What is Wilms tumor?
Wilms tumor is the most common childhood malignant tumor of the kidney. Another name is nephroblastoma.

Is this a serious condition?
This is a malignant tumor. Treatment would usually imply the loss of the involved kidney. Treatment results have been very good with many long term survivors. If the disease is not controlled, tumor relapse and death may result.

How is it detected?
Patients commonly present with a large abdominal mass, abdominal pain and/or blood in the urine. As the kidney is a deep structure, patients who present with abdominal mass usually have large tumors. Further evaluations would include ultrasonography, CT scan or MRI. 

How is it treated?
These tumors are routinely treated with surgery and chemotherapy. Patients with advanced stage disease and presence of anaplasia (aggressive cells found at histopathology) require more treatment, that is, more chemotherapy and radiotherapy. The decision of whether to perform surgery first followed by chemotherapy or in the reverse order would depend on the patient’s disease status at presentation.  

Can the child have a good quality of life with only one kidney?
Treatment of Wilms tumor often leaves the child with only one kidney at the end of his successful treatment. This is due to the need to remove the tumor-laden kidney as part of the treatment regime. The remaining kidney should be able to compensate for all necessary daily functions. A normal lifestyle is recommended for these children.  

Which patients are associated with a higher chance of success at treatment?
Patients with Stage I and II disease in the absence of anaplasia have the best chance for cure. Other patients without these features are experiencing improved cure rates with new treatment protocols.

For patients with bilateral Wilms tumors, how is treatment possible with preservation of kidney function?
Wilms tumor may occur in both kidneys. Recent studies have shown that bilateral kidney-sparing Wilms tumor resection after chemotherapy obviated the need for renal transplantation and provided good quality post-treatment function. Specialized surgical techniques enabled removal of tumors whilst preserving normal kidney structure. Such treatment should be performed in specialized centres. 

Is it possible to remove the tumor without removing the entire kidney for unilateral Wilms tumor?
With the experience from bilateral Wilms tumor, kidney-sparing tumor resection in unilateral Wilms tumor may seem feasible. This option is still controversial and should not be taken easily. Such a decision should be carefully discussed with your Paediatric Surgeon. The disadvantages are many and include the need for preoperative chemotherapy, the possibility of upstaging the disease at surgery and the increase in amount of postoperative treatment.

Will my child’s siblings develop Wilms tumor?
Majority of Wilms tumors are sporadic and only minority are inherited. It is unlikely to be diagnosed before birth.