The Wilms tumor is a rare type of rare kidney cancer that particularly affects children. It is also known as nefroblastoma and is the most common kidney cancer in children. The disease affects, especially children, 3, 4 years old and becomes much less frequent after the age of 5 years.
Tumor Wilms occurs most often in one kidney, although sometimes it can be diagnosed in both kidneys simultaneously.
Experts say the Wilms tumor is caused by the loss or inactivation of a tumor suppressor gene called QT1 on chromosome 11. Tumor suppressor genes generally hinder tumor growth and control cell growth.
The diagnosis and treatment of children with the Wilms tumor has improved over the past decade, so the prognosis for children with this disease is a good one.
Causes leading to the Wilms tumor
Cases of children with Wilms tumors represent 6% of total solid tumors and 95% of kidney malign tumors. There is no known cause of the tumor, but experts believe that cancer probably begins to form when the baby is still in the uterus due to the fact that some kidney cells do not develop properly. Abnormal cells multiply in their primitive condition and form a tumor, which is usually detectable at the age of three, four years.
Family history. Some cases of Wilms tumor may be caused by a genetically defective genetic defect from a parent. There are two transmission-related genes, namely WT1 and WT2, and specialists do not rule out the possibility of chromosomal mutations. However, less than 2% of children suffering from this disease have a close relative who has the affection.
Symptoms of the Wilms tumor
Children suffering from this disease may not always have symptoms, but when they exist, they include:
- General discomfort (general malaise)
- Loss of appetite
- Swelling of the abdomen
Diagnosis of the Wilms tumor
For Wilms tumor diagnosis, the physician can perform a series of analyzes such as:
Blood and urine tests. Blood tests can not detect the Wilms tumor but can provide a general report on the general health of the baby.
Imaging tests. Imaging tests create kidney images, whereby the doctor can determine if there is a kidney tumor. Imaging tests may include ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI).
Biopsy. If the kid has a kidney tumor, the doctor will extract a tissue sample to analyze it and determine if the tumor is cancerous. Remote tissue is also analyzed to determine what cell types are involved.
Stages of the Wilms tumor
Stage I. - Cancer is present in only one kidney, and can generally be completely eliminated by surgery.
Stage II - Cancer has spread to the tissues and structures near the kidneys, but can still be completely removed by surgery.
Stage III. - Cancer has spread beyond the kidney and nearby lymph nodes, and can not be completely eliminated by surgery.
Stage IV. - Cancer has spread to distant structures such as lungs, liver, bones or brain.
Stage V. - Cancer cells are in both kidneys
Wilms tumor treatment
It is the doctor who chooses the treatment according to the stage of the child's illness.
- Surgical treatment. Surgical removal of kidney tissue is called nephrectomy. The doctor may perform:
- Simple nephrectomy. In this case, the surgeon removes the entire kidney and the second kidney can take over the entire blood filtration task.
- Partial nephrectomy. Involves the removal of the tumor and of a piece of tissue surrounding the kidney.
- Total nephrectomy. In this type of surgery, doctors remove the kidney and surrounding tissues, including the adrenal gland. Nearby lymph nodes may also be removed.
- Chemotherapy - Chemotherapy uses drugs to destroy cancer cells all over the body. This treatment affects both cancer cells and healthy cells. As a result, these medicines may have side effects such as nausea, vomiting, loss of appetite, hair loss. Most side effects will blur after the treatment is stopped.
- Radiation therapy - Radiation uses radiation to destroy cancer cells. Possible side effects include nausea, tiredness, skin irritation, or diarrhea.
Treatment regimens vary depending on the Wilms tumor stage
Stage I or II cancer. If the cancer is limited to kidneys or nearby structures, the child will undergo a procedure to remove the affected kidney as well as some tissues and lymph nodes near the kidney, after which chemotherapy or radiation will be performed.
Stage III or IV cancer. If the cancer has spread to the abdomen and can not be completely eliminated, the radiation will be included in the treatment schedule along with surgery and chemotherapy.
Stage V of cancer. If the tumor cells are in both kidneys, part of the kidney from both kidneys will be surgically removed and chemotherapy will be used to shrink the rest. Surgery is repeated to remove the tumor as much as possible after which chemotherapy and radiation are again applied.
The Wilms tumor can not be prevented, but as it is discovered earlier, the chances of recovery are greater.
Because the child's age is rather small, parents will have to explain to the child what is happening, in his understanding. It is also recommended that parents accompany children during the testing and treatment period.
Include playtime during treatment and make a daily record of your child's status once you get home, note your body temperature, energy level, sleep times, medications administered and side effects.
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