Wilms' tumor, also known as nephroblastoma, is a type of cancer that affects children. It is a malignant growth that can occur in one or both kidneys, but most commonly affects just one kidney. The Lippincott Manual of Nursing Practice states that Wilms' tumor constitutes approximately six percent of all childhood tumors with 75% of cases occurring before a child is five years old.
Signs of Wilms' Tumor
There is no known cause for Wilm's tumor but it has been associated with genetic inheritance patterns and is believed to arise from immature kidney cells. Wilm's tumors grow quickly and your child may appear healthy or show some or all of the following signs stomach pain, swelling in the stomach, a mass in the kidney area that you can feel with your hands, and nausea. As the tumor gets larger and puts pressure on surrounding tissues, it may cause constipation, vomiting, weight loss, shortness of breath and loss of appetite. Hypertension, fever, anemia and blood in the urine are less common signs of Wilm's tumor.
Tests For Diagnosing Wilms' Tumor
Diagnosis of Wilms’ tumor is made by performing an ultrasound of the kidneys to visualize the tumor. A chest X-ray is done to see if the cancer has spread to the lungs and an MRI or CT scan of the stomach area is done to assess the spread of cancerous cells to lymph nodes and organs around the kidneys.
Wilms' Tumor Treatment
The tumor is primarily treated by removing it with surgery. Other treatments given after surgery include radiation therapy and chemotherapy. Wilms’ tumor has the highest survival rates when compared to other childhood cancers. It has a greater than 90 percent survival rate at four years old. The outcome of treatment, however, depends on the extent at which the lymph nodes are affected, the child’s age, the size of the tumor and possible genetic involvement.
Complications of WIlms' Tumor
Certain issues may arise from having Wilms' tumor. They include the risk that the tumor may spread from the kidneys to the lungs, lymph nodes, liver, bone and brain. If a child undergoes radiation therapy, he or she might experience stomach disturbances, liver damage, inflammation of the kidneys, infertility in girls, pneumonia or scoliosis. It is also possible that the tumor will recur.
Health Maintenance After Wilms Tumor Surgery or Treatment
If a child is left with one kidney after treatment for Wilms' tumor, the child should not be allowed to play rough contact sports to avoid damaging the remaining kidney. The following signs should be reported to a health care provider quickly: a fever, bleeding, signs of infection or exposure to chickenpox if the child has not had it yet. Infection prevention methods such as hand washing and avoiding other children with contagious diseases should be practiced. It is important for parents to refrain from manipulating the stomach area of a child with Wilms' tumor before or after treatment. Wilms' tumor is soft and has good blood supply. Excessive handling of the child’s stomach may lead to the spread of the tumor cells to surrounding tissues or organs.
References:
Health.google.com, "Wilms' tumor" (accessed March 2, 2010)
MayoClinic.com, "Wilms' tumor" (accessed March 2, 2010)
Nettina, Sandra M., Lippincott Manual Of Nursing Practice, Lippincott Williams & Wilkins, 2009.
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