Children’s Cancer - Wilms tumour (Nephroblastoma )

Wilms tumour is generally a rare kidney cancer which mainly affects the children. It is also known as nephroblastoma which is the most common form of cancer of kidneys in children. Usually, this tumour disease mostly affects children ages 3 to 4. Wilms tumor becomes less common after the age 5 but it can also affect older children and also older adults.

Most of the time, Wilms tumour occurs in just one kidney but it can also affect the both kidneys at the same time.

Over the years passed, the diagnosis and treatment methods of Wilms tumour has significantly improved the progress of children who are affected with this disease. With the help of treatment, results can be good with children with wilms tumours.

Wilms tumour Symptoms

Some of the children who are affected with Wilms Tumour won’t notice any symptoms. But some other may notice any of the below symptoms:

• Belly pain

• Swelling in their belly

• A growth of tumour which you can see or feel in your belly

• Fever 

• Nausea

• Lack of appetite

• High blood pressure

• Blood in their pee

• Constipation

• Shortness of breath

Many Wilms tumours become very big before noticing the symptoms of disease. This growth is the only sign of disease. The average size of a tumour is 1 pound.

Wilms tumour Causes

Generally, all cancers happen when cells in your body start to grow abnormally out of control. If your children has a wilms tumour, then their kidney cells did not grow like normal size. Instead of this, they turned into cancer cells. Wilms tumour mostly happens because of a random change in a gene. In rare cases,  it’s because of gene changes which are handed down from biological parents.

Types of Wilms tumours

Usually, types of wilms tumour are identified under a microscope which can be divided by how the cells look under the microscope.

• Favourable histology. This type of Wilms tumour is one of the most common groups among all other types. More than 9 out of 10 people with this tumour fall under this group. Which means, there is no more difference among the cancer cells. Children who are affected by this type must have a great chance of being cured.

• Unfavourable or anaplastic histology. This type has a different type of deformed cancer cells in your body. Usually, this type can be harder to cure with treatment.

Wilms tumour Risk Factors

Some of the risk factors that make a child more likely to get Wilms tumour include:

• Age. Children who are affected by this type of cancer come under the age between 3 and 5 years old.

• Gender. Generally, girls are more likely to be affected than boys.

• Race. Black children are having more chances to get Wilms tumour than children with other races.

• Family history. If someone or a closed one in your family had a wilms tumour disease then the odd ones are having great chances to get it too.

• Birth defects. These can include:

• Cryptorchidism which means Testicles that haven’t dropped properly

• Hypospadias - which means children will have the opening of the penis is on the underside instead of on the tip 

• Aniridia - which means a total or some portion lack of the coloured area of the eye

• Hemihypertrophy - Which means children have oversized (abnormal) arm or leg 

• Another health condition. Wilms tumour disease happen in children who are affected with other rare health conditions:

• WAGR syndrome which usually causes problems in the urinary tract of children.

• Generally, boys with Denys-Drash syndrome must have testicles but they also have female traits.

• Microcephaly which means when an infant is born with an abnormal small head.

• Beckwith-Wiedemann syndrome which typically causes internal organs which are larger than the usual size of inner organs in your body.

Wilms tumour Diagnosis

Your children’s medical appointment will include:

• A physical exam and medical history: your physician will ask about the signs and symptoms and also they ask about whether cancer or urinary tract problems happen in your family.

• blood test - This is to check how well your child’s kidneys and liver are working, and their red and white blood cells in your body, and their blood clotting are working properly.

• urine test - which can be used to look for blood 

• And Imaging tests - such as ultrasound, MRI, or CT scan of your children’s belly.

If your healthcare provider finds a tumour in your child’s kidney, they may:

• Biopsy which is to take a small sample that can be look under a microscope

• They may order more imaging tests which can be help you to find out whether the disease has spread or not

• Or Do a bone scan which can be to look for diseased bone

Wilms tumour Staging

Your healthcare provider will use these test results which are used to figure out how far a tumour has spread. This is so called staging. Stages of Wilms tumour are:

• Stage I. Disease can be spread in only one kidney. Surgery will help you to remove it all.

• Stage II. Cancerous tumours have moved into the parts around the kidney, but surgery will help you to remove it all.

• Stage III. Cancerous tumours haven't spread outside the children’s abdomen. Surgery can’t remove the cancer tumour.

• Stage IV. Cancer cells are spread to some other parts of the body that are farther away, body parts like the lungs, bones, or brain, or to lymph nodes which are outside the belly.

• Stage V. In this stage, tumours develop in both the kidneys.

Treatment

Wilms tumour is always treated with the help of a combination of surgery and chemotherapy. In rare cases, treatment will include radiation therapy.

Many children with low-risk tumours are mostly treated with surgery alone, if the tumours have not spread. And it can be taken out completely. In some cases, your children may undergo chemotherapy before surgery to make the tumour smaller which helps for safe surgery.

Frequently Asked Questions

Q1. What is a Wilms tumour caused by?

Ans: Most of the time, Wilms tumour is caused by a gene change (mutation). 

Q2. What is a Wilms tumour also known as?

Ans: Wilms tumour, or nephroblastoma, is the most common pediatric renal cancer.

Q3. What is the treatment for Wilms tumour?

Ans: The main treatments for a Wilms tumour are surgery, chemotherapy, and radiation therapy.

Q4. What are the complications of Wilms tumour?

Ans: Spread of the tumour to the lungs, lymph nodes, liver, bone, or brain is the most worrisome complication.

Q5. What is the most common site of Wilms tumour?

Ans: The most common site of metastatic spread of Wilms tumour is the lungs;