Treatments for Wilms Tumors

Surgery is usually the primary treatment for almost all children with Wilms tumors. When the tumor is only in one kidney, a radical nephrectomy (which removes the entire kidney, the tissue surrounding the kidney, the ureter, and the adrenal gland), is the most common procedure. If your child has bilateral Wilms tumor (in both kidneys), a partial nephrectomy may be performed to remove the tumor while leaving the maximum amount of healthy kidney tissue.

Chemotherapy is medicine that can be used to destroy cancer cells. Sometimes, it is given after surgery to kill any remaining cells. Other times, it is used before surgery to shrink the Wilms tumor to make the surgery possible. The type and amount of chemo drugs depends largely on the stage and histology of the cancer. To treat Wilms tumor, a combination of chemo drugs is generally used, injected through a vein (IV) or through a catheter that is surgically inserted.

Radiation therapy uses high-energy rays to destroy cancer cells. It may be a treatment option for certain Wilms tumors, such as more advanced tumors or earlier stage tumors with anaplastic histology. Radiation may be given before surgery to shrink the tumor or administered after surgery to ensure that all of the cancer is eradicated. In general, radiation therapy is delayed as long as possible in very young children in order to allow them a chance to grow and develop more. In addition, certain ways of administering radiation therapy can help prevent it from damaging nearby healthy tissues. Our radiation oncologists at Sheba have specialized techniques to determine the dose and volume of radiation so that it provides maximum benefits with minimal long-term effects over your child’s general health.

In rare or recurrent cases of Wilms tumor, very high-dose chemotherapy followed by a stem cell transplant may be an option. As a consequence of the powerful chemo drugs, many healthy cells are also destroyed. In order to replace the blood-forming cells that have been destroyed, stem cells can be transplanted into the patient. The infused stem cells develop into healthy blood cells and restore the normal cells that were destroyed.

Targeted therapy uses drugs or other substances to identify and destroy cancer cells without damaging normal healthy cells. Targeted drugs work differently from standard chemotherapy and can work when chemo does not. The specific gene changes in your child’s tumor will largely determine whether or not targeted therapy is an option.

When we personalize your child’s treatment program for Wilms tumor at Sheba Medical Center in Israel, we treat more than just cancer. Our compassionate medical team considers your child’s overall quality of life, striving constantly to provide a comfortable, pain-free, and efficient experience. We offer a variety of support services for children and their families, including psychologists, social workers, alternative therapies, and nutrition counseling. Our knowledgeable staff is always available to answer questions and ease the journey for you and your child as you fight cancer.