There are many types of childhood cancer with different symptoms and treatments. Childhood cancer survival rates in the United States have increased from less than 20 percent in the 1960s to almost 80 percent today. Parents are the best advocates for their children so being informed will help guide a family to make the best decisions for the child battling cancer.
Wilms’ tumor, also known as nephroblastoma, is a rare form of kidney cancer that affects young children. About 500 cases are diagnosed each year, generally at two to five years of age. If diagnosed and treated early, up to 95% of Wilms’ tumor cases are curable.
Wilms tumor is a cancer that starts in one, or rarely, both kidneys. It can show up as a swelling or lump in the belly (abdomen). Sometimes the child may have other symptoms, such as fever, pain, or poor appetite. Wilms tumor accounts for about 5% of childhood cancers.
The stage is set for Wilms’ tumor in the womb. As kidney cells mature in the fetus, they become specialized and form different regions of the kidney. Some of these cells are still immature at birth and continue to develop over the first three or four years of life. In Wilms’ tumor, however, the cells remain immature and begin to reproduce rapidly, forming a mass that can grow quite large before it produces any symptoms.
In addition to the stages, Wilms tumors are described by their histology.
The histology (how the cells look under a microscope) of the tumor affects the prognosis and the treatment of Wilms tumor. The histology may be favorable or anaplastic (unfavorable). Tumors with a favorable histology have a better prognosis and respond better to chemotherapy than those with anaplastic histology. Tumor cells that are anaplastic divide rapidly and do not look like the type of cells they came from. Anaplastic tumors are harder to treat with chemotherapy than other Wilms tumors at the same stage.
The most common and noticeable symptom of Wilms’ tumor is a hard lump or mass in the stomach area, easily felt through the skin. Less frequent symptoms include:
Standard Wilms Tumor Treatment (additional new types of treatments are being tested in clinical trials and can be found on the NCI Web site): The treatments listed below are to be used as a suggestion of what you may expect. Please speak with your doctor about specific treatment plans he or she may have for your child.
In addition, new types of treatments are often being tested in clinical trials and can be found on the National Cancer Institute Website.
The following stages are used for both favorable histology and anaplastic Wilms tumors:
In stage I, the tumor was completely removed by surgery and all of the following are true:
* Cancer was found only in the kidney and did not spread to blood vessels of the kidney.
* The outer layer of the kidney did not break open.
* The tumor did not break open.
* A biopsy of the tumor was not done.
* No cancer cells were found at the edges of the area where the tumor was removed.
In stage II, the tumor was completely removed by surgery and no cancer cells were found at the edges of the area where the cancer was removed. Before the tumor was removed, one of the following was true:
* Cancer had spread out of the kidney to nearby soft tissue.
* Cancer had spread to blood vessels of the kidney.
In stage III, cancer remains in the abdomen after surgery and at least one of the following is true:
* Cancer spread to lymph nodes in the abdomen or pelvis (the part of the body between the hips).
* Cancer spread to or through the surface of the peritoneum (the layer of tissue that lines the abdominal cavity and covers most organs in the abdomen).
* Chemotherapy was given before surgery and a biopsy of the tumor was done during surgery to remove it.
* The tumor broke open before or during surgery to remove it.
* The tumor was removed in more than one piece.
In stage IV, cancer has spread through the blood to organs such as the lungs, liver, bone, or brain, or to lymph nodes outside of the abdomen and pelvis.
Stage V and those at high risk of developing Wilms tumor
In stage V, cancer cells are found in both kidneys when the disease is first diagnosed.
MD Anderson Childhood Cancer Types. Houston, TX: MD Anderson. Retrieved August 15, 2011 from http://www.mdanderson.org/patient-and-cancer-information/
National Institute of Health. Types of Cancers 2011. Retrieved September 13, 2011 from http://www.cancer.gov/cancertopics/pdq/treatment
American Cancer Society. Cancer Facts and Figures 2009. Atlanta, GA: American Cancer Society. Retrieved September 1, 2011, from http://www.cancer.org/downloads/STT/CAFF2009PWSecured.pdf.
You must be logged in to post a comment.
Sign up to comment in the forums, on posts, and receive our newsletters.