When is chemotherapy recommended for Wilms tumour?

Wilms tumour, also called nephroblastoma, is a kidney cancer that mainly affects children. Treatment is planned by a paediatric oncology team and usually combines surgery with chemotherapy; radiotherapy is added for selected higher-stage or higher-risk findings. Chemotherapy before surgery may shrink the tumour and make removal safer, particularly when the tumour is large or involves nearby structures. After the kidney tumour is removed, the pathology and stage help determine which medicines are needed.

The treatment plan also considers whether cancer is present in the other kidney or has spread to the lungs or elsewhere. Some children need a shorter, less intensive plan, while higher-risk disease may require additional medicines or radiotherapy. The team balances cancer control with protecting growth, kidney function, hearing and other developing organs.

Ask the team to explain the stage, histology and treatment group in language your family can use. Keep a record of medicines, fever instructions, appointments and test results. Tell clinicians about allergies, previous illnesses and medicines. Encourage the child to drink as advised and follow infection-prevention guidance; never give a new medicine without checking the oncology team.

Call the oncology team urgently for fever, chills, repeated vomiting, inability to drink, reduced urine, unusual bleeding or marked sleepiness. Seek emergency help for breathing difficulty, seizure, severe abdominal pain, collapse or confusion. Use the emergency instructions supplied by the child’s treatment centre.

Will chemotherapy be given before surgery, after surgery, or both? What do the stage and histology mean for the plan? How will the remaining kidney and long-term health be monitored?