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Chemotherapy (chemo) is the use of drugs to treat cancer. These drugs enter the blood and reach all areas of the body, which makes this treatment useful for cancer that has spread or might have spread beyond the kidney.
Most children with Wilms tumors will get chemo at some point during their treatment. (Some children with very low risk tumors might not need it.)
In the United States, chemo is usually given after surgery. Sometimes it may be needed before surgery to shrink a tumor to make the operation possible. In Europe, chemo is given before surgery and continued afterward. In both cases, the type and amount of chemo depend on the stage and histology of the cancer.
A combination of chemo drugs is used to treat children with Wilms tumors. The chemo drugs used most often are:
For tumors at more advanced stages, those with anaplastic histology, or tumors that recur (come back) after treatment, other drugs might also be used, such as:
Different drugs, doses, and lengths of treatment are used, depending on the type and stage of the Wilms tumor and the child’s age. Most often, the drugs are given once a week for at least several months.
Chemo is usually given by a nurse in the doctor’s office or in the outpatient section of the hospital. Some children with Wilms tumors might need to stay in the hospital while they are getting chemo, but usually this is not needed.
Chemo drugs can affect cells other than cancer cells, which can lead to side effects.
The side effects of chemo depend on the types and doses of drugs used, and the length of treatment. Possible short-term side effects can include:
Your child’s doctor and treating team will watch closely for any side effects that develop. There are often ways to lessen these side effects. For example, drugs can be given to help prevent or reduce nausea and vomiting. Be sure to ask your child’s doctor or nurse about medicines to help reduce side effects, and let them know if your child has side effects so they can be managed.
Along with the effects listed above, some drugs can have specific side effects. For example:
Before each chemo session, your child’s doctor will get blood tests to check blood cell levels and to see how well the liver and kidneys are working. If there are problems, chemo might need to be delayed or the doses reduced.
Possible long-term effects of treatment are one of the major challenges children might face after cancer treatment. For example:
See Living as a Wilms Tumor Survivor for more on the possible long-term effects of treatment.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Chintagumpala M, Muscal JA. Treatment and prognosis of Wilms tumor. UpToDate. Accessed at www.uptodate.com/contents/presentation-diagnosis-and-staging-of-wilms-tumor on September 4, 2018.
Fernandez CV, Geller JI, Ehrlich PF, et al. Chapter 29: Renal Tumors. In: Pizzo PA, Poplack DG, eds. Principles and Practice of Pediatric Oncology. 7th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2016.
National Cancer Institute. Wilms Tumor and Other Childhood Kidney Tumors Treatment (PDQ®). 2018. Accessed at www.cancer.gov/types/kidney/hp/wilms-treatment-pdq on September 4, 2018.
Last Revised: October 17, 2018