Wilms' tumor is considered one of the rare types of cancer that affects children, and it is considered a major medical challenge despite the development of treatment methods. It often appears in the kidneys before the age of five, and its symptoms do not appear clearly at first, but early detection and rapid intervention have a major role in increasing the chances of recovery. In the coming lines with Al-Mousa Specialist Hospital, we will learn more about the disease, including its causes, symptoms, and treatment methods.

What is Wilms' tumor?

Wilms' tumor is also known as renal tumor. It is a rare type of kidney cancer that affects children and appears at the age of less than 5 years. The tumor also arises from immature kidney cells. It is believed that this disease occurs as a result of genetic mutations that affect the normal development of the kidneys during pregnancy or in the first years of the child's life. Wilms' tumor usually affects only one kidney, but it can appear in both kidneys in some rare cases. This tumor is considered one of the most common kidney cancers in children, but it is rare in adults, due to diagnostic and treatment methods such as

Stages of Wilms' tumor

The tumor is classified into 5 stages, which are used to determine the extent of the disease and guide the appropriate treatment plan. These stages are as follows:

• The first stage, in which the tumor is confined to one kidney, and the tumor can be completely removed with surgery without spreading to surrounding tissues.
• The second stage, in which the tumor extends to tissues and tissues near the kidney, but is still completely resectable using surgery.
• The third stage, in which the tumor spreads to nearby lymph nodes, or part of the tumor remains after surgery, or the tumor ruptures within the abdomen.
• The fourth stage, in which the tumor spreads to organs far from the kidney, such as the liver, lungs, brain, or bones.
• The fifth stage, in which the tumor affects both kidneys upon diagnosis. This stage requires a precise treatment plan to preserve kidney function as much as possible.

Types of Wilms tumor

Tumor types are divided into two main types, and they are classified based on the appearance of the cells under the microscope. It should be noted that tumor classification is very important for doctors, as it affects the treatment plan and expectations of recovery. Its types come as follows:

Tumor with favorable histology

It is a more common type, representing 90% of cases, and is characterized by the presence of largely non-cancerous cells. These tumors also respond to treatment, and the chances of recovery are very high, especially if the tumor is discovered at an early stage.

Tumor with unfavorable Anaplastic Histology

It is less common and more aggressive, and its cells have an abnormal appearance, which is known as anaplasty. This type is also more resistant to treatment, especially if the spread is widespread or in advanced stages. It is divided into focal anaplasty and diffuse anaplasty, depending on the extent of the spread of abnormal cells in the tumor.

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Causes of Wilms tumor

In fact, the causes of the tumor are not fully understood until now, but there is a group of genetic and genetic factors that are believed to play a major role in its development, especially since it often occurs at an early age. The following are the most prominent causes and factors associated with the tumor: It comes as follows:

• Changes in some genes responsible for kidney growth and development, such as both the WT1 gene and the WT2 gene on chromosome 11, and these mutations lead to abnormal growth of kidney cells.
• Some cases are caused by rare genetic disorders, including Wager syndrome, Denis-Drash syndrome, and Beckwith-Wiedemann syndrome, which increase the risk of developing Wilms' tumor.
• In some rare cases, the tumor may appear in more than one family member, which indicates a genetic factor.
• Children who are born with congenital defects in the urinary system or reproductive organs are more susceptible to infection. Despite all these factors, most tumor cases occur randomly, without a genetic history or clear syndromes.

If your child is diagnosed with Wilms' tumor, you can visit Al Mousa Specialist Hospital, which includes: Oncology center Integrated care for children with tumors, with precise treatment plans that include surgery and chemotherapy under the supervision of a multidisciplinary team.

Symptoms of Wilms tumor

Tumor symptoms vary from one child to another, and are often unclear at first, but there are some common signs that are important to pay attention to, They are as follows:

• Abdominal bloating and a painless mass or swelling next to the abdomen.
• Recurrent abdominal pain or discomfort when touched.
• Urine appears pink or red.
• High fever for no apparent reason.
• Anorexia Or lose weight.
• High blood pressure due to the influence of kidney functions and thus disruption in blood pressure regulation.
• Nausea or vomiting in some cases, especially if the tumor begins to put pressure on nearby organs.
• Feeling tired or general exhaustion. The tumor is often discovered by chance during a routine examination or due to abdominal bloating, which is why early detection is very important.

Methods for diagnosing Wilms' tumor

Diagnosing Wilms' tumor requires a set of clinical, imaging, and laboratory tests to confirm the presence of the tumor and determine its stage. The most prominent diagnostic methods are explained below:

• The doctor begins by examining the child manually, and may notice the presence of a mass or swelling in the abdomen.
• He performs the first ultrasound examination, because it is safe and painless, and it also shows the presence of a mass in the kidney.
• Computed tomography gives a detailed picture of the kidneys and abdomen, and it helps evaluate the size of the tumor and its spread to surrounding tissues.
• Magnetic resonance imaging is used in some cases to accurately determine the extent of the tumor's spread, especially if there is a need to evaluate blood vessels or the spine.
• Conducting urine and blood tests, which are used to evaluate kidney function and detect indicators of malfunction or injury.
• In rare cases, a biopsy is taken to confirm the diagnosis if the condition is unclear, and it is rarely performed initially to avoid the spread of cancer cells.
• Any possible spread to the lungs is detected through a chest X-ray or CT scan of the chest, and all of these examinations help doctors determine the stage of the tumor and develop an appropriate treatment plan.

