How effective is chemotherapy for Wilms tumour?

Wilms tumour, also called nephroblastoma, often responds to medicines that destroy or slow cancer cells. Chemotherapy may be given before surgery to make removal safer or after surgery to treat cells that may have travelled beyond the kidney. Children with more extensive disease or particular tumour features may need a stronger or longer treatment plan. Surgery and, in selected situations, radiotherapy may be part of the same programme. Imaging, examination, kidney-related checks and review of the tissue removed at surgery help the team refine treatment. A response can mean that the tumour becomes smaller, disappears from scans, or remains controlled while treatment continues.

The paediatric oncology team will explain treatment days, blood tests and medicines for nausea or other effects. Ask how to protect the child from infection and when school or activities can continue. Report reduced drinking, repeated vomiting, diarrhoea, mouth sores, pain, unusual bruising or marked sleepiness. Keep a record of medicines and temperatures if the team recommends it. Because treatment can affect growing bodies, ask about kidney function, hearing, heart health, fertility and long-term follow-up when those issues apply to the planned medicines.

Call the oncology team promptly for fever, chills, breathing trouble, repeated vomiting, inability to drink, severe pain, unusual bleeding or a child who is difficult to wake. Chemotherapy can reduce infection-fighting blood cells, so fever during treatment needs prompt guidance. Use emergency services for collapse, severe breathing difficulty or uncontrolled bleeding.

What tumour features guide my child’s chemotherapy plan? Is treatment before or after surgery, and why? How will you assess response? Which late effects will follow-up monitor?