Wilms Tumor

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Treating Wilms Tumor TOPICS

How is Wilms tumor treated?

This information represents the views of the doctors and nurses serving on the American Cancer Society’s Cancer Information Database Editorial Board. These views are based on their interpretation of studies published in medical journals, as well as their own professional experience.
The treatment information in this document is not official policy of the Society and is not intended as medical advice to replace the expertise and judgment of your cancer care team. It is intended to help you and your family make informed decisions, together with your doctor.
Your doctor may have reasons for suggesting a treatment plan different from these general treatment options. Don’t hesitate to ask him or her questions about your treatment options.

General treatment information

Overall, about 9 of 10 children with Wilms tumor are cured. A great deal of progress has been made in treating this disease. Much of this progress in the United States has been because of the work of the National Wilms Tumor Study Group (now part of the Children’s Oncology Group), which runs clinical trials of new treatments for children with Wilms tumor. Today, most children with this cancer are treated in a clinical trial to try to improve on what doctors believe is the best treatment. The goal of these studies is to find ways to cure as many children as possible while limiting side effects by giving as little treatment as needed.

Because Wilms tumors are rare, few doctors outside of those in children’s cancer centers have much experience in treating them. Children with Wilms tumors are treated with a team approach that includes the child’s pediatrician as well as specialists at a child’s cancer center. For Wilms tumors, the doctors on this team often include:

  • A pediatric surgeon or pediatric urologist (doctor who treats urinary system problems in children [and genital problems in boys])
  • A pediatric oncologist (doctor who uses chemotherapy and other medicines to treat childhood cancers)
  • A pediatric radiation oncologist (doctor who uses radiation therapy to treat cancer in children)

Many other specialists may be involved in your child’s care as well, including other doctors, physician assistants (PAs), nurse practitioners (NPs), nurses, psychologists, social workers, rehabilitation specialists, and other health professionals. Having a child go through cancer treatment often means meeting lots of specialists and learning about parts of the medical system you probably haven’t been exposed to before. For more information, see our document Children Diagnosed With Cancer: Understanding the Health Care System.

After your child’s tumor is found and its stage and histology are determined, the cancer care team will discuss treatment options with you. It’s important to discuss all of the options as well as their possible side effects with your child’s doctors so you can make an informed decision. (For a list of some questions to ask, see the section “What should you ask your child’s doctor about Wilms tumor?”)

If time allows, it can often be helpful to get a second opinion if you have questions about the recommended plan (or if you just want to confirm that it’s the best option). This can provide you with more information and help you feel more confident about the treatment plan you choose.

The main types of treatment for Wilms tumor are:

Most children will get more than one type of treatment.

In the United States, surgery is the first treatment for most Wilms tumors. In Europe, doctors often prefer to give a short course of chemotherapy before the surgery. There seems to be no difference in the results from these 2 approaches.

The first goal of treatment is to remove the primary (main) tumor, even if the cancer has spread to distant parts of the body. Sometimes the tumor might be hard to remove because it is very large, it has spread into nearby blood vessels or other vital structures, or it’s in both kidneys. For these children, doctors might use chemotherapy, radiation therapy, or a combination of the 2 to try to shrink the tumor(s) before surgery.

If any cancer is left after surgery, radiation therapy or more surgery may be needed.

The most common approaches used for these tumors, based on the tumor stage (extent) and histology (appearance under a microscope), are discussed in a separate section.

Last Medical Review: 03/06/2015
Last Revised: 03/19/2015