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.

The first part of this section describes the types of treatments used for Wilms tumors. This is followed by a description of the most common approaches used for these tumors based on the tumor stage (extent) and histology (appearance under a microscope).

General comments about treatment

Overall, about 9 out of 10 children with Wilms tumor are cured. A great deal of progress has been made in treating this disease with surgery, radiation therapy, and chemotherapy. 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 organizes clinical trials of new treatments for most children with Wilms tumor. Today, most children with this cancer are treated in a clinical trial to try and improve on what doctors believe is the best treatment.

After your child's Wilms tumor is found and its stage and histology are determined, your cancer care team will suggest a treatment plan. It is important that you take time and think about all of your options.

Because Wilms tumor is rare, few doctors outside of those in children's cancer centers have much experience in treating them. Most doctors recommend a team approach that includes the child's pediatrician as well as specialists at a child's cancer center. You can often get a second opinion, but you should do it quickly because Wilms tumors are usually very large and tend to grow fast.

Treatment for Wilms tumor is usually surgery, chemotherapy, and sometimes radiation therapy. If any cancer cells are left after the first operation, radiation therapy or more surgery may be needed. The first goal of treatment is to remove the primary tumor even if the cancer has spread to distant parts of the body (metastasis). Sometimes the tumor may be hard to remove. It may be very large, it may have spread into nearby blood vessels or other vital structures, or it may be in both kidneys. In these children, doctors might use chemotherapy, radiation therapy, or a combination of the 2 to shrink the tumor before trying to remove it.

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

Last Medical Review: 09/14/2009
Last Revised: 09/14/2009