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Chemotherapy (“chemo”) is the use of drugs to kill cancer cells. The drugs are given into a vein or by mouth (in pill form). Once the drugs enter the bloodstream, they go throughout the whole body. This makes chemo especially useful for cancer that might have spread beyond the kidney.

Most children with Wilms tumors will get chemo at some point during their treatment. In the United States it is usually given after surgery. Sometimes it may be needed before surgery to shrink a tumor to make the operation possible.

Chemo drugs are given in different combinations and strengths and at different times, depending on the stage of the tumor and the child's age. They are usually given by a nurse in the doctor's office or in the outpatient section of the hospital. In some cases, children with Wilms tumors stay in the hospital while they are getting chemo, but usually this is not needed.

Possible side effects of chemo

These drugs can have some side effects, depending on the type of drugs, how much is given, and how long they are given. Short-term side effects could include:

  • Nausea and vomiting
  • Not wanting to eat (loss of appetite)
  • Mouth sores and pain
  • Diarrhea or constipation
  • Weakness, tingling, numbness in the arms and legs
  • Hair loss (the hair grows back after treatment ends)
  • An increased chance of infection (from a shortage of white blood cells)
  • Bleeding or bruising after minor cuts or injuries (from a shortage of blood platelets)
  • Tiredness or shortness of breath (from low red blood cell counts)

These side effects tend to go away when treatment is over, but be sure and talk to the doctor if your child has problems. Often there are ways to help. For example, there are drugs that can be taken at the same time as the chemo to lessen or prevent nausea and vomiting.

Long-term side effects: The possible long-term effects of treatment can be a major challenge facing children after cancer treatment. For instance, if your child is given doxorubicin (Adriamycin®), there is a chance it could damage his or her heart. Your child's doctor will carefully watch the doses used and will check your child's heart function. Chemo can also increase your child's risk of getting a second type of cancer in the future. But the importance of treating Wilms tumor far outweighs these risks. See the section, “Moving on after treatment” for more on the possible long-term effects of treatment.

To learn more about chemo, see the American Cancer Society document, Understanding Chemotherapy: A Guide for Patients and Families.

Last Medical Review: 08/01/2012
Last Revised: 08/01/2012