What is the first treatment for Wilms tumour?

Wilms tumour, also called nephroblastoma, usually develops in a kidney and mainly affects children. Starting with chemotherapy can shrink the tumour before an operation and may help the surgeon remove it safely. The affected kidney is then removed in an operation called nephrectomy when the team considers this suitable.

The final treatment plan depends on scans, the tumour’s appearance, whether one or both kidneys are involved, and the pathology after surgery. Further chemotherapy may be advised, and the team may discuss other treatment if the tumour has spread.

Ask the paediatric oncology team how medicines will be given, how nausea and appetite changes will be managed, and which infections or symptoms require a call. Keep a written list of medicines and appointments, and tell the team about fever, reduced urine, vomiting or unusual tiredness.

Before kidney removal surgery, ask about hospital stay, wound care, activity limits and protecting the remaining kidney. Follow guidance about hydration, medicines and follow-up scans. Emotional support can help children and family members cope with the treatment schedule.

Contact the oncology team urgently for fever, repeated vomiting, severe abdominal pain, a swollen abdomen, blood in the urine, much less urine, unusual bleeding or marked sleepiness. Trouble breathing or a child who is difficult to wake needs emergency help.

Why is chemotherapy being started before surgery? When is kidney removal surgery planned? How will you protect the remaining kidney? What side effects need same-day advice? Will more chemotherapy be needed after the operation?