1. What is wilms’ tumour?
Wilms’ tumour is a type of kidney cancer in children. It often affects children under the age of 5.
2. What are the causes of Wilms tumour?
In most children, the cause of Wilms’ tumour is unknown. Very rarely, people who develop Wilms’ tumour have other specific conditions, which are present at birth. These include absence of the iris in the eye (aniridia), and a condition where one side of the body is slightly larger than the other (hemihypertrophy). In 1 in 100 people with Wilms’ tumour, another family member may also has Wilms’ tumour.
3. What are the signs and symptoms of Wilm’s tumour?
The most common symptom is a swollen abdomen, which is usually painless. Sometimes parents may feel a lump in the abdomen. Rarely, the tumour may bleed slightly which may lead to pain in the abdomen. There may be blood in your child’s urine, or their blood pressure may be raised. The child may also have upset stomach, a lack of appetite or weight loss.
4. How wilm’s tumour is diagnosed?
A variety of tests and investigations are needed to diagnose a Wilms’ tumour.The most useful and easy to-do investigation is the ultrasound scan of the abdomen.The most important test to confirm a diagnosis of wilm’s tumour is a biopsy. Urine and blood samples will also be taken to check your child’s kidney function and general health.
5. What is a biopsy test ?
A biopsy is a procedure where a sample of the swelling is removed and its cells are looked at under a microscope. It is s a small operation, which is done under general anaesthesia
6. What does the stage of the cancer mean?
The stage of a cancer describes its size and whether it has spread beyond its original site. Knowing the stage of the cancer helps doctors decide on the most appropriate treatment.ന്നത്.
7. What are the staging investigations in the case of wilms tumor?
Once wilms tumor is confirmed, your doctor will suggest a few tests including a detailed scanning of the abdomen and chest. These tests will help your doctor identify exactly where the tumour is and whether it has spread beyond the kidney. These are known as staging investigations, which include x-rays, blood tests, CT, and MRI.
8. What are the available treatments for wilm’s tumour?
Treatment of wilms tumor includes chemotherapy, radiotherapy and surgery. This will depend on a number of factors including, how the cells appear under the microscope (histology) and the stage of the tumour.
Surgery
All children with Wilms’ tumour will have surgery. Initially, this may involve taking only a small sample of cells from the tumour to confirm the diagnosis. This is called a biopsy and is done usually under general anesthesia , using a needle inserted through the skin. At some stage the entire tumour is removed. Sometimes, the whole kidney is removed along with the tumour . Most children can live normally with one kidney remaining . In some hospitals patients will receive chemotherapy before having a bigger operation to remove the entire tumour.
Chemotherapy
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It’s usually given as an injection or drip into a vein (intravenously). This chemotherapy may be given as inpatient or outpatient depending on the tumour staging
Chemotherapy given before surgery is called ‘pre-operative’ chemotherapy. This is done to destroy the cancer cells and reduce the size of the tumour before suregery. Depending on the stage and type of tumour, additional chemotherapy may be given . This helps reduce the risk of the cancer coming back (recurring).
Radiotherapy
Radiotherapy treats cancer by using high-energy rays to destroy the cancer cells. All children with Wilms’ tumour do not need radiotherapy. It depends on the stage of the tumour at diagnosis. Radiotherapy can also be used when tumors have spread elsewhere in the body including the chest.
9. What is the treatment for wilm’s tumour affecting both kidneys?
In about 1 in 20 cases, Wilms’ tumour affects both kidneys. Treatment usually involves surgery. The aim of the treatment is to remove as much cancer as possible, while leaving as much healthy kidney as possible. Chemotherapy is always given as part of the treatment and sometimes radiotherapy is needed to improve the outcome.
10. What are the late effect seen in children who survived kidney tumors?
The cure rate for wilm’s tumour is very high, however some children may develop side effects many years after treatment. These include a possible reduction in bone growth, a change in the way the heart and lungs work, and a slight increased risk of developing another cancer in later life. Infertility is a possible late side effect, although rare. It depends on the type of treatment your child received. When your child completes their treatment, they should then go for regular follow ups There will be occasional scans, x-rays, and blood tests done for several years after completing the treatment, to detect early or any late effects of the cancer treatment. Regular follow ups, X rays and scaling may also help doctors to identify if the cancer is coming back early on
11. What are the treatments available if wilm’s tumour has come back after treatment?
The cure rate of wilm’s tumour is very high. Therefore It is very rare that it would come back after treatment. If the cancer comes back, a different course of treatment is available, which can be given.
