Cancer

Wilms Tumor

Description

Wilms tumor is a kind of kidney cancer most commonly found in children under 5 years old, which forms when the early cells of the kidney don’t develop into nephrons or glomeruli, resulting in a huddle of immature cells. Normally, these cells should get mature by the time the child reaches the age of 3-4, however, in some cases, they grow out of control and forms a cancerous tumor. It is also called nephroblastoma.

Cause of Wilms Tumour

Anything that increases the chances of a person developing tumor could be the cause of Wilms tumor as well. However, it is not always necessary that the child will develop a tumor if those factors are present. It cannot be inherited, but genetic disorders can result in Wilms tumor.

Other factors include children with birth defects, WAGR syndrome, Beckwith-Wiedemann syndrome, Deny-Drash syndrome found in boys and family history with the disease.

Diagnosing Wilms Tumour

The tumor is not detected until it becomes quite large, however, in most cases, it is discovered before it spread to other parts of the body. The average weight of the tumor can be over 500 grams. Signs and symptoms can help discover the defect, which are:

  • Lump in the child’s belly
  • Blood in the urine
  • High blood pressure
  • Abdominal pain
  • Larger belly
  • Anemia
  • Fatigue
  • Fever

If the child experience these symptoms, consult him/her to the doctor at once, where medical examination can confirm if the child has Wilms tumor. Tests involve blood test, urine test, CT scan, ultrasound, MRI, X-ray or a biopsy. Chromosome test is also done by pathologist to find the tumor.

Treatment of Wilms Tumour

Treatment of Wilms tumor in children is performed by a team of doctors in a specialized center. The treatment option is decided depending upon the size of the tumor and the results of the tests. These are:

  • Surgery: Surgery involves the removal of tumor and surrounded cells and is considered as the most common treatment option in all stages of the cancer. Performed by a pediatric surgeon, it consists of two types, i.e. partial nephrectomy and radical nephrectomy.
  • Chemotherapy: Chemotherapy is the use of drugs to kill the cancer cells and stop them from multiplying. It is given by a pediatric oncologist, which gets into the bloodstream and reach the cancer cells all over the body.
  • Radiation therapy: Radiation therapy uses high intensity rays aimed at the tumor to kill the cancer cells. Performed by a radiation oncologist, the most common type of radiation therapy is external beam radiation therapy, which is given to the body from an outside machine.

Complications

Even though, the treatment is quite successful and most of the children are cured, there are high chances of getting side effects due to radiotherapy and chemotherapy that can damage healthy parts of the body. These side effects are:

  • Kidney failure
  • Lung issues
  • Bowel obstruction
  • Heart related problems
  • Skeletal abnormalities
  • New cancer
  • Pregnancy issues
  • Abdominal pain and vomiting

Post operative care

After the child is treated with Wilms cancer, there is still a lifelong follow up care is required as late effects of treatment may occur.

Keep the child well hydrated to increase the functionality of the kidney. Ibuprofen and codeine are some drugs to be given in small amounts to avoid kidney damage.

Regular check ups will be necessary that may go on for a lifetime, where echocardiogram may be used to see the effects on the heart and pulmonary tests may be done to see the functionality of the lungs.

Parents are advised to see for any signs and symptoms that shows the recurrence of cancer or developing any new cancer.