Wilms Tumour

Wilms Tumour, also known as nephroblastoma, is a type of cancer that originates in the kidneys. It is the most common type of kidney cancer in children and typically affects children between the ages of three and four. A tumour is a mass of abnormal cells forming in one or both kidneys. It can grow quickly, and if left untreated, it can spread to other parts of the body.

The prognosis for Wilms Tumour is generally good, with a survival rate of over 90% for children with localised tumours.

There are several types of Wilms Tumours, which are classified based on their histological (microscopic) characteristics and the stage at which they are diagnosed.

The three main types of Wilms Tumours are:**

Favourable histology Wilms Tumour: This is the most common type of Wilms Tumour, accounting for about 70-80% of cases. It is characterised by relatively well-differentiated (normal-looking) tumour tissue and has a good prognosis.

Unfavourable histology Wilms Tumour: This type of Wilms Tumour is characterised by poorly differentiated (abnormal-looking) tumour tissue and a higher risk of recurrence and metastasis. This type of Wilms Tumour accounts for about 10-15% of cases.

Anaplastic Wilms Tumour: This is the rarest and most aggressive type of Wilms Tumour, characterised by highly malignant and fast-growing cells. This type of Wilms Tumour accounts for less than 5% of cases.

Another way Wilms Tumours are classified is by the stage of cancer, which is based on the size of the tumour, whether it has spread to the lymph nodes or other parts of the body, and other factors. These stages are used to determine the appropriate treatment plan and prognosis.

It is important to note that the type and stage of Wilms Tumour will influence the treatment options and the overall prognosis for the child.

Bilateral Wilms Tumour

Bilateral Wilms Tumour is a rare form of Wilms Tumour, a childhood kidney cancer, in which tumours develop in both kidneys simultaneously. It is a more aggressive form of the disease, accounting for about 5% of all Wilms Tumor cases. Tumours in both kidneys may lead to more severe symptoms and kidney failure.

The prognosis for bilateral Wilms Tumor is considered to be worse than for unilateral Wilms Tumour due to the increased risk of recurrence and metastasis. However, advances in treatment and new therapies have improved the outcomes for children with bilateral Wilms Tumors.

Wilms Tumour is typically Staged using the International Society of Pediatric Oncology (SIOP) staging system.

The system includes three Stages:

Stage 1: The tumour is confined to the kidney and has not spread to the surrounding tissue or lymph nodes.

Stage 2: The tumour has grown outside the kidney and may have spread to the surrounding tissue or lymph nodes but is still confined to the abdomen.

Stage 3: The tumour has spread to other parts of the body, such as the lungs, liver, or bones.

Stage 4: Cancer metastasises to other organs like the lungs, liver, brain, or even bones. Nearly one-tenth of Wilms Tumor cases are in **Stage 4.

Stage 5: This is also called bilateral Wilms Tumour, where the cancerous cells appear in both kidneys.

It is important to note that the **Stage of the Wilms Tumour will influence the treatment options and the overall prognosis for the child.

Children with Stage 1 and favourable histology tumours generally have a better prognosis than those with higher-Stage tumours, and treatment will likely involve surgery, radiation therapy, and/or chemotherapy. Children with Stage 3 and unfavourable histology tumours have a higher risk of recurrence and metastasis, and more intensive treatment plans are required.

The exact cause of Wilms Tumour is not known, but it is thought to be related to genetic mutations that occur during early kidney development. Studies have also suggested that certain genetic conditions, such as WAGR syndrome and Beckwith-Wiedemann syndrome, may increase the risk of developing a Wilms Tumour.

While the causes might be unknown, some known risk factors that can increase the likelihood of developing a Wilms Tumour include:

Genetics: Children with certain genetic conditions, such as WAGR syndrome and Beckwith-Wiedemann syndrome, have a higher risk of developing Wilms Tumour.

Family history: Children with a family history of Wilms Tumour may have an increased risk of developing the disease.

Race: Wilms Tumour is more common in African American children than in children of other races.

Birth defects: Children with certain birth defects, such as abnormal development of the urinary tract, may have an increased risk of developing Wilms Tumour.

Prematurity: Children born prematurely may have a slightly increased risk of developing Wilms Tumour.

It's important to note that most children with Wilms Tumour do not have any known risk factors, and most cases occur in otherwise healthy children.

