What to expect from chemotherapy for Wilms tumour

Wilms tumour, also called nephroblastoma, is a kidney cancer that mainly affects children. Chemotherapy may be used to shrink the tumour before an operation, treat cancer cells that could remain after surgery, or address disease that has spread. Some children receive it alongside other treatments. The plan depends on the tumour’s features, its stage, the operation, and how the child responds.

Medicines are usually given through a vein or another access device, during visits to a hospital or day-treatment unit. Treatment is arranged in cycles, with rest between medicines so the body can recover. The oncology team checks blood counts, kidney function, growth, nutrition and general wellbeing throughout care. Nausea, tiredness, reduced appetite, mouth soreness, hair loss and a higher chance of infection can occur, but effects vary with the medicines used. The team can offer medicines and practical support to ease symptoms.

Ask the team for the written schedule, the names of each medicine, and instructions for medicines given at home. Keep a record of temperature readings, fluid intake, meals, bowel changes and new symptoms. Encourage hand washing and follow the team’s guidance about visitors, school, food safety and activities. Offer small frequent meals and regular drinks when allowed, and tell the team if eating, drinking or taking medicines becomes difficult. Do not give a new medicine, supplement or vaccine without checking first.

Call the oncology team promptly for a fever or a child who seems suddenly unwell, because chemotherapy can make infections harder to fight. Seek urgent help for breathing difficulty, severe weakness, confusion, uncontrolled vomiting, inability to drink, very little urine, unusual bleeding, or a seizure. Use the temperature threshold and after-hours number supplied by your child’s treatment centre; do not wait for the next appointment if the team has told you to call sooner.

Useful questions include: Which medicines will my child receive, and why? How will the schedule fit around surgery? Which symptoms should be reported immediately? What can my child eat, drink and do during treatment? How will you check kidney function and blood counts? Who should we contact at night or during a public holiday?