### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
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?

### output:

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 mg/DL) 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,