Wilms tumour is a highly curable tumour in most children. Several factors are known to influence treatment for Wilms tumour. Your doctor will decide the type of treatment based on:
- Patient factors such as age, overall health and medical history.
- Stage of cancer (the size of the tumor and metastasis to other organs).
- Grade of tumor (how abnormal or malignant the cancer cells appear and the rate at which the cells grow and spread).
- Child's tolerance for different therapies (medications, procedures etc).
- Prognosis of the disease.
- Your personal preference.
Standard treatment options for Wilms tumour include:
- Radiation therapy.
Surgery: Surgery to remove the kidney (also called nephrectomy) is the primary mode of treatment for almost all stages of Wilms tumour. Various types of surgery are done for Wilms tumour. The type of surgery that your child will need will be determined by the stage of cancer. The different surgeries done for this tumour include:
- Simple nephrectomy: The entire kidney is removed during this surgery. The other kidney has the ability to increase its function to take over the entire job of filtering the blood.
- Partial nephrectomy: In this procedure, the tumor and part of the kidney tissue surrounding it are removed. It's usually reserved for cases in which the other kidney is damaged or has already been removed.
- Radical nephrectomy: The entire kidney and surrounding tissues, including the ureter and adrenal gland, and neighboring lymph nodes are removed during this surgery.
When surgery is done, the doctor will examine both the kidneys and the abdominal cavity to look for evidence of spread of cancer. Samples for pathological examination are taken from kidney, lymph nodes and any tissues that appear abnormal. Tissue samples are sent to the laboratory for pathological examination under a microscope to identify cancer cells. If both kidneys have cancer, they will have to be removed. After the surgery, your child will be put on dialysis until he or she undergoes a transplant.
Chemotherapy: Chemotherapy uses medications, also known as "anti-cancer" drugs or "anti neoplastics", to destroy the cancer cells or treat cancer. Cancer cells tend to divide rapidly; the anticancer or antineoplastic drugs attack and kill cells that divide quickly. Healthy cells of the body are also harmed, especially those that divide quickly such as bone marrow, the lining of the mouth and intestines, and hair follicles. Injury to healthy cells causes side effects such as nausea, vomiting, loss of appetite, hair loss and low white blood cell counts when chemotherapy is given. The doctor will prescribe medications to treat side effects as required. During chemotherapy, you may be given one, two or more drugs in combination. These medications may be given orally or through your veins (intravenously). The doctor will decide the medications and the dose that is needed for the treatment based on factors such as the stage of cancer, age of the child etc.
Radiation therapy: Radiation therapy, also called radiotherapy, uses high-powered energy beams (X-rays or other energy beams) to destroy cancer cells and shrink tumours. Radiation therapy is usually given in the affected area to treat or destroy cancer cells. Most cases receive radiation within a few days after surgery to kill any remaining cancer cells. Most cases with Wilms' tumour are treated with surgery and chemotherapy. The stage of the tumour and how abnormal or malignant the cancer cells appear on biopsy will determine whether your child needs radiation therapy or not.
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