Wilms’ Tumor Cancer from Diagnosis to Treatment


What Is Wilms’ Tumor?

Wilms’ Tumor, also called nephroblastoma, is a rare kidney cancer that mainly affects children, usually between the ages of 2 and 5.

It is the most common type of kidney cancer in children, but it is highly treatable, especially when detected early.

Wilms’ tumor usually affects one kidney, but in about 5-10% of cases, it can affect both kidneys | bilateral.


Types of Wilms’ Tumor

Favorable Histology
Most common type
Cells look less aggressive
Very high cure rate

Unfavorable Histology | Anaplastic
More abnormal, fast-growing cells
Harder to treat
Requires more intensive therapy


1. Signs and Symptoms

Abdominal swelling or a firm lump
Abdominal pain
Blood in urine | hematuria
Fever
Nausea and vomiting
Loss of appetite
High blood pressure
Fatigue or weakness

Parents often notice a swelling in the child's belly during bathing or dressing.


2. Causes and Risk Factors

Family history of Wilms’ tumor

Genetic syndromes, including:
WAGR Syndrome
Denys-Drash Syndrome
Beckwith-Wiedemann Syndrome

Birth defects, such as:
One kidney instead of two
Enlarged kidneys
Abnormal development of urinary tract

Wilms’ tumor is not caused by anything the parents did.


3. Diagnostic Procedure

Medical History & Physical Exam
Swelling or mass in the abdomen
Blood pressure check
General symptoms assessment

Imaging Tests
Ultrasound:
First test to detect kidney mass

CT Scan / MRI:
Determines tumor size & spread

Chest X-ray/CT:
Checks if cancer spread to lungs | metastasis

Lab Tests
Blood tests:
Kidney function, anemia

Urine tests:
Blood or abnormal proteins

Biopsy or Surgery

In many cases, surgeons remove the tumor/kidney before biopsy because imaging is very accurate for Wilms’ tumor.

Biopsy confirms histology
Determines favorable vs. unfavorable


4. Staging

Stage I ➧ Limited to one kidney, fully removable
Stage II ➧ Spread beyond kidney but removable
Stage III ➧ Tumor left behind after surgery
Stage IV ➧ Spread to lungs, liver, bone, or brain
Stage V ➧ Tumors in both kidneys


5. Treatment Options

Surgery

Nephrectomy:
Removal of one kidney

Partial nephrectomy:
If both kidneys have tumors

Removes tumor and helps determine staging

Chemotherapy

Common regimens:
Vincristine
Actinomycin-D | Dactinomycin
Doxorubicin | for higher stages

May be given:
Before surgery | to shrink tumor
After surgery | to kill remaining cells

Radiation Therapy

Advanced stages | III & IV
Unfavorable histology
Residual disease after surgery

Treatment for Bilateral Wilms’ Tumor

Pre-surgery chemotherapy to shrink tumors
Kidney-sparing surgery
Goal: remove cancer while preserving kidney function


6. Preferred Nutrition for Patients

Protein-rich foods:
chicken, eggs, yogurt, beans

Fruits & vegetables:
antioxidants aid recovery

Whole grains:
oatmeal, rice, pasta

Healthy fats:
avocado, olive oil, nuts

Hydration:
water, herbal teas, soups

Small, frequent meals
to manage nausea.


7. Follow-Up and Monitoring

Children require long-term follow-up to monitor

Kidney function
Growth & development
Heart health
Tumor recurrence

Follow-up usually continues for years after treatment.