Wilms tumor or nephroblastoma is a type of kidney tumor that attacks children aged 3-4 years, especially boys. These tumors generally only attack one kidney, but it is possible that the tumor can attack both kidneys in the child's body. Wilms tumor is a rare type of tumor. However, this tumor is the most common kidney tumor in children compared to other types of tumors.
Causes of Wilms Tumor
The exact cause of Wilms' tumor is not known. However, there are several factors that can increase a child's risk of developing this condition, namely:
- Genetic factors. If a family member has a history of Wilms tumor, the risk of a child also having Wilms tumor is higher.
- Congenital (congenital) abnormalities. Wilms tumor is at high risk for infants or children who have congenital abnormalities, such as:
- aniridia, This is a condition in which the colored part of the eye (iris) is partially or completely lost.
- hypospadias, namely a condition when the urinary tract hole in the penis is not in the position it should be.
- cryptorchidism, This is a condition in which the testes do not descend into the scrotum at birth.
- hemihypertrophy, This is a condition when one part of the body is larger than the other.
- Have certain diseases. Some types of disease can also put a child at risk for Wilms tumor, although the disease is also rare. Among them:
- WAGR syndrome, a combination of symptoms of aniride, abnormalities in the genitals and urinary system, and mental retardation.
- Beckwith-Wiedemann syndrome, characterized by above-average birth weight (>4 kg) and abnormal growth.
- Denys-Drash syndrome, This includes a combination of kidney disease and testicular abnormalities.
Symptoms of Wilms Tumor
The main symptom of Wilms tumor is pain and swelling in the abdomen. However, Wilms tumor can also cause other symptoms, such as:
- Fever
- Excessive fatigue and weakness
- Decreased appetite
- Nausea and vomiting
- Constipation
- Hard to breathe
- Increased blood pressure
- Hematuria or bloody urine
- Unbalanced body growth
Wilms Tumor Diagnosis
As a first step in diagnosis, the doctor will examine the patient's medical history and symptoms. Next, the doctor will perform a physical examination to detect the presence of a tumor by pressing the patient's abdomen. To confirm the diagnosis, the doctor will recommend the patient to undergo several supporting tests, namely:
- Blood and urine tests, to check the patient's kidney and liver function, as well as the patient's overall health condition.
- imaging test, to get a more detailed picture of the condition of the body's organs, especially the kidneys, and to detect the spread of tumor cells. The types of imaging tests that can be done are abdominal ultrasound, X-rays, CT scans, and MRIs.
- Biopsy, namely taking tumor tissue samples to go through the process of analysis and evaluation in the laboratory.
After the doctor confirms the diagnosis, the doctor will determine the stage of Wilms tumor suffered by the child. There are 5 stages of Wilms tumor that indicate the severity of the tumor, namely:
- Stage 1 – The tumor is only in one kidney and can be cured through surgery.
- Stage 2 – The tumor has spread to the tissues surrounding the kidney, including the blood vessels. At this stage, surgery is still an option to treat Wilms' tumor.
- Stage 3 – The tumor has spread and has begun to reach other abdominal organs or lymph nodes.
- Stage 4 – The tumor has spread to other organs that are far from the kidney, such as the lungs, bones, or brain.
- Stage 5 – The tumor has invaded both kidneys.
Wilms Tumor Treatment
The doctor will determine the steps for treating Wilms tumor based on the age, severity of the tumor, and the child's overall health. There are three main treatment methods that can be done, namely:
- Surgical removal of the kidney (nephrectomy), This is a procedure that removes part, all, or both of the kidney where the tumor is located. Patients who have both kidneys removed will undergo dialysis (hemodialysis) for the rest of their lives or undergo a kidney transplant if they get a kidney from a donor. Surgery is the most common treatment method for Wilms tumor patients.
- Chemotherapy.This procedure is performed if the tumor is large enough or surgery is not able to remove all the cancer cells. Chemotherapy will destroy the remaining cancer cells. Sometimes, chemotherapy is also done before surgery to shrink the size of the tumor.
- radiation therapy (radiotherapy), namely treatment therapy using high-frequency radiation beams that are directed to the body part infected with cancer cells. Radiation therapy can also be an option for patients with tumors that have spread to other organs of the body.
The doctor will give the patient medication to control pain, nausea, and prevent infection. Patients are also advised to have regular check-ups to detect if cancer cells reappear and evaluate new or remaining kidney function.
Wilms Tumor Complications
Complications of Wilms tumor occur when the tumor has spread and invaded other organs in the body, such as the lungs, lymph nodes, liver, bones, or brain. Some of the complications that may be experienced by patients with Wilms tumor are:
- Impaired kidney function, especially if the tumor is in both kidneys.
- Heart failure.
- Impaired growth and development of children, especially height.
Wilms Tumor Prevention
Wilms tumor cannot be prevented. However, if the baby is born with certain congenital abnormalities or suffers from a syndrome associated with Wilms' tumor, it is highly recommended to carry out regular ultrasound examinations, at least every 3-4 months until the child is 8 years old, so that the tumor can be detected and treatment steps can be taken early. .
