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Treating Wilms Tumor

If your child has been diagnosed with a Wilms tumor, your child's treatment team will discuss the options with you. It’s important to weigh the benefits of each treatment option against the possible risks and side effects.

How is Wilms tumor treated?

Overall, about 9 of 10 children with Wilms tumors are cured. A great deal of progress has been made in treating this disease in recent decades. Much of this progress is the result of children with Wilms tumors taking part in clinical trials of new treatments. 

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.

Most children with Wilms tumors will get more than one type of treatment. The main types of treatment are:

Common treatment approaches

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 approaches.

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

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

Who treats Wilms tumors?

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 typically treated by a team of specialists. The doctors on this team often include:

  • pediatric surgeon or pediatric urologist (a surgeon who treats urinary system problems in children [and genital problems in boys])
  • pediatric oncologist (a doctor who uses chemotherapy and other medicines to treat childhood cancers)
  • pediatric radiation oncologist (a 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, nurses, nurse practitioners (NPs), physician assistants (PAs), psychologists, social workers, rehabilitation specialists, and other health professionals.

Making treatment decisions

The treatment for Wilms tumors can often be effective, but it can also cause serious side effects. It’s important to discuss all treatment options as well as their possible side effects with your child’s doctors so you can make an informed decision.

The treatment team will also help you take care of side effects and can help you work closely with nutritionists, psychologists, social workers, and other professionals to understand and deal with medical problems, stress, and other issues related to the treatment.

If time allows, getting a second opinion from another doctor experienced with your child’s type of cancer is often a good idea. This can give you more information and help you feel more confident about the treatment plan you choose. If you aren’t sure where to go for a second opinion, ask your doctor for help.

Thinking about taking part in a clinical trial

Today, most children and teens with cancer are treated at specialized children’s cancer centers. These centers offer the most up-to-date-treatment by conducting clinical trials (studies of promising new therapies). Children’s cancer centers often conduct many clinical trials at any one time, and in fact most children treated at these centers take part in a clinical trial as part of their treatment.

Clinical trials are one way to get state-of-the art cancer treatment. Sometimes they may be the only way to get access to newer treatments (although there is no guarantee that newer treatments will be better). They are also the best way for doctors to learn better methods to treat these cancers. Still, they might not be right for everyone.

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

Considering complementary and alternative methods

You may hear about alternative or complementary methods that your doctor hasn’t mentioned to treat your child's tumor 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 your regular medical care. Alternative treatments are used instead of standard medical treatment. Although some of these methods might be helpful in relieving symptoms or helping people feel better, many have not been proven to work. Some might even be harmful.

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. 

Preparing for treatment

Before treatment, the doctors and other members of the team will help you, as a parent, understand the tests that will need to be done. The team’s social worker will also counsel you about the problems you and your child might have during and after treatments such as surgery, and might be able to help you find housing and financial aid if needed.

Help getting through cancer treatment

Your child's 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 can also be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help. For children and teens with cancer and their families, other specialists can be an important part of care as well. 

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 your cancer care team any questions you may have about your treatment options.