The Gleason score (a number that describes how abnormal the cells look under a microscope) can be any level. stage IV renal cell cancerCancer has spread (1) beyond the layer of fatty tissue around the kidney and may be found in 1 nearby lymph node; or (2) to 2 or more nearby lymph nodes; or (3) to other organs, such as the bowel, pancreas, or lungs, and may be found in nearby lymph nodes.