Kidney Cancer - Wilms' Tumor (nephroblastoma)
Treatment Options
Wilms' tumor is best treated when diagnosed in the early stages, before
the cancer has spread in the body. Nearly half of all Wilms’ tumor
cases are diagnosed in the first stage, when the treatment outcome is
good. The prognosis for most cases is good and statistics show that 92
percent of the children diagnosed with Wilms' tumor are treated effectively.
The treatment approach is based on two factors: (1) the cancer stage,
and (2) the tumor histology (favorable or unfavorable tumors), and it’s
main goal is to remove the primary tumor (the one located in the kidney)
even if the cancer has spread to other areas of the body. The treatment
options for Wilms' tumor include: surgery, chemotherapy, and radiation
therapy.
Surgery
Surgery is the main treatment approach used in patients with Wilms'
tumor in the USA. In Europe, the patient undergoes surgery after
they receive chemotherapy.
Surgical removal of the kidney tissue is called nepherectomy.
There are four types of nepherectomy performed in patients with
Wilms’ tumor:
- Simple nepherectomy. During this surgery, the doctor
removes the entire kidney where the tumor is present.
- Partial nepherectomy. During this surgery, the doctor
removes the tumor together with the surrounding kidney tissue.
- Radical nephetectomy. During this surgery, the doctor
removes the tumor together with the entire kidney, the ureters
(thin tube that carries the urine from the kidney to the urine
bladder), the adrenal gland, the fat tissue that capsules the
kidney, and sometimes with the adjacent lymph nodes.
- Nephron-sparing surgery. During this surgery, the doctor
tries to remove only the tumor with as little damage to the
kidney tissue as possible .
|
|
|
During the surgery, the doctor will examine the nearby structures and
organs to determine whether or not the cancer has spread. This step is
essential in establishing a further treatment approach. In some cases,
especially when the patient needs further chemotherapy, during surgery
the doctor inserts a thin tube (called venous access device) into a large
blood vessel (usually under the collar bone) while the other end is placed
beneath the skin. Through this tube, the doctor can later remove blood
samples and administrates drugs or transfusions.
Chemotherapy
Chemotherapy is a systemic treatment (affects cells throughout the entire
body) that uses drugs either to stop the abnormal growth and dividing
process of the cancer cells, or to kill the cancer cells. This treatment
can be administrated as pills, through injections, or through a catheter
placed in a blood vessel.
The most common drugs used in patients with Wilms’ tumor are:
- For early stages: actinomycin D, vincristine.
- For advanced stages and unfavorable tumors: doxorubicin (Adriamycin),
cyclophosphamide, and/or etoposide.
In Europe, chemotherapy is used as a primary treatment approach in treating
patients with Wilms' tumor. The doctors prescribe chemotherapy before
and after the surgery. In US, chemotherapy is used as a secondary treatment
option.
Like every medicated treatment, chemotherapy can cause side effects.
The complexity and extent of the side effects depend on the drug used
and its dosage. The most common chemotherapy side effects include:
- Severe nausea with or without vomiting.
- Temporary hair loss
- Fatigue
- Mouth and lip sores
- Diarrhea
- Loss of appetite
- Tiredness
- Weakness
- Constipation
- High vulnerability to infections
- Easily bruising and bleeding after minor cuts or injuries.
- Heart damage (if the drug used is Adriamycin)
- Bone marrow damage (this side effect can occur in those patients that
receive a high dose of chemotherapy; the doctor will remove bone marrow
and freeze it until the treatment is over, when the marrow will be returned
intravenously)
- A slight risk of developing a secondary type of cancer (such leukemia)
within few years after the Wilms’ tumor was cured.
Radiation Therapy
This is a treatment approach which uses high-energy rays or particles
to destroy cancerous cells. The most common type of radiation therapy
used in patients with Wilms' tumor is external beam therapy, which
uses an external device (linear accelerator) to generate high-energy rays
that focus on the tumor. In some cases, if the child is too small, he/she
will be sedated during the treatment to remain still. The doctors will
try to limit the area of radiation to avoid growth problems, because this
treatment interferes with the normal growth of the tissue.
This type of treatment is often use along with surgery in advanced stages
of Wilms' tumor patients (stage III, V, and VI) or in early stages (stage
I and II) if the tumor has an unfavorable histology.
The radiation therapy side effects include:
- Feeling tired as the treatment continues
- Skin irritation (the skin becomes red, dry, or tender in the area
where the body is irradiated).
- Loss of appetite
- Diarrhea
Article by Alina Morrow, MS
Medical Writer
OmniMedicalSearch.com
Page Covers: What is the treatment for Wilms Tumor (kidney cancer)?
How is treated?
Sources:
- American Cancer Society, Detailed Guide: Wilm’s Tumor,
February 2006
- Medline Plus, Wilms tumor, March 2007
- Brigham and Women’s Hospital, Laurie Rosenblum, Wilms’
Tumor, March 2006
- Wrong Diagnosis, Wilms’ Tumor, March 2007
- CureSearch.org, Wilm’s Tumor Staging, September 2006
- Ped-Onc Resource Center, Wilms’ Tumor, June 2005
|
|
|
