Wilms’ tumor

Wilms’ tumor is an uncommon type of kidney cancer that affects mostly youngsters. It’s also known as nephroblastoma, and it’s the most common kidney cancer in children. Wilms’ tumor strikes youngsters between the ages of three and four, and it becomes considerably less prevalent after that.

Wilms’ tumor most commonly affects one kidney, although it can sometimes affect both kidneys at the same time.

Advances in the identification and treatment of Wilms’ tumor have improved the prognosis (prognosis) for children with this disease dramatically throughout the years. Most children with Wilms’ tumor have a fairly favorable prognosis if they receive the right treatment.

Symptoms of Wilms’ tumor

Signs and symptoms of Wilms’ tumor vary widely, and some children don’t show any obvious signs. But most children with Wilms’ tumor experience one or more of these signs and symptoms:

• An abdominal mass you can feel
• Abdominal swelling
• Abdominal pain

Other signs and symptoms may include:

• Fever
• Blood in the urine
• Nausea or vomiting or both
• Constipation
• Loss of appetite
• Shortness of breath
• High blood pressure

What causes Wilms’ tumor?

It’s unclear what causes Wilms’ tumour, however heredity may play a role in some cases.

When cells’ DNA becomes faulty, cancer develops. The flaws allow the cells to expand and divide at an uncontrollable rate, allowing them to survive when other cells would have died. A tumour develops from the accumulated cells. This happens in the kidney cells in Wilms’ tumour.

Wilms’ tumour is caused by DNA mistakes that are passed down from parent to child in a small percentage of instances. In the vast majority of cases, there is no known link between parents and children that could result in cancer.

Diagnosis of Wilms’ tumor

Several tests are used to confirm a Wilms tumor diagnosis and determine the stage of the disease. These tests can include:

• Ultrasound: usually the first test done, it uses sound waves instead of X-rays to make an image of the area.
• CT/CAT scan: makes a detailed cross-sectional view of an organ through X-rays. It is extremely useful in finding tumors and seeing whether the cancer has spread (metastasized).
• MRI: uses radio waves and strong magnets to make detailed pictures of the internal parts of the body. This lets doctors see if the cancer is in any major blood vessels near the kidney.
• X-rays: to look for any metastasized areas, especially in the lungs.
• Bone scans: uses small amounts of radioactive material to highlight any areas of diseased bone.
• Lab tests: such as blood tests and urine tests to check a child’s general health and to detect any adverse side effects (such as low red or white blood cell counts) of the treatment.

Treatment of Wilms’ tumor

The treatment of Wilms tumour is dependent on a few factors. The stage of the cancer at the time of diagnosis, as well as the state, or histology, of the cancer cells, are crucial. The majority of Wilms tumours have a “favourable” histology, which means they are easier to treat.

A staging system is used by doctors to indicate the size of a tumour. To achieve the highest possibility of a cure, a very aggressive tumour is treated with an intense medical regimen. A youngster with a less-invasive condition will receive the least quantity of medication, reducing long-term negative effects.

The most common stages are:

• Stage I: Cancer is found in one kidney only and can be completely removed by surgery. About 41% of all Wilms tumors are stage I.
• Stage II: Cancer has spread beyond the kidney to the surrounding area, but can be completely removed by surgery. About 23% are stage II.
• Stage III: Cancer has not spread beyond the abdomen, but cannot be completely removed by surgery. About 23% are stage III.

Surgery is usually done to treat Wilms tumor. In a radical nephrectomy, the surgeon removes:

• the tumor
• the entire kidney
• its ureter (a tube that carries pee from the kidney to the bladder)
• its adrenal gland (a gland that sits on top of the kidney)
• surrounding fatty tissue

When cancer is in both kidneys, surgeons usually take out as much of the cancer as possible and preserve as much healthy kidney tissue as they can to avoid a kidney transplant.

All treatment plans usually include both surgery and chemotherapy. More advanced stages also may require radiation therapy. Both treatments have short-term and long-term risks.

Short-term (or temporary) effects may include:

• nausea and vomiting
• loss of appetite
• mouth sores
• tiredness
• hair loss
• a weakened immune system
• bleeding or bruising

Long-term (or late) effects may include:

• the development of secondary cancers (like leukemia)
• weakening of some internal organs, such as the heart
  However, the benefits of treatment far outweigh these risks.