Nephroblastoma, also known as Wilms’ tumor, is the most common kidney cancer in children. It accounts for between 5% and 14% of all childhood cancers (1 case per 10,000 births, with nearly a hundred cases per year on average in France). Wilms’ tumor usually appears in children under 5 years old, but it can sometimes be diagnosed in older children and, exceptionally, in adults. It is a very different tumor from adult kidney cancers. It is considered an embryonic tumor because the cancer cells resemble embryonic cells that will form the kidney.
The causes of this disease remain unknown, and research has not demonstrated any links between the development of nephroblastoma and the environment, diet, the child’s lifestyle, or psychological factors. In only 10% of cases, nephroblastoma is associated with malformations (for example, abnormalities of the urinary or genital tracts) linked to genetic anomalies that may promote its occurrence (these are not familial forms with genetic transmission).
Symptoms
The presence of a mass in the abdomen often represents the first warning sign and is often painless. It is often discovered by parents during bathing or dressing (a lump in the abdomen or the impression of a large, swollen belly). Less commonly, the appearance of blood in the urine leads parents to consult their general practitioner.
Diagnosis
Additional examinations to those of the doctor are necessary to establish the diagnosis (a blood test does not confirm or exclude the presence of nephroblastoma). Imaging tests (ultrasound, CT scan, or MRI) are performed to better locate the tumor and to see if it has spread (metastasized), particularly to the lungs and liver. In rare cases, if the radiologist suspects another tumor, a biopsy will be performed to confirm its nature. At the end of these examinations, the doctor can confirm the diagnosis of nephroblastoma, which can be limited to the kidney (localized), have distant locations (metastatic, or stage 4), or affect both kidneys (bilateral, or stage 5). At the slightest doubt, we recommend that you make an appointment with your general practitioner so that the necessary examinations can be prescribed for the child.
Treatments
Thanks to significant therapeutic advances over the past 40 years and specialized care, the cure rate for nephroblastoma now reaches 90%. The classic treatment begins with chemotherapy, lasting about a month, aimed at reducing the tumor before surgery. This allows for the complete removal of the tumor and the affected kidney (nephrectomy). In some rare situations (such as disease in both kidneys), part of the kidney will be preserved. The examination of the removed kidney under a microscope will then allow for the adaptation of postoperative treatment, consisting of chemotherapy (which can be short or last up to 34 weeks) and in some cases, radiotherapy. It is entirely possible to live with one kidney, with the remaining kidney enlarging to ensure normal blood waste filtration. Recommendations are given to limit any toxicity to the remaining kidney, and close monitoring is established. Indeed, after treatment, children are regularly followed for several years to detect any recurrence or other complications.
Research Against Nephroblastoma with Imagine for Margo
Since 2011, Imagine for Margo has made research against cancer in children, adolescents, and young adults its priority. Given the current situation, the association funds numerous research programs to cure more and better the young affected by cancer.
Current research on childhood nephroblastoma aims to further improve the management of this disease by increasing the effectiveness of treatments and reducing their side effects.
If you wish to support research and help build a world with children free from cancer, please consider making a donation by clicking here. Every gesture is essential in our fight for life.
Together, we will defeat children’s and adolescents’ cancer.
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