Wilm's Tumor Treatment Information for Patients

Treatment of Wilms' tumor by stage

Treatments for Wilms' tumor depend on the stage of your child's disease, the cell type (histology), and your child's age and general health.

Your child may receive treatment that is considered standard based on its effectiveness in a number of patients in past studies, or you may choose to have your child take part in a clinical trial. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to test new treatments and to find better ways to treat cancer patients. Clinical trials are ongoing in most parts of the country for most stages of Wilms' tumor. If you want more information, call the Cancer Information Service at 1-800-4- CANCER (1-800-422-6237); TTY at 1-800-332-8615.

Stage I Wilms' Tumor

Your child's treatment depends on the histology of the cancer.

If your child has a favorable histology tumor or if your child has anaplastic Wilms' tumor, your child's treatment will probably be surgery to remove the cancer followed by chemotherapy.

If your child has either clear cell sarcoma of the kidney or rhabdoid tumor, your child's treatment will probably be surgery to remove the cancer followed by radiation therapy plus chemotherapy.

Stage II Wilms' Tumor

Your child's treatment depends on the histology of the cancer.

If your child has a favorable histology tumor, your child's treatment will probably be surgery to remove the cancer followed by chemotherapy.

If your child has an unfavorable histology tumor (anaplasia, clear cell sarcoma, or rhabdoid tumor of the kidney), your child's treatment will probably be surgery to remove the cancer followed by radiation therapy plus chemotherapy.

Stage III Wilms' Tumor

If your child has a favorable or an unfavorable histology tumor (anaplasia, clear cell sarcoma, or rhabdoid tumor), 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 IV Wilms' Tumor

If your child has a favorable or an unfavorable histology tumor (anaplasia, clear cell sarcoma, or rhabdoid tumor), 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 V Wilms' Tumor

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.

Recurrent Wilms' Tumor

If your child's cancer comes back (recurs), treatment depends on the treatment he or she received before, how much time has passed since the first cancer was treated, the histology of the cancer, and where the cancer came back.

Depending on the above factors, your child's treatment may be surgery to remove the cancer, plus radiation therapy and chemotherapy.

Clinical trials are evaluating new treatments, such as new chemotherapy drugs and combinations, and very high doses of chemotherapy followed by bone marrow reinfusion.

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