How would you feel if you were bathing, dressing, or just holding your little one and felt a small lump on their stomach? That's really scary, isn't it? At times like these, we need to think about this condition called Wilms' tumor. Let's talk about it simply today.
What exactly is Wilms Tumor?
Simply put, Wilms tumor is a type of kidney cancer that occurs in young children. It accounts for about 90 percent of kidney cancers in children. Sometimes, Wilms tumor can occur together with other conditions that are present at birth. We call these ``congenital syndromes'' or a collection of conditions that are present at birth.
This is also called `(Wilms' tumor)` and `(nephroblastoma)`. Most often, there is only one tumor in one kidney. However, some children can have tumors in both kidneys `(bilateral),` or there can be more than one cancerous area in one kidney.
Who gets this the most?
This is a rare condition that affects adults. Wilms tumor is a cancer that mainly affects children under the age of 15. 95% of children with this disease are diagnosed before the age of 10.
Black children of African descent are at slightly higher risk. Asian children are at lower risk. Also, girls are slightly more likely to develop it than boys.
In a very small percentage of families, this has also been reported to be something that comes from genes.
How common is this condition?
In a country like America, it is said that about 500 new cases of Wilms tumor are reported every year. It is difficult to find exact statistics on how it is in Sri Lanka, but this is a cancer that can be seen among children.
What are the congenital syndromes that can be seen with Wilms tumor?
It is very rare for children with Wilms tumor to have other congenital conditions. But it can happen. Here are some of the main syndromes:
- Beckwith-Wiedemann syndrome: Children with this syndrome have a 5% to 10% risk of developing Wilms tumor. This is a condition in which parts of the body grow larger than normal. Sometimes one side of the body may be larger than the other.
- WAGR syndrome: Children with this syndrome have a 50% risk of developing Wilms' tumor (the W in the name stands for Wilms). This can cause partial loss of the iris (Aniridia), as well as genital and renal problems.
- Denys-Drash syndrome: Children with this combination of symptoms have a very high risk of developing Wilms tumor, up to 90%. This also causes problems with the genitals and kidneys.
What are the symptoms of a Wilms tumor?
Look for these signs in your child:
- A lump or a firmness/lump in the abdomen (belly). This lump or lump can sometimes be painful, but most of the time it is not painful.
- A stomach ache.
- Blood in the urine (hematuria).
- Fever.
- High blood pressure (hypertension). This can cause nosebleeds, headaches, and bloodshot eyes in the child.
If you have one or more of these symptoms , you should see a doctor immediately.
What causes Wilms tumor?
In fact, we still don't know exactly what causes Wilms' tumor. Although a very small number of people may have a genetic predisposition, it's not clear why it develops in most cases.
How is a Wilms tumor diagnosed (diagnosed)?
If you notice a lump in your baby's diaper area, or if the lump is causing you to use a larger diaper, your doctor may want to test for a Wilms tumor. These tumors can sometimes be larger than a kidney.
If your child has one of the syndromes we discussed earlier or a genetic problem, you can talk to your doctor and decide whether to continue testing.
The tests used to diagnose Wilms tumor are:
- Physical examination: During this, the doctor carefully palpates the child's abdomen.
- Imaging tests:
- Abdominal ultrasound scan.
- CT scan - This is often done by injecting a special liquid (contrast).
- The doctor may also do a chest X-ray or CT scan to see if the cancer has metastasized to the lungs.
- These imaging tests can help determine if your child has a tumor. They can also help differentiate between Wilms tumor and another type of kidney cancer.
- Blood and urine tests: These include liver function tests and blood clotting tests.
- Biopsy: This involves taking a small piece of tissue from the tumor and sending it to a lab for testing.
What do you need to know about cancer staging?
There are two ways to determine the stage of Wilms tumor, that is, how far the cancer has spread. This is called ``staging.'' The higher the number, the more extensive the cancer has spread.
Doctors in European countries use the International Society of Paediatric Oncology (SIOP) system. Doctors in the United States and Canada use the Children's Oncology Group (COG) system.
The one difference between these two methods is that in the COG method, the stage of the tumor is checked after surgery and before chemotherapy (anti-cancer drugs) is given. In the SIOP method, the surgery is done after chemotherapy and the stage is checked only after that.
The stages under the COG system are divided as follows:
- Stage I: The tumor is only in the child's kidney and can be completely removed with surgery.
- Stage II: The tumor has grown out of the kidney, but can be completely removed with surgery.
- Stage III: The tumor cannot be completely removed. Cancer cells remain in the child's stomach (abdominal cavity).
