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Wilms tumour

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Treatments for Wilms tumour

The healthcare team will create a treatment plan just for your child with Wilms tumour. It will be based on the child’s needs and may include a combination of different treatments. When deciding which treatments to offer for Wilms tumour, the healthcare team will consider the:

  • type of Wilms tumour – if it is favourable histology or unfavourable (anaplastic) histology
  • stage of the tumour
  • child’s age
  • child’s overall health
  • chromosome changes

Treatment options for Wilms tumour

There are 2 main approaches to treating children with Wilms tumour. Each approach has pros and cons.

In North America, the standard approach of the Children’s Oncology Group (COG) is to remove the affected kidney (called nephrectomy) at diagnosis, if possible. If the kidney can’t be removed, then a biopsy is usually done. After surgery to remove the kidney or biopsy, doctors will examine tumour cells to confirm the histology and look for chromosome changes. They give the tumour a stage based on imaging tests and how the tumour cells look and act when examined under a microscope. They use this information to plan treatment. Doctors will decide to give chemotherapy, radiation therapy or both based on the tumour’s histology and stage.

The European approach is to diagnose kidney tumours based on imaging studies. Most kidney tumours are treated with chemotherapy, and then the affected kidney is removed later (usually following 6 weeks of chemotherapy). Further treatment after surgery to remove the kidney is based on the tumour’s stage and how it has responded to chemotherapy.

In Canada, doctors follow the North American COG approach. Treatment for Wilms tumour includes the following.

Surgery

Surgery is the main treatment for Wilms tumour. Surgery may involve radical nephrectomy or sometimes partial nephrectomy. Chemotherapy or radiation therapy may be used along with surgery.

Chemotherapy

Chemotherapy is usually used to treat Wilms tumour. It usually includes different combinations of drugs. Chemotherapy may be used:

  • after surgery to prevent recurrence (called adjuvant therapy)
  • before surgery (called neoadjuvant therapy) for tumours that cannot be removed completely
  • to treat advanced tumours

Radiation therapy

Radiation therapy is sometimes used to treat Wilms tumour. Radiation therapy may be used:

  • after surgery to prevent recurrence (called adjuvant therapy)
  • before surgery (called neoadjuvant therapy) for tumours that cannot be removed completely
  • to treat advanced tumours

Follow-up care

Follow-up after treatment is finished allows the healthcare team to watch for a possible recurrence of Wilms tumour and for any late effects of treatment. Children with Wilms tumour should have regular follow-up visits, especially in the first 5 years after treatment. Children who have radiation therapy or some types of chemotherapy for Wilms tumour may need life-long follow-up.

Clinical trials

Clinical trials look at new and better ways to prevent, find and treat cancer. Wilms tumour is rare. Many children with this cancer will be offered treatment in a clinical trial. Find out more about clinical trials.

Questions to ask about treatment

To make the decisions that are right for your child, ask the healthcare team questions about treatment.

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