Wilms' Tumor

What is Wilms’ tumor?

Wilms’ tumor is a disease in which cancer cells are found in the kidney. Inside each kidney are tiny tubes that filter and clean the blood, taking out products that are not needed, and making urine. The urine made by the kidneys passes through a tube called a ureter into the bladder. Wilms’ tumor occurs most commonly in children under the age of 5. It is curable in most cases.

Treatment option overview

Treatments for Wilms’ tumor depend on the stage of the disease, the type of cancer cells, and the age and general health of the child being treated. Surgery is a common initial treatment for Wilms’ tumor. This involved removing all or part of the affected kidney.

Stages and Treatment

Once Wilms’ tumor has been found, more tests will be done to find out if cancer cells have spread from the kidney to other parts of the body. This is called staging. Your child’s doctor needs to know the stage of the disease to plan treatment.

• Stage 1. Cancer is found only in the kidney and can be completely removed by surgery. Treatment following surgery will involve chemotherapy.
• Stage II. Cancer has spread to the areas near the kidney, such as to fat or soft tissues. The cancer can be completely removed by surgery. Treatment following surgery will involve chemotherapy and possibly radiation therapy.
• Stage III. Cancer has spread to areas near the kidney such as lymph nodes, important blood vessels or organs or throughout the abdomen. The tumor cannot be completely removed by surgery. Treatment will include surgery to remove the cancer followed by chemotherapy and radiation therapy. In Stage III, if the tumor is too close to important organs or blood vessels or if it is too big, it cannot always be removed during surgery. In this case, the doctor may only perform a biopsy, and then give chemotherapy with or without radiation therapy, to reduce the size of the tumor. Once the tumor has become smaller, surgery can be performed, followed by additional chemotherapy and radiation therapy.
• Stage IV. Cancer has spread to organs further away from the kidney, such as the lungs, liver, bone, and brain. Treatment may include surgery to remove the tumor followed by chemotherapy, with or without radiation therapy. If the cancer has spread to the liver and the cancer cannot be removed through surgery, radiation therapy may be given to the liver. If the cancer is spread to the lungs, radiation therapy is given to the lungs.
• Stage V. Cancer cells are found in both kidneys. It is not possible to remove both kidneys. Treatment will probably include surgery to remove a piece of the tumor from both kidneys and to remove some of the lymph nodes around the kidneys to see whether they contain a tumor. A second operation is performed later to remove as much of the tumor as possible, leaving as much of the kidneys as possible. Surgery may be followed by more chemotherapy and/or radiation therapy. 

Recurrent Wilms’ tumor

Recurrent disease means that the cancer has come back after it has been treated. The cancer may come back in the same place it started or in another part of the body. If your child’s cancer comes back, treatment depends on the kind of treatment he or she received before, how much time has passed since the first cancer was treated, and where the cancer came back. It may include surgery, chemotherapy, and/or radiation therapy.