Treatments for stage 5 Wilms tumour
The following are treatment options for stage 5 Wilms tumour. The healthcare team will suggest treatments based on your child’s needs and work with you to develop a treatment plan.
A diagnostic biopsy is not usually done for stage 5 Wilms tumour. Chemotherapy is given to shrink the tumours, and then surgery is done. The goal of surgery is to remove as much of the tumour from each kidney as possible while leaving enough normal kidney tissue behind. Chemotherapy is usually given again after surgery. Radiation therapy may also be given after surgery.
Chemotherapy is usually given for 6 weeks before surgery to shrink the tumours before they are removed. Chemotherapy is also given after surgery. The type of chemotherapy and how long it is given again will depend on the stage and histology of the tumour tissue that remains after surgery.
Surgery is an important part of treatment for stage 5 Wilms tumour. Surgery for stage 5 Wilms tumour is typically delayed for 6 weeks or more. The type of surgery done will depend on the stage of the tumours and how well chemotherapy works to shrink them. Surgery to remove part of a kidney is called a partial nephrectomy. Surgery to remove all of a kidney is called a radical nephrectomy.
The surgeon may remove all of the kidney that contains the most tumour and part of the other kidney. The surgeon may also remove part of both kidneys.
The surgeon may need to completely remove both kidneys, but this is uncommon. If both kidneys are removed, the child will need dialysis. A kidney transplant will be done when a donor kidney becomes available. Most transplant centres will want to wait 1to 2 years after treatment before doing a kidney transplant to ensure that the cancer is not going to come back (recur).
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Radiation therapy may be given to the abdomen after surgery.
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