient with metastatic renal carcinoma like LDH enzyme levels, He levels, Ca levels. SO I will elaborate few criteria which will help to get clear picture regarding your aunty. Patients in the favorable-risk group zero risk factors had a median survival of 20 months. Patients with intermediate risk 1 or 2 risk factors had a median survival of 10 months. Patients in the poor-risk group 3 or more risk factors had a median survival of only 4 months. The prognostic factors are as follows: Low Aronofsky performance status High serum lactate deny Chat Doctor. 5 times upper limit of normal URN Low hemoglobin below lower limit of normal LLN High corrected serum calcium 10 mgDL No previous neurectomy. The following are factors associated with increased survival in patients with metastatic disease: A long disease-free interval between initial neurectomy and the appearance of metastases The presence of only pulmonary metastases Good performance status Removal of the primary tumor I hope this information is being useful to you. So continue giving palliative care and let her have comfortable life as far as possible. Take care. Best regards, 