Wilms tumour, also called nephroblastoma, is a type of kidney cancer that mainly affects children. Treatment depends on several factors, including the child's age, tumour stage, histology, whether one or both kidneys are involved and whether the tumour has spread.
Treatment may include surgery, chemotherapy and, in selected cases, radiation therapy. Surgery is an important part of treatment for many children, but the timing and type of surgery depend on the child's individual condition and overall treatment plan.
For families looking for Wilms tumour treatment in Mumbai, care should be planned by a multidisciplinary pediatric cancer team with experience in childhood kidney tumours.
Wilms tumour is a cancer that develops in the kidney and is also known as nephroblastoma. It is the most common kidney cancer in children.
The tumour may develop in one kidney or, less commonly, in both kidneys. The treatment approach is planned according to the child’s individual disease and response to treatment.
Wilms tumour treatment may involve a combination of surgery, chemotherapy and radiation therapy.
The order of treatment can vary. In some treatment approaches, surgery is performed first when the tumour can be safely removed. In other situations, chemotherapy may be given before surgery to reduce the tumour and make surgery safer or more feasible.
The treatment plan depends on factors such as the tumour’s stage, histology, location, involvement of one or both kidneys and response to treatment.
The aim is to control the cancer while removing the tumour safely and preserving kidney function whenever possible.
Two children with Wilms tumour may need different treatments. The medical team considers several factors before deciding on the treatment approach.
These may include:
These factors help the treatment team decide which combination and sequence of treatments may be appropriate for the child.
Surgery is a major part of treatment for most children with Wilms tumour.
The main goal is to remove the tumour safely and, when possible, without rupturing it. The surgeon also assesses the extent of the disease during the operation.
Nearby lymph nodes are usually assessed and sampled because their involvement can help determine the stage of the disease and guide further treatment.
The type and timing of surgery depend on the tumour’s size, location, relationship with nearby structures and whether one or both kidneys are affected.
If the tumour cannot be safely removed at the beginning, other treatment may be given first. If the tumour responds and becomes suitable for surgery, the surgical plan can then be reassessed.
A radical nephrectomy involves removing the kidney containing the tumour along with nearby structures as appropriate.
It is commonly used when Wilms tumour affects one kidney and can be safely removed. Nearby lymph nodes are also assessed during the procedure to help determine the extent of disease.
The decision to remove the whole kidney depends on the tumour and the need to achieve safe and effective tumour removal.
A partial nephrectomy removes the tumour while preserving part of the affected kidney. It is also called kidney-sparing or nephron-sparing surgery.
This approach may be considered in selected children, particularly when both kidneys are affected or when there is a specific need to preserve as much functioning kidney tissue as possible.
The goal is to remove the tumour while retaining healthy kidney tissue where this can be done safely. Partial nephrectomy is not suitable for every child, and the decision depends on the tumour and the overall treatment plan.
In selected children, kidney-sparing surgery may be possible.
Whether part of the kidney can be preserved depends on the tumour’s location, size, involvement of surrounding structures and the amount of healthy kidney tissue that can safely be retained.
Kidney preservation becomes particularly important when both kidneys are affected. In these situations, the treatment team needs to balance effective cancer treatment with preservation of kidney function.
Partial nephrectomy may be considered when the tumour can be removed while leaving enough functioning kidney tissue in special conditions.
Wilms tumour affecting both kidneys requires an individualised treatment strategy.
The aim is to control the cancer while preserving as much healthy kidney tissue as possible. Depending on the treatment approach, chemotherapy may be given before surgery to reduce the size of the tumours and help plan kidney-sparing surgery.
After the response to treatment is assessed, surgery may be planned to remove the tumours while preserving kidney tissue where this can be done safely.
Children with bilateral Wilms tumour also need long-term attention to kidney function because preserving remaining functioning renal tissue is an important part of their care.
Before surgery, the team reviews imaging to assess the tumour’s size, location, relationship with nearby structures and the condition of the opposite kidney. This helps determine whether surgery can be performed safely and whether treatment should be given before surgery.
After surgery, the tumour and sampled tissue are examined by a pathologist. The pathology findings, surgical stage and other clinical information help the oncology team decide whether additional chemotherapy or radiation therapy is needed.
Wilms tumour can spread beyond the kidney. The lungs are one of the important sites of distant spread, although other organs can also be involved.
Treatment for advanced disease may involve a combination of chemotherapy, surgery and radiation therapy. The exact approach depends on where the tumour has spread, its histology, response to treatment and other clinical factors.
Treatment decisions are made by the child’s oncology team based on the complete clinical picture.
Wilms tumour treatment involves more than surgery alone.
A child’s care may involve a pediatric surgical oncologist, pediatric medical oncologist, radiation oncologist, pediatric radiologist, pathologist, pediatric anesthetist and critical care team. Other specialists may also be involved when needed.
These specialists work together to review the diagnosis, plan treatment and decide the appropriate timing and type of surgery.
A multidisciplinary approach helps ensure that surgical decisions are considered as part of the child’s complete cancer treatment.
Follow-up continues after the main treatment is completed.
The child’s follow-up plan may include clinical assessments, imaging and other tests when needed. The medical team may also monitor kidney function and possible long-term effects of treatment.
The exact follow-up schedule depends on the child’s diagnosis, treatment and risk of recurrence.
Children who have had tumours in both kidneys may require particular attention to long-term kidney health because preserving adequate kidney function is an important part of their ongoing care. Almost all of them lead a normal healthy life with one kidney also.
Wilms tumour surgery in children requires careful planning because the tumour can be large or close to important structures.
A pediatric surgical oncologist considers the tumour, the child’s age, kidney function and the overall cancer treatment plan when planning surgery.
The aim is to achieve safe tumour removal while completing the complete staging as it is critical and determining further course of treatment.
Parents may consider a second opinion if surgery has been recommended or if they want another specialist’s view of their child’s treatment plan.
A consultation may be particularly useful when both kidneys are involved, the tumour is difficult to remove, chemotherapy before surgery has been suggested, kidney-sparing surgery is being considered or the tumour has returned after treatment.
A second opinion can help families understand the diagnosis, treatment options and possible role of surgery before making decisions about their child’s care.
Bring available imaging reports and scans, pathology or biopsy reports, previous treatment records and discharge summaries. If your child has already received chemotherapy or surgery, treatment summaries can also help the specialist understand the medical history.
Yes. The available pathology report can be reviewed as part of a specialist consultation. If a further pathology review is considered necessary, the family can be advised about any additional pathology material or information required.
Yes. A second opinion can be sought at different stages of treatment. Another specialist can review the available medical information and help the family understand the current treatment plan and possible next steps.
Parents may ask why surgery is being recommended, what type of surgery is being considered, how kidney function will be considered, what the possible risks are and whether additional treatment may be needed after surgery.
Wilms tumour can return in some children after initial treatment. If this happens, the treatment team reassesses the location and extent of the disease, previous treatment and other factors before deciding on the next treatment approach.
If your child has been diagnosed with cancer or a tumour, a specialist consultation can help you understand the diagnosis and treatment options. Dr. Monica Bhagat provides international pediatric surgical oncology care for children with cancer and solid tumours.
Discuss your child's condition, whether surgery may be appropriate, and the next steps in care
Plot No. 8, PU04, Commercial Scheme 54, Rasoma Square, Vijaynagar, AB Road
Plot No. 8, PU04, Commercial Scheme 54, Rasoma Square, Vijaynagar, AB Road
Plot No. 8, PU04, Commercial Scheme 54, Rasoma Square, Vijaynagar, AB Road
