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According to the American Cancer Society, about 500 children, most between ages 2 and 5, are diagnosed with Wilms' tumor each year in this country. While it is rare, it is the most common type of kidney cancer in children.
Problems that cause Wilms' tumor may begin before birth. As kidney cells mature in the fetus, they become specialized and form different parts of the kidney. Some of the cells continue developing after birth and mature over the next three or four years.
However, in children with Wilms' tumor, the cells remain immature. They begin to grow and reproduce too quickly, forming a tumor.
Wilms' tumor generally forms one tumor in one kidney. In rare cases, there may be more than one tumor in one kidney or tumors in both kidneys.
Because they grow rapidly and often don't have early symptoms, Wilms' tumors may be large when they are found. Sometimes they spread to other parts of the body, particularly the lungs.
Types of Wilms' tumors
Wilms' tumors can be classified into two categories depending on how they appear when they are examined with a microscope.
Favorable histology: Almost all Wilms' tumors are this type. The cells are slightly abnormal. Chances for successful treatment are good.
Unfavorable histology (anaplastic Wilms' tumor): The cell area that holds the DNA is large and distorted, or anaplastic. Anaplastic tumors are more difficult to treat successfully.
Wilms' Tumor risk factors
Anything that increases your child's chance of getting Wilms' tumor is a risk factor. Although we don't know exactly what causes Wilms' tumors, some things may make your child more likely to develop the disease.
Risk factors include:
- Age: Most children who develop Wilms' tumors are between 3 and 5 years old
- Race: Wilms' tumor is more common in African American children. It is least prevalent in Asian American children
- Gender: It is more common in females
- Birth defect syndromes, including:
- Other birth defects, including:
- Aniridia (complete or partial lack of the iris [colored area] of the eyes)
- Hemihypertrophy (an oversized arm and/or leg on one side of the body)
- Cryptorchidism (failure of the testicles to descend into the scrotum) in boys
- Hypospadias (defect in boys where the urinary opening is on the underside of the penis)
- Other genetic conditions, including:
- Perlman syndrome
- Sotos syndrome
- Simpson-Golabi-Behmel syndrome
- Bloom syndrome
- Li-Fraumeni syndrome
- Frasier syndrome
- Trisomy 18
Not everyone with risk factors gets Wilms' tumor. However, if your child has risk factors, you should discuss them with your doctor.
Research shows that some cancers can be prevented. Visit our Prevention site to learn more.
Symptoms of Wilms' tumor vary from child to child. Because tumors often grow large before they are discovered, the main symptom is a bloated or enlarged abdomen. A mass in the abdomen also might be notic
Other signs of Wilms' tumor include:
- Blood in the urine
- High blood pressure
- Stomach pain
- Loss of appetite
- Shortness of breath
- Recurring fever
If your child has these symptoms, they are probably caused by something less serious than Wilms' tumor. However, it's a good idea to talk to your child's doctor, as they may signal other health problems.
Wilms' tumors may be quite large when they are found. In fact, many Wilms' tumors are larger than the kidney where they developed. However, most Wilms' tumors are found before they spread to other organs.
At MD Anderson's Children's Cancer Hospital, our world-renowned specialists take the time to examine each child closely. Their high level of skill and expertise help them pinpoint Wilms' tumors, which can lead to better chances for successful treatment. They are supported by the very latest in leading-edge diagnostic technology.
If your child has symptoms that may indicate Wilms' tumor, the doctor will examine your child and ask you questions about your child's health and your family medical history.
One or more of the following tests may be used to find out if your child has Wilms' tumor and if it has spread. These tests also may be used to find out if treatment is working.
Imaging tests, which may include:
- CT or CAT (computed axial tomography) scans
- MRI (magnetic resonance imaging) scans
- PET (positron emission tomography) scans
- Bone scan
A biopsy is almost always needed to diagnose Wilms' tumor. Because surgery is required for Wilms' tumor treatment, the biopsy may be done at the same time as the surgery to remove the tumor.
Sometimes, doctors may remove cells to examine before doing surgery. If so, one of these methods may be used:
- Fine needle aspiration (FNA): A thin needle is inserted into the tumor to remove a small amount of tissue or fluid
- Core biopsy: Similar to FNA, but a thicker needle is used to remove small cylinder-shaped samples (cores)
- Surgical biopsy: Tissue is removed during an operation
Blood and urine tests
Getting a Second Opinion at Children’s Cancer Hospital
The experts at Children’s Cancer Hospital are highly specialized in diagnosing complex cancers, including Wilms’ tumor. We welcome the opportunity to provide second opinions for Wilms’ tumor.
Wilms' tumors are rare, and many cancer doctors see few – if any – cases throughout their careers. As part of one of the world's largest and most comprehensive cancer centers, MD Anderson'sChildren's Cancer Hospital has a level of expertise and experience that can be found at few hospitals in the nation.
Our highly specialized experts personalize care to deliver leading-edge therapies with the least impact on your child's body – now and in the future. They take a team approach to ensure your child has the best chances for successful treatment.