- Stage IV: The cancer has spread beyond the child's abdomen and pelvis to other areas, such as the lungs, liver, bones, and brain.
- Stage V: The tumor is in both kidneys (bilateral). In this stage, doctors look at the stage of both kidneys separately.
How is Wilms tumor treated?
Wilms' tumor is often treated with a combination of surgery and chemotherapy. Sometimes radiation therapy may also be used.
Children with low-risk tumors, where the cancer has not spread and the tumor can be completely removed, may be able to have surgery alone. Sometimes, chemotherapy can be given before surgery to shrink the tumor, making the surgery safer.
Chemotherapy is often given intravenously (IV). This can be done on an outpatient basis or in a hospital setting.
Your child may have side effects from chemotherapy or radiation therapy. If this happens, be sure to tell your doctor. There are things you can do to reduce the side effects and medications you can give your child.
Can Wilms' tumor be prevented?
There is really nothing you or your child can do to cause or prevent Wilms tumor. This is something that is beyond our control.
What is the prognosis for someone with Wilms tumor?
The prognosis for Wilms' tumor is generally good in most cases. The outcome is usually very good, especially if the doctor is able to completely remove the tumor and the cancer has not spread elsewhere in the body. However, there is a small chance that Wilms' tumor will ``recur''.
Can Wilms tumor be fatal?
Although Wilms tumor can be successfully treated with a combination of surgery, chemotherapy, and/or radiation therapy, it is still a cancer. And therefore, it can be fatal. That's why it's important to recognize it early and start treatment.
What is the survival rate for Wilms tumor?
About 90% of people diagnosed with Wilms tumor are still alive after five years. This rate can vary slightly depending on factors such as the stage of the cancer, the size of the tumor, and how the cancer cells look under a microscope (histology). While it used to be said that children under the age of 2 had a lower risk of recurrence, age is now less of a factor than it used to be.
When should I see my doctor about Wilms tumor?
If your child is being treated for Wilms' tumor, see your doctor if you have any concerns or questions. Especially if you notice any new symptoms or if something seems to be getting worse, let them know right away.
During your treatment, your medical team will tell you what to watch out for, such as signs of urinary tract infections. If this happens, you may need to go to the emergency room.
The child will also need to go for follow-up visits at regular intervals to make sure they are doing well. The doctor may also refer the child to a kidney specialist (nephrologist) or a urinary system specialist (urologist).
How can I help my child stay healthy after treatment for Wilms tumor?
It is important that your child does these things:
- Drink enough fluids to help your kidneys function properly.
- Limit the use of medications such as aspirin, ibuprofen, and naproxen. Talk to your child's doctor about which products are least likely to harm your child's kidneys.
- Check your blood pressure at regular intervals.
Is Wilms tumor painful?
Sometimes Wilms tumor can be painful, but it is not always painful.
What is the difference between Wilms' tumor (nephroblastoma) and neuroblastoma?
Although these two words sound similar, they are two types of cancer that start in two different types of cells. Nephroblastoma is a cancer of the kidneys. Neuroblastoma is a cancer that starts in nerve cells. It most often starts in the adrenal glands, but it can also invade the kidneys. Both types of cancer occur in children, and both can present as a lump in the abdomen. Therefore, it is important to get an accurate diagnosis.
If your child is diagnosed with Wilms tumor, your doctor will likely recommend that you contact a medical center that specializes in treating childhood cancers. Although Wilms tumor is rare, it is a treatable disease. Your child may also be eligible to participate in a clinical trial. Many children with Wilms tumor are enrolled in this program. Many advances in Wilms tumor treatment are the result of these clinical trials.
The most important thing (Take-Home Message)
Okay, so we've talked a lot about Wilms' tumor, haven't we? The main thing to remember is that if you see any unusual lumps or swellings on your child's stomach, don't panic and see a doctor right away.
- Wilms' tumor is a cancer that develops in the kidneys of young children.
- Although the exact cause of this is unknown, there may be some genetic influence.
- If diagnosed early and treated properly, the chances of recovery are much higher.
- Surgery, chemotherapy, and sometimes radiation therapy are the main treatments.
- Even after treatment, it is very important to follow the doctor's instructions carefully and go for check-ups at the scheduled times.
Don't be afraid. Medical science is very advanced today. The most important thing is your attention and quick action. I wish your child a speedy recovery!
` Wilms tumor, nephroblastoma, childhood cancer, kidney cancer, children's health, cancer symptoms, cancer treatment
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