Treating Wilms Tumor

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 on this, see 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 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.

Thinking about taking part in a clinical trial

Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the art cancer treatment. In some cases, they may be the only way to get access to newer treatments. They are also the best way for doctors to learn better methods to treat cancer. Still, they are not right for everyone.

If you would like to learn more about clinical trials that might be right for your child, start by asking the doctor if your clinic or hospital conducts clinical trials. See Clinical Trials to learn more.

Considering complementary and alternative methods

You may hear about alternative or complementary methods that your doctor hasn’t mentioned to treat your child's cancer or relieve symptoms. These methods can include vitamins, herbs, and special diets, or other methods such as acupuncture or massage, to name a few.

Complementary methods refer to treatments that are used along with regular medical care. Alternative treatments are used instead of a doctor’s medical treatment. Although some of these methods might be helpful in relieving symptoms or helping your child feel better, many have not been proven to work. Some might even be dangerous.

Be sure to talk to your child's cancer care team about any method you are thinking about using. They can help you learn what is known (or not known) about the method, which can help you make an informed decision. 

Help getting through cancer treatment

The cancer care team will be your first source of information and support, but there are other resources for help when you need it. Hospital- or clinic-based support services are an important part of your child's care and your care, too. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help.

The American Cancer Society also has programs and services – including rides to treatment, lodging, and more – to help you get through treatment. Call our National Cancer Information Center at 1-800-227-2345 and speak with one of our trained specialists.

The treatment information given here is not official policy of the American Cancer 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.