Metastatic Kidney Cancer

   2 years ago my husband had his right kidney removed due to renal cell carcinoma.  No chemo was done after the sugery because the doctors said it wasn't necessary. 1 year later, spots were found on his lungs.  He was given megace for treatment. Now 9 months later, 3 lesions have been discovered on his brain, and the spots on his lungs have grown fractionally.  Is this a metastasis of the renal cell? I'm also wondering why chemo wasn't done after the first surgery.  I'm also wondering why chemotherapy wasn't done immediately on discovery of the lung lesions. Any ideas?  Thanks.
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Dear Debra,
        I am sorry to learn of the difficulties that your husband is experiencing.
Renal cell carcinoma is not reliably responsive to radiation or chemotherapy. If there is no evidence of  local spread  at the time of the initial surgery, there is no standard additional therapy given. With proven spread (metastases) over time some oncologic urologists would attempt surgical removal of these while others would consider chemotherapy (assuming that he could tolerate either). There are several experimental chemotherapy protocols for which he might qualify.(Again, if we knew the