Wilms Tumor: Causes, Symptoms, Risk Factors and Diagnosis

Children are most commonly affected by Wilms tumour, a rare kidney cancer. It is the most typical kidney cancer in children and is also referred to as nephroblastoma. Children between the ages of 3 and 4 are most frequently affected by Wilms tumours. Once a child reaches the age of 5, it is considerably less common, but it can still affect older children and even adults.

The one kidney is where Wilms tumours typically develop. However, it can occasionally occur simultaneously in both kidneys.

The prognosis for children with Wilms tumour has significantly improved over time because of advances in diagnosis and treatment of this condition. For the majority of children with Wilms tumours, the prognosis is favourable with treatment.

Causes Of Wilms Tumor

What causes Wilms's tumour is unknown.

Cancer starts when cells' DNA is altered. The instructions that inform cells what to do are encoded in their DNA. The adjustments instruct the cells to rapidly divide and expand. As part of their normal life cycle, healthy cells die, but cancer cells continue to exist. In the case of a Wilms tumour, the modifications result in additional kidney cells that eventually grow into a tumour.

Rarely, genetic mutations passed down from parents to children can increase the chance of Wilms tumour.

Symptoms Of Wilms Tumor

The signs and symptoms of a Wilms tumour can be extremely varied. Some children don't appear to be suffering any symptoms. However, some people with Wilms tumours experience one or more of the following symptoms:

• a noticeable lump in the lower abdomen.
• stomach swelling.
• stomach pain.

Other signs could be:

• Fever.
• Urine with blood
• Anaemia, a condition marked by a low amount of red blood cells.
• High blood pressure

Risk Factors Of Wilms Tumor

There are several elements that could raise the likelihood of developing a Wilms tumour.

• Identifying as Black: Black children in North America and Europe have a slightly higher risk of developing Wilms tumour than children of other races. Children of Asian descent tend to be at a reduced risk than children of other races.
• A family history of Wilms tumour: The likelihood of developing Wilms tumour is increased by having a family history of the condition.

Children with certain birth problems, such as:

• Aniridia: The iris, or coloured component of the eye, does not form at all or only partially in those with aniridia.
• Hemihypertrophy: Hemihypertrophy indicates that one side of the body or a specific area of the body is larger than the other side.

Wilms tumours can be a part of uncommon disorders, such as:

• The WAGR syndrome: This condition consists of a Wilms tumour, aniridia, genital and urinary system problems, as well as cerebral difficulties.
• The Denys-Drash syndrome: This condition involves male pseudohermaphroditism, kidney dysfunction, and Wilms tumour. A male genitalia may not be obviously masculine in cases of male pseudohermaphroditism.
• Beckwith-Wiedemann disorder: This syndrome, also known as macrosomia, causes children to grow substantially larger than average. This syndrome may result in abnormally formed ears, a huge tongue, large internal organs, and stomach organs that protrude into the base of the umbilical cord.

Diagnosis Of Wilms Tumor

Wilms tumor can be diagnosed with the help of the following methods:

• Taking a family history and doing the following tests could help a doctor identify Wilms's tumour.
• A physical examination: Indicators of a Wilms tumour could be seen by the healthcare professional.

• Blood and Urine Tests: These laboratory examinations can demonstrate the kidneys' functional state.
• Imaging Examinations: If a child has a kidney tumour, imaging tests that produce images of the kidneys can detect it. Chest X-rays, CT scans, and MRIs are a few examples of imaging exams.

Cancer staging

The healthcare provider may advise additional testing to determine whether the cancer has spread after identifying a Wilms tumour. If the cancer has progressed past the kidneys, a bone scan, chest CT scan, or X-ray can reveal this.

Choosing a course of treatment is influenced by the cancer's stage. The phases of Wilms tumour are as follows in the US:

• Stage 1: Only one kidney is affected by the malignancy. All of it can be removed surgically.
• Stage 2: The cancer has progressed outside of the kidney, maybe to adjacent fat or blood vessels. However, surgery can still completely remove it.
• Stage 3: The cancer has progressed to adjacent lymph nodes, which are small organs that fight infection, as well as organs other than the kidneys. It can also spread to other areas of the abdomen. Before or during surgery, the cancer cells may leak into the abdomen, or the operation may not be able to completely remove the tumour.
• Stage 4: The cancer has gone outside of the kidney to the lungs, liver, bones, or brain.
• Stage 5: Both kidneys have cancer cells. Each kidney tumour is staged separately.

Treatment Of Wilms Tumor

Chemotherapy and surgery are frequently used in the treatment of Wilms tumours. Radiation therapy is occasionally a part of it. The type of treatment depends on the cancer's stage. A children's cancer centre that has experience treating this sort of cancer would be an excellent option given how rare it is.

Surgery

Kidney removal may be the first step in the Wilms tumour treatment plan. Furthermore, surgery supports the diagnosis. To determine whether the tissue is carcinogenic and what form of cancer is present in the tumour, it is submitted to a lab after being removed during surgery.

Surgery options for a Wilms tumour include:

• Removing a kidney portion: This procedure, known as a partial nephrectomy, entails removing the tumour along with a tiny portion of the kidney surrounding it. If the tumour is very small or if the child only has one functional kidney, this procedure might be used.
• Removing the kidney and its surrounding tissue: Known as a "radical nephrectomy," this procedure involves the removal of a portion of the ureter, some surrounding lymph nodes, and occasionally the adrenal gland. Both kidneys' functions can be performed by the remaining kidney.
• Removing one or both of the kidneys: Surgery involves removing as much cancer from both kidneys as possible if the malignancy spreads to both. Sometimes, this involves removing both kidneys. The child would then need kidney transplantation or renal dialysis.

Chemotherapy

Chemotherapy uses strong drugs to attack cancer cells all over the body. When treating a Wilms tumour, numerous drugs are frequently used to kill cancer cells. A vein is used to inject the medicine.

Chemotherapy side effects vary depending on the drugs taken. Nausea, vomiting, lack of appetite, thinning hair, and an increased risk of infections are typical adverse effects. Inquire about potential side effects from your child's healthcare provider. Ask if the treatment may have caused any problems

Chemotherapy can decrease tumours and make them easier to remove when administered prior to surgery. It can eradicate any cancer cells that are still active in the body after surgery. Children with malignancies that have progressed too far may potentially be eligible for chemotherapy.

Chemotherapy is administered prior to surgery to children who have cancer in both kidneys. One kidney's potential survival may be increased as a result of this.

Radiation treatment

Radiation therapy may be administered to some children. High-powered energy beams are used in radiation therapy to destroy cancer cells. Protons, X-rays, and other kinds of energy can all contribute.

The child is positioned on a table for radiation treatment. Around the child, a large piece of equipment moves while shooting energy beams at the cancer. Nausea, diarrhoea, fatigue, and sunburn-like skin irritation are all potential adverse effects.

After surgery, radiation therapy may be given to some kids to eradicate any remaining cancer cells. Additionally, it might be applied to treat cancer that has spread to different parts of the body. Inquire if there might be long-term problems as a result of radiation therapy.

Prevention Of Wilms Tumor

It is difficult to prevent Wilms tumour.

A medical professional could advise performing periodic renal ultrasounds to check for anything unusual in the kidneys if a child has any of the disorders that raise the risk of Wilms tumour. Wilms tumour cannot be prevented, but this screening might help in detecting the condition early.

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