Wilms' Tumor

Wilms' Tumor

Wilms' tumor is a type of kidney cancer that most often affects children. It is the most common type of childhood kidney cancer. Symptoms may include such things as blood in the urine, abdominal pain, fever, and abdominal swelling. Treatment options for this type of cancer may include surgery, chemotherapy, and radiation therapy.

What Is Wilms' Tumor?
Wilms' tumor is a disease in which cancer cells are found in certain parts of the kidney. This condition is the most common type of childhood kidney cancer.

Understanding the Kidneys
The kidneys are a matched pair of organs found on either side of the backbone. They are shaped like kidney beans. Inside each kidney are tiny tubes that filter and clean the blood, taking out unneeded products and making urine. The urine passes through a tube called a ureter into the bladder, where it is held until it is passed from the body.

Symptoms of Wilms' Tumor
In early stages of Wilms' tumor, there are usually no symptoms of the disease. However, as the tumor grows, common symptoms of Wilms' tumor can include:

* Blood in the urine
* Abdominal pain
* Fever
* Nausea
* Weight loss
* High blood pressure
* Constipation
* Poor appetite
* A lump felt or seen in the abdomen
* Abdominal swelling.

These symptoms are not sure signs of Wilms' tumor. Other health problems can also cause these symptoms. People with possible signs or symptoms of Wilms' tumor should see a doctor as soon as possible -- only a doctor can diagnose and treat the problem.

Making a Diagnosis
If a child has symptoms of Wilms' tumor, the child's healthcare provider will likely need to:

* Feel the child's abdomen for lumps and run blood and urine tests.

* Order a special x-ray called an intravenous pyelogram (IVP). During this test, a dye containing iodine is injected into the child's bloodstream. This allows the child's doctor to see the kidney more clearly on the x-ray.

* Order an ultrasound, which uses sound waves to make a picture, or a special x-ray called a computed tomography (CT) scan to look for lumps in the kidney.

* Order a special scan called magnetic resonance imaging (MRI), which uses magnetic waves to make a picture.

* Order chest and bone x-rays.

If abnormal tissue is found, the child's doctor will need to cut out a small piece and look at it under the microscope to see if there are any cancer cells. This is called a biopsy.

Wilms' Tumor Staging
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 Wilms' tumor staging. The child's healthcare provider will need to determine the stage of Wilms' tumor in order to plan treatment. For Wilms' tumors, the stage is based on the amount of tumor that remains after the patient has had surgery to look at or remove the tumor.

Specific Wilms' tumor stages include:

* Stage I
* Stage II
* Stage III
* Stage IV
* Stage V
* Recurrent.

In addition to the stages, Wilms' tumors are described by their histology. The histology, or how the cells look under a microscope, of the tumor affects the prognosis and may be favorable or unfavorable. Tumors with a favorable histology respond better to treatment than those with unfavorable histology.

Treatment Options
Treatment for Wilms' tumor will depend on:

* The Wilms' tumor stage
* The histology (cell type)
* The child's age and general health.

Treatment that may be used for this condition can include:

* Surgery (taking out the cancer in an operation)
* Chemotherapy (using drugs to kill cancer cells)
* Radiation therapy (using high-dose x-rays or other high-energy x-rays to kill cancer cells).

The child's healthcare provider can describe the treatment choices and the expected results of each. Choosing the most appropriate Wilms' tumor treatment is a decision that ideally involves the patient, the family, and the healthcare team.

Prognosis for Wilms' Tumor
The Wilms' tumor prognosis will depend on:

* The stage of the child's cancer (whether it is only in the kidney or has spread to other places in the body).

* How the cancer cells look under a microscope (histology).

* The child's age and general health.

It is important to note that Wilms' tumor is curable in the majority of affected children.

Other Childhood Kidney Tumors
Clear cell sarcoma of the kidney, rhabdoid tumor of the kidney, and neuroepithelial tumor of the kidney are childhood kidney tumors that are unrelated to Wilms' tumor. The treatment of these tumors is different from the treatment of Wilms' tumor.