FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

WILMS TUMOR: A CURABLE CHILDHOOD CANCER

Question: When my daughter was eight months old she was diagnosed with Wilms tumor. She had the kidney with the tumor removed and then had chemotherapy. She is now six and doing great. I had another daughter two years later who was checked for Wilms tumor, but she did not have it. The doctors didn't explain very much to me. I hope you can tell me more.

Answer: Wilms tumor is a type of cancer that usually strikes children. It is not common, but it certainly doesn't qualify as a rare disease. It occurs in one out of every 100,000 children under the age of 5.

Wilms tumor is usually found during a well-child examination as a lump, what we physicians call a mass, deep inside the abdomen. This cancer grows from the kidney and, therefore, is located deep below the stomach, intestines and other abdominal contents. Only in unusual cases does the growth become large enough to be noticed without specifically feeling for it. Children with this often have no complaints to suggest there is a problem. Rarely, some do complain of low-back pain or generally not feeling well.

A child who is found to have an abdominal mass must undergo several tests to determine the specific cause of it. An MRI, CT scan, kidney X-rays and biopsy are often used. Wilms tumor has a characteristic appearance on these tests and the tissue sample obtained from the biopsy shows a type of cancer called ìnephroblastoma.

The thought of having your child stricken with cancer is every parents' nightmare. Wilms tumor treatment is one of the brighter spots in that dark realm of cancer fears. About 90 percent of those diagnosed when the tumor is in one kidney (90 percent of cases) and has not spread outside that kidney are cured by surgery and chemotherapy. Even those whose cancer has spread into neighboring tissues have an 80 percent cure rate. Treatment is more complicated and less successful when tumors occur simultaneously in both kidneys or when the diagnosis is made after the cancer is too widely spread for surgical removal. Fortunately, your daughter was diagnosed early.

In about 20 percent of the cases, a child with Wilms tumor is born with a defect on chromosome 11. The tests your younger daughter had, thankfully, indicated that she does not have this abnormality, which means she is at very low risk of Wilms.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.