Treatments and drugs

By Mayo Clinic Staff

Treatment for Wilms' tumor usually involves surgery and chemotherapy. But treatments may vary by the stage of the cancer. Because this type of cancer is rare, your doctor may recommend that you seek treatment at a children's cancer center that has experience treating this type of cancer.

Surgery to remove all or part of a kidney

Treatment for Wilms' tumor usually begins with surgery to remove all or part of a kidney (nephrectomy). Surgery is also used to confirm the diagnosis, since the tissue removed during surgery is sent to a laboratory to determine whether it is cancerous.

Surgery for Wilms' tumor may include:

  • Removing part of the affected kidney. Partial nephrectomy involves removal of the tumor and part of the kidney tissue surrounding it. Partial nephrectomy may be an option if your child's cancer is very small or if your child has only one functioning kidney.
  • Removing the affected kidney and surrounding tissue. In a radical nephrectomy, doctors remove the kidney and surrounding tissues, including the ureter and adrenal gland. Neighboring lymph nodes also may be removed. The remaining kidney can increase its capacity and take over the entire job of filtering the blood.
  • Removing all or part of both kidneys. If your child's cancer affects both kidneys, the surgeon works to remove as much cancer as possible from both kidneys. In a small number of cases, this may mean removing both kidneys, which means your child would then undergo kidney dialysis. A kidney transplant may be an option so that your child will no longer need dialysis.

Chemotherapy

Chemotherapy uses powerful drugs to kill cancer cells throughout the body. Chemotherapy treatment usually involves a combination of drugs that work together to kill cancer cells. Chemotherapy can be administered through a vein or taken in pill form.

What side effects your child experiences will depend on which drugs are used. Common side effects include nausea, vomiting, loss of appetite, hair loss and frequent infections. Ask your child's doctor what side effects may occur during treatment, and if there are any potential long-term complications.

Chemotherapy may be used before surgery to shrink tumors and make them easier to remove. Chemotherapy may be used after surgery to kill any cancer cells that may remain in the body. Chemotherapy may also be an option for children whose cancers are too advanced to be removed completely with surgery.

For children who have cancer in both kidneys, chemotherapy is administered before surgery. This may make it more likely that surgeons can save at least one kidney in order to preserve kidney function.

Radiation therapy

Radiation therapy uses high-energy beams, such as X-rays, to kill cancer cells.

During radiation therapy, your child is positioned on a table and a large machine moves around your child, precisely aiming energy beams at the cancer. Possible side effects include nausea, diarrhea, fatigue and sunburn-like skin irritation.

Radiation therapy may be used after surgery to kill any cancer cells that weren't removed during the operation. Radiation therapy may also be an option to control cancer that has spread to other areas of the body, depending on where the cancer has spread.

Clinical trials

Your child's doctor may recommend participating in a clinical trial. These research studies allow your child a chance at the latest cancer treatments, but they can't guarantee a cure.

Discuss the benefits and risks of clinical trials with your child's doctor. The majority of children with cancer enroll in a clinical trial. However, enrollment in a clinical trial is up to you and your child.

Nov. 06, 2014

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