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Kidney Cancer - Wilms' Tumor
See Also:
Kidney
Cancer Introduction and Types
Wilms' Tumor
Overview and Types
Wilms'
Tumor Causes and Risk Factors
Wilms' Tumor Signs
& Symptoms
Wilms' Tumor Stages
Wilms' Tumor
Medical Tests and Diagnosis
Wilms' Tumor
Treatment
Treatment Options
Wilms'
tumor is best treated when diagnosed in the early
stages, before the cancer has spread in the body.
However, nearly half of all Wilms’ tumor
cases are diagnosed in the first stage, when the
treatment outcome is good. 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. |
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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
leukemia cells, or to kill the leukemia 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 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 brushing 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
See Also:
Kidney
Cancer Introduction and Types
Wilms' Tumor
Overview and Types
Wilms'
Tumor Causes and Risk Factors
Wilms' Tumor Signs
& Symptoms
Wilms' Tumor Stages
Wilms' Tumor
Medical Tests and Diagnosis
Wilms' Tumor
Treatment
Article by Alina Morrow, MS
Medical Writer
OmniMedicalSearch.com
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
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