Treatment

Treatment for Wilms' tumor usually involves surgery and chemotherapy, and sometimes radiation therapy. Treatments may vary by the stage of the cancer. Because this type of cancer is rare, your child's 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 may begin with surgery to remove all or part of a kidney (nephrectomy). Surgery is also used to confirm the diagnosis — the tissue removed during surgery is sent to a lab to determine whether it's cancerous and what type of cancer is in the tumor.

Surgery for Wilms' tumor may include:

  • Removing part of the affected kidney. Partial nephrectomy involves removal of the tumor and a small part of the kidney tissue surrounding it. Partial nephrectomy may be an option if the 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 part of the ureter and sometimes the adrenal gland. Nearby lymph nodes also are removed. The remaining kidney can increase its capacity and take over the job of filtering the blood.
  • Removing all or part of both kidneys. If the cancer affects both kidneys, the surgeon removes as much cancer as possible from both kidneys. In a small number of cases, this may mean removing both kidneys, and your child would then need kidney dialysis. If a kidney transplant is an option, your child would no longer need dialysis.

Chemotherapy

Chemotherapy uses powerful drugs to kill cancer cells throughout the body. Treatment for Wilms' tumor usually involves a combination of drugs, given through a vein, that work together to kill cancer cells.

What side effects your child may experience will depend on which drugs are used. Common side effects include nausea, vomiting, loss of appetite, hair loss and higher risk of infections. Ask the 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. It 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

Depending on the stage of the tumor, radiation therapy may be recommended. Radiation therapy uses high-energy beams to kill cancer cells.

During radiation therapy, your child is carefully 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, tiredness and sunburn-like skin irritation.

Only a few centers in the United States, such as Mayo Clinic, offer proton beam therapy — highly targeted precision beam therapy that destroys cancer while sparing healthy tissue.

Radiation therapy may be used after surgery to kill any cancer cells that weren't removed during the operation. It 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, if available. However, enrollment in a clinical trial is up to you and your child.

Aug. 16, 2017
References
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