Childhood Wilms’ Tumor: What Parents Should Know

Childhood kidney cancer is rare, but knowing what to watch for can save lives. Wilms’ tumor, or nephroblastoma, is a form of kidney cancer that occurs in childhood, usually before the age of 5 years. With the developments in pediatric cancer care, people consider it a treatable childhood cancer. To support parents in their journey, understanding everything from early diagnosis to after-treatment support is essential.

Symptoms parents should look out for

The tumor generally grows without any pain, and parental vigilance is necessary. The most common symptom is swelling or an abdominal mass, which is a hard lump noticed during bathing or dressing. Other symptoms can include:

• Abdominal pain: Some children may experience pain, yet it usually remains painless in the early stages.
• Fever: Persistent unexplained fever.
• Blood in urine: Also known as hematuria, it is less common.
• High blood pressure: The tumor can affect blood pressure regulation.
• Constipation or appetite loss: While vague, these symptoms can be due to tumor growth. 

Consult a pediatrician immediately if any combination of the symptoms above is observed.

Options for surgery and treatment success rates 

Pediatric cancer care has a wide approach for treating Wilms' tumor. The main treatment is almost always surgical, which is preceded or followed by chemotherapy. The surgical procedure includes radical nephrectomy or partial nephrectomy. Radical nephrectomy removes the entire kidney and structures near it. This is done when the Wilms’ tumor is in one kidney.

When the tumor is present in both kidneys, partial nephrectomy is preferred. Surgeons aim to save healthy kidney tissue by removing only the affected part. The larger tumor may require a full nephrectomy, while the other kidney may undergo a partial removal. Globally, the treatment success rates are above 90%; in India, they are from 50% to 85%. Success rates are often determined by the stage of cancer at diagnosis and the tumor’s pathology.

Kidney health post-treatment 

After the removal of one kidney, long-term monitoring of the other kidney's functioning is a focus of pediatric cancer care. Many children live a normal and healthy life with just one kidney. But regular follow-up with a nephrologist is required for monitoring blood pressure and doing urine tests to ensure proper functioning of the other kidney. In case both the kidneys are removed, dialysis is needed several times a week; once healthy and a donor is available, the child can get a kidney transplant.

Psychosocial support for children

Children need specialized psychosocial support to help them in the hospitals, with the stress of treatment, and with routine changes. Social workers, child life specialists, and psychologists are important parts of the pediatric cancer care teams. They can help children adjust to the “new normal” and address their fears.

Options of financial aid for families

Many resources of financial aid for pediatric cancer care are available, including the government's support, hospital-based programs, and nonprofit organizations. The Ministry of Health and Family Welfare, under the Rashtriya Arogya Nidhi fund, provides financial assistance of 15 lakhs for patients below the poverty line. Tata Memorial Hospital gives financial assistance to socially and economically underprivileged patients. And NGOs like the Indian Cancer Society and Cancer Patients Aid Association help access financial support through many programs and platforms. 

With advances in pediatric cancer care, Wilms' tumor now has high cure rates. Early diagnosis is crucial, and kidney health must be monitored during recovery with proper guidance and care.