Wilms tumor is a cancerous tumor that starts in the cells of the
kidney. It’s the most common type of kidney cancer in children. It’s often found by
time a child is age 3 or 4. The tumor can be very large before it’s found. And it
spread (metastasize) to other body tissues. The most common site for Wilms tumor to
spread to is the lungs. But it may also spread to the liver, lymph nodes, other
kidney, brain, and bones.
Most cases of Wilms tumor occur by chance with no clear cause. Defects in genes affect
the growth of kidney cells. But it’s not common for Wilms tumor to run in families.
A small number of children with Wilms tumor also have a syndrome caused by abnormal
genes, such as:
Some birth defects may increase the
chance of Wilms tumor. For example, a child with defects of the penis or testicle
more at risk. Talk with your child's healthcare provider if you want more information
about these conditions.
Symptoms can be different for each
child. They can include:
- A lump in the belly (abdomen)
- Belly swelling
- Pain in the belly, but some children
have no pain
- Blood in the urine
- Low red blood cell count (anemia)
- High blood
Many of these symptoms may be
caused by other health problems. It's very important to see your child's healthcare
provider right away if you notice these symptoms. Only a healthcare provider can tell
your child has cancer.
If your child's healthcare provider
thinks your child might have Wilms tumor, certain exams and tests will be needed to
sure. Your child's provider will ask about your child's health history and symptoms.
They'll examine your child. Your child may have tests, such as:
Abdominal ultrasound. This test
uses sound waves and a computer to create pictures of blood vessels, tissues, and
organs. It can show the kidney, the tumor, and blood vessels of the kidney. It can
also help show if there are any tumors in the other kidney or other parts of the
Abdominal computed tomography (CT)
This test uses a series of X-rays and a computer to make detailed
images of the belly (abdomen). CT scans are much more detailed than standard
MRI. This test uses magnets, radio waves, and a computer
to make detailed images of the body. MRI can show if cancer has spread to other parts
of the body (metastasized). It can also show if there are cancer cells in the lymph
nodes or other nearby organs.
Chest X-ray. An X-ray is done with a small amount of radiation. It
can show if there the cancer has spread to the lungs.
Blood and urine tests. These can check how well the kidneys and
liver are working and check overall health.
Biopsy. A small piece of tissue is removed and checked with a
microscope for cancer cells. Samples of the tumor, nearby lymph nodes, and other
tissue may be taken. A biopsy can also show the type of tumor. A biopsy of kidney
tissue may not be done with some tumors.
Most children with Wilms tumor can be cured. Treatment will depend on the size and
location of the tumor and other factors. Your child will be treated by specialists
experience in treating Wilms tumor. They may include a pediatric surgeon and a pediatric
cancer specialist (oncologist). The cancer can be treated with any of the below:
Surgery. This is done to take out the
affected kidney (nephrectomy). Removing only part of the kidney isn't advised for
most children. Samples of the kidney that's removed are studied. Samples of nearby
lymph nodes may also be taken and checked for signs of cancer.
Chemotherapy. These are medicines
that kill cancer cells. They're used to destroy cancer cells before or after surgery.
They're also used to treat cancer that has spread or grows back.
Radiation therapy. These are high-energy X-rays or other types of
radiation. Radiation is used to kill cancer cells or stop them from growing. It may
used to treat cancer that has spread or grows back.
Supportive care. Cancer treatment can
cause side effects. Medicines and other treatments can be used to help ease side
effects, such as pain, fever, infection, and nausea and vomiting.
Clinical trials. Ask your child's healthcare provider if there are
any new treatments being tested that may work well for your child.
Your child will need follow-up care during and after treatment to:
- Check on your child's response to the treatment
- Manage the side effects of treatment
- Look for returning or spreading cancer
Some treatments may be hard on your
child, but they increase the chance of your child living a long time. Discuss the side
effects of treatment with your child's provider.
With any cancer, how well a child is expected to recover (prognosis) varies. Keep
- Getting medical treatment right away is important for the best outcomes.
- Ongoing follow-up care during and after treatment is needed.
- New treatments are being tested to improve outcomes and to lessen side effects.
You can ask your child's provider about survival rates and what you
might expect. But remember that statistics are based on large groups of people. They
can't be used to say what will happen to your child.
Possible complications can include:
- Side effects of chemotherapy or radiation therapy, such as heart failure or growth
of a new type of cancer
- Problems from surgery, such as bleeding or infection
- Pregnancy problems in the future
- Cancer that grows back or spreads
Your child's care team will review what complications you need to
think about based on your child's specific treatment plan.
You can help your child manage
their treatment in many ways. For example:
- Learn as much as you can about Wilms
tumor. This can help you make the best decisions for your child.
- Get emotional support for your child.
Finding a counselor or child support group can help.
- Get emotional support for yourself and other family members,
- Take your child to all appointments
and treatment visits.
- Your child may have trouble eating. A
dietitian may be able to help.
- Your child may be very tired. They'll
need to balance rest and activity. Encourage your child to get some exercise. This
good for overall health. And it may help to reduce tiredness.
Your child may need to:
- Be checked for Wilms tumor if they
have a condition that increases the chance of developing Wilms tumor
- Have genetic testing and
If needed, consider using the provisions under the Family and Medical
Leave Act (FMLA). This federal law gives you the right to take up to 12 work weeks
unpaid leave to care for a sick family member. For eligible employees, health insurance
must continue. When you go back to work, you'll be given your previous position or
equivalent job. For information, see the U.S. Department of Labor
When to Call a Healthcare Provider
Call the healthcare provider if your child has:
- Symptoms that get worse
- New symptoms
- Side effects from treatment
Ask the provider about any problems or changes you should watch for
and what you should do if you notice them.
- Wilms tumor is cancer that starts in
the kidney cells.
- It’s most often found in children ages
3 to 4.
- It may not cause any symptoms and may not be diagnosed until it’s large.
- Surgery, chemotherapy, and radiation
therapy may be used to treat Wilms tumor.
- Most children with Wilms tumor can be cured with treatment.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a
new diagnosis and any new medicines, treatments, or tests. Also write down any new
instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child.
Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child
doesn't take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose
for that visit.
- Know how you can contact your child’s provider after office hours. This is important
if your child becomes ill and you have questions or need advice.