Overview
Wilms tumor is a rare type of kidney cancer that primarily affects children. It is also known as nephroblastoma and is the most common cancer of the kidneys in children. Wilms tumor typically affects children between the ages of 3 and 4, although it can occur in older children and even adults. The tumor usually develops in just one kidney, but in some cases, it can affect both kidneys simultaneously. The prognosis for most children with Wilms tumor has greatly improved over the years due to advancements in diagnosis and treatment. Symptoms can vary, with some children showing no symptoms at all, while others may experience a mass in the stomach area, swelling, pain, fever, blood in the urine, low red blood cell levels (anemia), and high blood pressure. Wilms tumor can occur as part of rare syndromes, such as WAGR, Denys-Drash, and Beckwith-Wiedemann syndromes. There is no known prevention for Wilms tumor. If you notice any concerning symptoms in your child, it is important to consult with their healthcare provider.
Understanding the disease
Symptoms
The symptoms of Wilms tumor can vary a lot and may include:
- A mass in the stomach area that can be felt.
- Swelling in the stomach area.
- Pain in the stomach area.
- Fever.
- Blood in the urine.
- Low red blood cell level (anemia).
- High blood pressure. It is important to note that some children with Wilms tumor may not have any symptoms at all. If you notice any symptoms that concern you, it is important to consult with your child's healthcare provider.
Risk Factors
The risk factors for developing Wilms tumor include being Black, having a family history of Wilms tumor, and having certain conditions present at birth such as aniridia or hemihypertrophy. Wilms tumor can also occur as part of rare syndromes. No specific prevention method is available for Wilms tumor, but kidney ultrasounds may help detect the disease at an early stage if a child has any of these risk factors.
Development
Wilms tumor develops when cells in the kidney undergo genetic changes in their DNA. These changes cause the cells to grow and multiply rapidly, forming a tumor. In rare cases, Wilms tumor can be associated with inherited genetic mutations or certain syndromes, such as WAGR syndrome, Denys-Drash syndrome, and Beckwith-Wiedemann syndrome. However, the majority of cases occur spontaneously and are not linked to any known genetic or environmental factors. The tumor can develop in one or both kidneys and may or may not produce symptoms. If you have concerns about Wilms tumor or your child's health, it is important to consult with a healthcare provider for proper evaluation and guidance.
Assessment and Diagnosis
Triage
You should see a doctor if you notice symptoms that worry you, such as a mass in the stomach area, swelling in the stomach area, or pain in the stomach area, especially if they are persistent or worsening. Wilms tumor is a rare cancer, so it's important to have your child evaluated by a healthcare provider to determine the underlying cause of these symptoms. Remember, early detection can significantly improve the chances of successful treatment.
Diagnosis
To diagnose Wilms tumor, a health care provider might take a family history and perform the following:
- Physical exam: The provider will look for any signs of Wilms tumor.
- Blood and urine tests: These lab tests can assess the kidneys' function.
- Imaging tests: Tests such as ultrasound, CT scans, MRI, and chest X-rays create images of the kidneys to find any tumors. After diagnosing Wilms tumor, the health care team may recommend additional tests to determine if the cancer has spread. The cancer's stage will then be determined, and this information will help guide treatment decisions. In the United States, Wilms tumor stages are as follows:
- Stage 1: The cancer is found only in one kidney and can typically be removed with surgery. Questions to ask your child's health care provider about Wilms tumor include:
- What tests do I need to have done?
- What stage is the cancer?
- What treatment options are available, and which do you recommend?
- What side effects can be expected from the treatments?
- Will my child need to restrict their activities or change their diet during treatment?
- What is the outlook for my child?
- What is the likelihood of the cancer returning?
- Are there any brochures or printed materials I can have? What websites do you recommend? Don't hesitate to ask any other questions you may have. Your doctor will likely ask questions about your child's symptoms, family history, and any potential risk factors.
Management and Treatment
Home Remedies
It is important to consult a healthcare professional for proper diagnosis, treatment, and management of Wilms tumor.
Treatment
Treatments for Wilms tumor are tailored to the individual patient and may include a combination of approaches. The most common treatments for Wilms tumor are surgery, chemotherapy, and radiation therapy.
- Surgery: The primary treatment for Wilms tumor is surgery to remove the tumor and affected tissue. Depending on the extent of the tumor, the surgeon may remove the entire kidney, a portion of the kidney, or just the tumor itself.
- Chemotherapy: Chemotherapy is often used before surgery to shrink the tumor and increase the chances of a successful surgical removal. It may also be used after surgery to eliminate any remaining cancer cells. Chemotherapy can be given intravenously or orally, and the drugs may be given in cycles.
- Radiation therapy: Radiation therapy uses high-energy X-rays or other types of radiation to destroy cancer cells. It is typically used in combination with chemotherapy, especially for cases where the tumor is too large to be removed surgically or has spread to other areas of the body.
- Follow-up care and monitoring: After initial treatment, patients with Wilms tumor require close follow-up care and regular monitoring. This includes imaging tests, blood work, and physical exams to ensure that the cancer does not return. It's important to note that the outlook for most children with Wilms tumor is good, especially when the disease is diagnosed and treated early. Prognosis varies depending on factors such as the stage of the cancer, the patient's overall health, and the effectiveness of the treatment.
Preparing for medical consultation
To prepare for an appointment for Wilms tumor, you should:
- Be aware of any pre-appointment restrictions: At the time you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet.
- Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
- Write down key personal information, including any major stresses or recent life changes.
- Make a list of all medications, vitamins, or supplements that you're taking.
- Consider taking a family member or friend along for support.
- Bring any previous medical records, scans, or X-rays relevant to your situation.
- Prepare a list of questions to ask your doctor, including:
- What may be causing my symptoms?
- Are there any other possible causes?
- What kinds of tests do I need? Do these tests require any special preparation?
- What is the appropriate treatment for Wilms tumor?
- What are the potential side effects of the treatment?
- What can I expect during and after treatment?
- Are there any clinical trials or new treatments available for Wilms tumor? Remember, it's essential to consult with a healthcare professional who specializes in treating cancer, such as an oncologist, for Wilms tumor.