What are the treatment options for Wilms tumour?

Wilms tumour, also called nephroblastoma, develops in kidney tissue and is most often managed by a paediatric oncology team. Kidney removal surgery may remove the affected kidney and surrounding tissue. The surgeon also assesses nearby structures and may examine lymph nodes to help understand how far the tumour has extended.

Chemotherapy uses medicines that travel through the bloodstream to target cancer cells. It may be given before surgery to shrink a tumour, after surgery to treat cells that may remain elsewhere, or in both phases. The exact plan depends on the tumour’s features, whether it has spread, the amount of surgery needed and how the tumour responds.

The team will explain the proposed sequence and how kidney function will be protected. Ask about eating, activity, school, medicines and the practical arrangements for hospital visits. Keep a record of fever, vomiting, pain, reduced urine, swelling or unusual tiredness. Give chemotherapy and other medicines exactly as prescribed, and check before adding any over-the-counter product.

You can read about [Kidney Removal Surgery](/treatments/surgical-oncology/nephrectomy/) and [Chemotherapy](/treatments/systemic-therapy/chemotherapy/) before the next appointment. A child may need reassurance, play support and age-appropriate explanations throughout treatment.

Contact the oncology team urgently for fever during chemotherapy, repeated vomiting, inability to keep fluids down, very little urine, worsening abdominal swelling, severe pain, bleeding or marked drowsiness. After surgery, increasing redness, wound discharge or difficulty breathing also needs prompt assessment.

Will surgery happen before or after chemotherapy? How will the remaining kidney be monitored? What side effects should prompt a call? How can we support normal eating, activity and school during treatment?