What is a Wilms' tumour?
A Wilms’ tumour is a type of kidney cancer also known as nephroblastoma. It can begin to develop when a baby is still inside the womb when the cells that should have matured into kidney cells stay immature. If these cells do not mature they can grow to form a Wilms’ tumour.  Wilms’ tumours mainly affect one kidney, but around 7% of cases affect both kidneys.

Who does it affect?
Wilms’ tumours generally affect children under the age of five. Some children have a genetic tendency to develop Wilms’ tumour, this is usually obvious because other family members have developed Wilms’ or because there have been certain development problems form birth.

What are the symptoms?
The most common is a swollen tummy which can occur quite suddenly. Other symptoms include blood in the urine, raised blood pressure and a loss of appetite.

How is it diagnosed?
Wilms’ tumours are diagnosed using urine samples to check kidney function and ultrasound or CT scans to see if the cancer has spread. A biopsy is also carried out.

How is it treated?
The treatment for Wilms’ tumours will depend on its size and whether it has spread to other areas of the body. This is known as its stage. The stages vary between a tumour that has not spread and can be removed by surgery to a tumour that has formed other (secondary) tumours in distant parts of the body.

Another factor in the treatment of Wilms’ tumours is the presence of what is known as “anaplasia”. Anaplasia is the term used for cells that are large and do not look like kidney cells. The presence of anaplasia will require a stronger treatment because these tumours are more difficult to treat. If possible the tumour will be removed by surgery. The surgery may involve removing part or the entire kidney, but the aim will be to keep as much healthy kidney as possible. If the Wilms’ tumours are in both kidneys then each kidney is operated upon separately. Chemotherapy is given before surgery to shrink the tumour. Chemotherapy is also usually given after the surgery to stop the cancer from returning, and radiotherapy may also be given – depending upon the stage of the tumour.

Side-effects
The side-effects associated with chemotherapy are tiredness, sickness and diarrhoea, temporary hair loss and infection, all of which can be managed with help from the child’s Consultant or nursing team.

Long term side-effects
Some children may go on to develop longer term side effects. Please remember that all children are different and only a small number develop long-term problems as a result of their treatment. Parents can talk to their child’s Consultant if they are concerned about them.

Follow-up care
All children will need to be monitored regularly at an outpatient's clinic. The Consultant will be looking for any signs that the cancer has returned (recurrent cancer) and checking the functions of major organs to make sure that they have not been affected by the cancer treatment.  Because most cases of Wilms’ tumour occurs in one kidney only, very few children have long term kidney problems as a result of their disease.

Source: www.clicsargent.org.uk