Rick - take it from me (husband diagnosed/DX in May this year!), this is the worst bit of it all - the shockwave from the diagnosis! It's brutal and panicking and the gut terror is bad - BUT it does ease off as you get your head round things.
I'd say the most important thing is to start reading up on all this (and this is a great site for it, plus I fully recommend http://www.kidneycancer.org/index.cfm?pageID=214 (The Kidney Cancer Association)
You want to find out what stage you are at - IF your tumour is, you say, around five inches, and it's on, rather than just contained within your kidney, then I THINK you are stage II (but please check, and I'm sure others here will correct me)(my husband is Stage IV so I'm not too clear about the earlier stages!). Ask you oncologist if it's got the adrenal gland (sits on top of the kidney).
Also, you need to find out what exact type of kidney cancer you've got. The most common is clear cell (around 80%) but there are some rarer variants (again, sites like this and the KCA are good on taking you through the differences) - a rarer type may have different drug therapy and treatment.
I'll say straight out that so far as I understand, IF they get all the tumour out (maybe with all the kidney or not, it depends what's necessary), AND there is no evidence that it has spread in the blood to distant places like lungs and lymph nodes and bones (the most common destination)(that would make you Stage IV - distant mets, or metastases), THEN just getting rid of the primary tumour (the one on the kidney) should do the trick..... (I can find the stats on 'cure rate' for this stage, I know I've seen them somewhere, and will get back to you!) (I know if the tumour is small and contained within the kidney itself, then the 'cure rate' is something fantastic like 90%)
With the kidney/primary tumour gone, what you THEN have to watch out for is the damn beastie trying to sneak back in - which can happen. ie, the cancer can recur in the renal bed, where the kidney was taken out, or, if it's 'seeded' in the blood, can pop up with distant mets in the lungs etc. This is then called recurrent RCC.
Yes, this happens, BUT, again, from what I understand, it does NOT happen in every case! I'm still tracking down stats for recurrence, but one I found just now on the Internet (keyed in recurrent RCC....) is
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=14
This is a couple of years old now (2006) but I doubt the stats change much? The reference Reviews in Urology says "after nephrectomy, RCC recurs in 20% to 40% of patients with clinically localized disease."
That's not bad, is it?! What will be essential is continual monitoring (for the rest of your life!) to check for any recurrence.
Now, if the beastie DOES make a comeback (or, indeed, there are already distant mets), all is still not endless gloom. We are living, folks, at what has to be 'the best time in history to get KC!' - for the last few years we've seen the arrival of a batch of new power drugs, the first new treatments for advanced (ie metastatic)(whether recurrent or Stage IV DX) for thirty years. (And the existing treatments weren't rubbish either - as you can read here above about IL2 - which CAN cure completely in SOME few cases, and can fend off in a lot more.)
The new drugs only came out of trial a couple of years ago, and are now the front line drug therapy. Sutent, for example, works for around 75% of patients, either stopping their mets growing or even shrinking and getting rid of them. (I'll tell you straight off the downside of Sutent is cost - it's about $5,000 a cycle, and you need around eight cycles a year...)(but I'm sure I've read here on this site of people getting it via compassionate programs?)(sorry, I'm from the UK - where it's not available on our wonderful free NHS - yet!!!!)(we have to convince the NHS of the survival stats!).
At the moment, the post-trial data is showing a median time to progression (ie, the mets are held stable, or shrink) of nearly a year, and overal median suvival of just over two years - and that's median/average, remember. If you browse these threads you'll see some people who were on the trial getting more than that already! The bottom line of the new drugs is that NO ONE really knows their long-term effect on keeping us going! They just haven't been around long enough. So it really is 'all to play for' with these new drugs.
I won't overload your brain right now when you are still in initial shock stage, but Sutent is not the only new drug around, and there are more coming along in trial as well. My mantra is ' the longer you last the longer you'll last'. (My husband's getting bored of me droning it at him!!)
All the very, very best to you. Take the best care of your 'outward health' you can at this stage (eg, keep a good diet as much as possible, keep active/fit as much as possible)(no more bike smashes!!!!!), find out everything you can about what your exact condition is, research all your treatment options, and what will happen post-op. (For example, some of the docs are experimenting with putting patients on Sutent after a nephrectomy, "preventatively" to see whether it lowers the odds on the cancer recurring - so that may be an option for you if you at that earlier stage still).
Take care, and let hope be with you.
Julie.
PS - take a look at Bunker's posts here. He was on the original Sutent trial with recurrent RCC (I think!), and he's been tumour free for a good couple of years now - the Sutent polished off his liver mets (I THINK I'm right on that - but please check for yourself - I would not want to give you the slightest false reassurance, which is worse than useless) (and I do hope everything else I've said here pans out too!)
PPS - don't forget to check out the threads under Renal cancer, as well as Kidney cancer! We mostly all post on both.