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How is Wilms treated?
It depends on the Stage and histology of the tumours.
There are three types of treatment that can be used for Wilms:
Surgery: An operation to remove the cancer.
A partial nephrectomy is when the cancer and part of the kidney are removed. It's usually done if the other kidney is damaged or has already been removed.
Simple nephrectomy is when the whole kidney is removed.
A radical nephrectomy removes the entire kidney and tissues around it, sometimes, some lymph nodes may also be removed.
Chemotherapy: Medication used to kill cancer cells. It is called a systemic treatment because the drugs enter the bloodstream, travel through the body, and can kill cancer cells throughout the body. Chemotherapy given after an operation when there are no cancer cells that can be seen is called adjuvant therapy.
Radiation: X-rays or other high-energy rays are used to kill cancer cells and shrink tumours. It may be used before or after surgery and/or chemotherapy.
Check out CancerNet for more info on Radiation Therapy.
Standard Treatment of Wilms by Stage
Treatment depends on the stage of the disease, the histology of the cell type and the patient's age and general health. Each case is unique and there may be situations where it is necessary or desirable to deviate from the standard course of treatment. The outlines below are to give a general overview of the standard treatment for each stage of Wilms' tumour.
Stage 1
If your child has a favourable histology tumour, your child's treatment will probably be surgery to remove the cancer followed by chemotherapy.
If your child has an unfavourable tumour, your child's treatment will probably be surgery to remove the cancer followed by radiation therapy plus chemotherapy.
Stage 2
If your child has a favourable histology tumour, your child's treatment will probably be surgery to remove the cancer followed by chemotherapy.
If your child has an unfavourable histology tumour, your child's treatment will probably be surgery to remove the cancer followed by radiation therapy plus chemotherapy.
Stage 3
If your child has a favourable or an unfavourable histology tumour, your child's treatment will probably be surgery to remove the cancer followed by radiation therapy plus chemotherapy.
Sometimes the cancer cannot be removed during surgery because it is too close to important organs or blood vessels or because it is too large to remove. In this case, the doctor may only perform a biopsy and then give chemotherapy with or without radiation therapy. Once the cancer has become smaller, surgery can be performed, followed by additional chemotherapy and radiation therapy.
Stage 4
If your child has a favourable or an unfavourable histology tumour, your child's treatment will probably be surgery to remove the cancer followed by radiation therapy with chemotherapy. Patients whose cancer has metastasized to the lungs will receive additional chemotherapy.
Stage 5
Because both kidneys contain cancer, it is not usually possible to remove both kidneys. Your child's doctor will probably take out a piece of the cancer in both kidneys and remove some of the lymph nodes around the kidney to see whether they contain cancer. Following surgery, chemotherapy is given to shrink the cancer. A second operation is then performed to remove as much of the cancer as possible, while leaving as much of the kidneys as possible. Surgery may be followed by more chemotherapy and/or radiation therapy.
To learn more, read the NCI/PDQ statement on Wilms' from OncoLink.
And the How is Wilms tumor treated? section on CureSearch (which you'll find under "For Parents/Family" and choosing "Kidney and Wilms Tumor" in the drop down list).
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