Focused on Your Child
This remarkable team may include renowned oncologists, surgical oncologists, radiation oncologists and pathologists, all of whom specialize in the unique medical needs of children with cancer. They are supported by a specially trained group of nurses, therapists and other professionals.
This group follows your child from diagnosis through survivorship, keeping a constant eye on your child's health and quality of life.
Surgical Expertise is Key
Surgical skill is of the utmost importance when treating Wilms' tumors. Like all surgeries, the procedure is most successful when performed by a specialist with a great deal of experience in the particular surgery.
Children's Cancer Hospital surgeons rank among the most skilled in the world. They have a high level of experience in Wilms' tumor surgeries, using the least-invasive and most-advanced techniques. We're at the forefront of discovering groundbreaking treatments for Wilms' tumor. This translates into a range of clinical trials for children with the disease.
Our Wilms' Tumor Treatments
Your child's doctor will design a course of treatment especially for your child and discuss suggestions for treatment. The age and health of your child and how advanced the cancer is will help determine the type of treatment.
Wilms' tumor is almost always treated with more than one type of treatment – usually surgery and chemotherapy. Sometimes chemotherapy or radiation therapy may be used to make the tumor smaller before surgery. If cancer cells remain after surgery, radiation therapy may be used.
One or more of the following approaches may be used to treat the cancer or help your child feel better.
The main goal of surgery to treat Wilms' tumor is to remove as much of the main tumor as possible. The kidney, ureter and adrenal glands will be removed as well. This surgery is called nephrectomy.
During surgery, the lymph nodes close to the kidney may be removed and examined for cancer cells. Nearby organs and the other kidney will be examined, and biopsies may be done.
Two types of nephrectomy are used to treat Wilms' tumor:
Radical nephrectomy: The most common surgery to treat Wilms' tumor. The entire kidney, along with surrounding tissue, is removed.
Partial nephrectomy (or kidney-sparing surgery): When Wilms' tumors are in both kidneys, this surgery may be done to save as much healthy tissue as possible. The cancer and some of the surrounding healthy tissue are removed.
Sometimes, both kidneys may need to be removed completely. If this is the case, your child will need dialysis (a machine is used to filter the blood) several times a week. A kidney transplant may be an option later.
Most children who are treated for Wilms' tumor will receive chemotherapy. If a tumor is large or difficult to reach, or if there are tumors in both kidneys, chemotherapy may be given before surgery to shrink the tumors and make them easier to remove.
Children's Cancer Hospital offers the most advanced chemotherapy agents.
Radiation therapy (also called radiotherapy) uses high-energy beams to destroy cancer cells. New radiation therapy techniques and remarkable skill allow Children's Cancer Hospital doctors to target tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.
- Children's Cancer Hospital provides the most advanced radiation treatments, including:
- 3D-conformal radiation therapy: Several radiation beams are given in the exact shape of the tumor
Intensity-modulated radiotherapy (IMRT): Treatment is tailored to the specific shape of the tumor
Our Clinical Trials
Because of our association with one of the world's premier cancer centers, Children's Cancer Hospital participates in many clinical trials (research studies) for Wilms' tumors. These include studies of the Children's Oncology Group, as well as clinical trials found at only a few institutions in the world. Sometimes these innovative treatments are your child's best option for treatment.
To find out more about clinical trials at Children's Cancer Hospital for Wilms' tumor, visit our Clinical Trials database or speak to your doctor.
Why choose MD Anderson for Wilms' tumor care?
MD Anderson's Children's Cancer Hospital is one of the nation's foremost treatment and research facilities for Wilms' tumors. When your child is a patient here, we customize a plan of action that includes the most advanced therapies with the least impact on the body.
Our renowned experts, including medical, surgical and radiation oncologists and pathologists, work as a highly specialized team to ensure your child receives the best opportunity for successful treatment. They are supported by a focused staff that includes nurses, physician assistants, therapists, social workers and others.
Personalized, expert treatments
This group of professionals follows your child from day one through survivorship. This continuity of care and close communication means comprehensive treatment and follow-up for your child.
Surgical expertise is important to Wilms' tumor treatment. The surgeons at Children's Cancer Hospital are among the best in the nation. They see a higher number of Wilms' tumor patients than most surgeons, giving them an incredible level of skill and expertise. This can make a big difference in the outcome of your child's treatment.
In addition, we offer a number of clinical trials of innovative agents. Some of them are available only at Children's Cancer Hospital. Our active research program is results oriented, evidenced by the fact that we discovered the first successful chemotherapy (vincristine) for children with inoperable Wilms' tumor.
Treating the whole child
Children's Cancer Hospital is designed just for children, with a full range of services and amenities that help make the child and family's experience as comfortable as possible. We go beyond medical care to deliver a comprehensive experience that treats the whole child.
And at Children's Cancer Hospital, your child benefits from the resources and expertise of one of the nation's top cancer centers.
Take it one day at a time and never give up.