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How to treat Wilms' tumor

Treatment of Wilms' tumor depends on the stage and type of tumor, and often includes a combination of surgery and chemotherapy, and sometimes radiation therapy is used. Below are the most important basic steps for treatment:

Surgery and nephrectomy

The first step in most cases is the complete removal of the affected kidney, and in some cases a partial resection is performed if the tumor is in both kidneys.

Chemotherapy

It is used to shrink the tumor before surgery or to destroy remaining cancer cells. It is given in the form of medications that are injected intravenously, and its type and dose vary according to the stage of the tumor.

Radiotherapy

This type of treatment is used in advanced cases, if the tumor is not completely removed, and it also helps in eliminating remaining cells and preventing relapse.

It is important to follow up after treatment, which includes regular visits, blood tests, and x-rays, in order to monitor the condition and ensure that the tumor does not return again. There are different treatment plans that differ according to the stage, such as using surgery with chemotherapy in the first and second stages, or using surgery with chemotherapy and radiation in the third stage, or using a complex plan that includes triple therapy and sometimes with a kidney transplant later in the fourth and fifth stages.

Ways to prevent Wilms' tumor

This type of tumor is considered one of the cancers that cannot be completely prevented, as it is often linked to hereditary and genetic factors that occur in the early stages of a child’s development, even before his birth. Despite this, there are steps that can help detect the disease early and reduce complications, especially in children who are most susceptible to infection. It comes as follows:

• If the child suffers from hereditary syndromes or has a family history of Wilms' tumor, it is important to perform regular ultrasound examinations every 3 to 4 months, until the age of 7 years.
• Families with a genetic history should consult a geneticist to assess the risk of passing on genetic mutations.
• Any swelling or abnormal distension in the child’s abdomen should be noted, and a doctor should be consulted immediately if the disease is suspected.
• Although genetic prevention is not possible at the present time, good care for the health of both the mother and the fetus helps reduce congenital malformations that are considered a risk factor.

In general, early detection is considered the best way to improve the chances of recovery and reduce the complications of the disease.

Complications of Wilms' tumor

Complications may result from the disease itself or from the treatments used, and its severity varies according to the stage of the tumor, the type, and the child’s response to treatment. Below are the most prominent possible complications:

• High blood pressure due to the effect of the tumor on kidney function and the regulation of fluids and salts in the body.
• The tumor ruptures before or during surgery, thus increasing the risk of cancer cells spreading within the abdomen.
• Kidney failure, especially if both kidneys are affected or if both kidneys are removed, either partially or completely.
• Side effects of chemotherapy such as hair loss, nausea, weak immune system, anemia, and general fatigue.
• Side effects of radiotherapy, which include delayed growth in the treated area, or effects on nearby organs such as the liver or spine.
• Having problems in physical or mental development.
• In rare cases, radiation therapy causes infertility, especially if the treatment includes the pelvic area.
• Increased risk of developing other cancers in the future due to the long-term effects of chemotherapy and radiation.

Frequently asked questions

What is the cure rate for stage III Wilms tumor?

The recovery rate in the third stage is considered fairly good, thanks to the advances in treatment methods used, and it reaches between 85% and 90%, especially in cases where the tumor has a favorable tissue, and at that stage the tumor has spread to the surrounding tissues or lymph nodes, but it is still possible to treat it effectively, using a combination of surgery, chemotherapy, and radiotherapy, in addition to careful follow-up after treatment.

Does every tumor need chemotherapy?

Not every Wilms tumor requires chemotherapy. Treatment depends on the stage of the tumor and the type of cellular tissue. In very early cases, such as the first stage, and with the presence of favorable tissue, surgery may be sufficient only in some special cases. However, in most cases, chemotherapy is used as part of the treatment plan to help eliminate the remaining cancer cells and prevent relapse, especially in the second stages and above, or in the case of the presence of additional risk factors.

How do I know that the tumor has responded to treatment?

There are a number of periodic examinations and follow-ups, including medical imaging such as CT scan or MRI, from which the extent of the tumor’s response to treatment is clarified, and they show a reduction in the size of the tumor or its complete disappearance. There are also some signs that indicate the extent of the response to treatment, such as the disappearance of the mass in the abdomen, an improvement in one’s appetite, and an improvement in one’s activity. Blood and urine analyzes also help evaluate kidney function and confirm that there are no signs of the disease continuing or returning.

Al Mousa Specialist Hospital has proven its competence in treating such cases. Do not hesitate to book an appointment to begin diagnosis and determine the appropriate treatment, to begin the treatment journey until recovery, God willing.