Early detection increases the chances of fighting Wilms Tumour. This is possible only if you recognise the symptoms and seek medical attention immediately.

Here are some common Wilms Tumour symptoms that you should be aware of:

Abdominal swelling: The most common symptom of Wilms Tumour is a noticeable swelling or lump in the abdomen.

Pain: Some children may experience pain in the side or the back.

High blood pressure (hypertension): Wilms Tumour can cause hypertension in some children.

Blood in the urine (hematuria): Some children with Wilms Tumour may have blood in their urine.

Fever: Some children may have a fever, which can signify an infection.

Loss of appetite: Some children may experience a lack of appetite.

Fatigue: Some children may feel tired or weak

Children at that age tend to ignore such symptoms or not tell their parents, fearing doctors or medicines. Hence, parents need to keep an eye open for any changes in their behaviour. It's also important to note that these symptoms can also be caused by other conditions, and they must see a doctor for a proper diagnosis.

The diagnosis of Wilms Tumour usually involves:

Physical Examination: The diagnosis of Wilms Tumour typically begins with a physical examination, during which a healthcare provider may feel a lump or mass in the child's abdomen.

Imaging Tests: Imaging tests such as an ultrasound, CT scan, or MRI may be used to confirm a mass's presence and determine its size and location. These imaging tests can also be used to check for any spread of cancer to other parts of the body.

Blood Tests: Blood tests, such as a complete blood count (CBC) and a blood chemistry panel, may also be performed to check for elevated levels of certain proteins indicative of cancer. These proteins include alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (beta-HCG), which are often elevated in Wilms Tumors.

Biopsy: A biopsy, in which a small tissue sample is taken from the tumour and examined under a microscope, is typically performed to confirm the diagnosis. A biopsy can also be used to determine the type of Wilms Tumor and the stage of cancer, which is important for determining the appropriate treatment plan.

Genetic Testing: In some cases, genetic testing may also be done to check for specific genetic mutations associated with Wilms Tumor.

It is important to note that Wilms Tumor is rare, and other conditions such as hydronephrosis, nephritis, and other kidney tumours can mimic the symptoms of Wilms Tumour. Therefore, the diagnosis needs to be made by a pediatric oncologist who specialises in treating Wilms Tumour.

Wilms Tumour is a type of kidney cancer that primarily affects children. Treatment options for Wilms Tumour typically include surgery, radiation therapy, and chemotherapy. The specific treatment plan will depend on the stage and characteristics of the tumour, as well as the age and overall health of the child.

Surgery: Surgery is typically the first line of treatment for Wilms Tumour and is used to remove the tumour and surrounding tissue. The type of surgery used will depend on the size and location of the tumour, as well as the overall health of the child.

In some cases, the entire kidney may need to be removed, while in others, only part of the kidney may need to be removed. The goal of surgery is to remove as much of the tumour as possible while preserving as much normal kidney tissue as possible.

Radiation: Radiation therapy is usually used after surgery to destroy any remaining cancer cells. Radiation therapy uses high-energy beams, such as X-rays, to kill cancer cells. The radiation is directed at the area where the tumour was removed.

This treatment is usually given for several weeks, and the child will need to stay in the hospital during this time.

Chemotherapy: Chemotherapy is a treatment that uses drugs to kill cancer cells. It is typically used with surgery and radiation therapy to destroy any remaining cancer cells.

The drugs are given through a vein or by mouth, and the child will need to stay in the hospital during treatment.

Treatment for Wilms Tumour usually takes several months to complete. The child will be closely monitored during and after treatment to ensure that the cancer has not returned. The treatment and recovery process may be difficult for both the child and the family, and it is important to have a strong support system in place.

Wilms Tumour generally has an excellent prognosis with a survival rate of over 90% when diagnosed early and treated aggressively. With current treatments, more than 9 out of 10 children with Wilms Tumor are cured.

There is currently no known way to prevent Wilms Tumour, as the exact cause of the disease is not yet understood. However, early detection and treatment can improve outcomes for children diagnosed with the disease.

Regular check-ups and screenings, including imaging tests such as ultrasound or MRI, can help detect Wilms Tumour in its early stages. Also, maintaining a healthy lifestyle, such as eating a well-balanced diet and getting regular exercise, may lower a child's risk of developing Wilms Tumour.

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