The chance that a child will be cured depends on the type, stage and location of the tumor.
For Wilms' Tumor
This type of tumor has a high cure rate with treatment. Now, more than 90 of every 100 children with favorable tumors survive. But there can be complications. The tumor can spread to the lungs, bone or brain. Removal of a bilateral tumor may harm the way kidneys function. Ongoing follow-up care will be important.
The outcome varies based on how far the tumor has spread. This is a very difficult cancer to treat. The 5-year survival rate is around 50-75% if the tumor is found early. If it has spread to the lymph nodes, the 5-year survival drops to 10-15%.
Ideally, tumors that return are caught quickly and can be more easily managed. A conservative approach to surgery will be used to protect the kidney.
Children with very aggressive cancers are harder to treat. Wilms' tumors may come back in several sites, including:
- Local surgical area
- Opposite kidney (occurs later)
The timing for when a returning tumor is found is important. If the disease comes back early in kids on chemotherapy, it is very hard to manage. If cancer is found in the abdomen after radiation, it also means the cancer is aggressive.
There are lesions (sores) in the kidney that are known to show up before Wilms' tumor. These lesions must be watched very closely. Regular imaging will be done to try to manage new tumors before they spread.
Treatment Side Effects
All cancer treatment has side effects. Some things can be managed well, like nausea. Other side effects can't be avoided. As a child's body develops, they may experience long term affects from cancer drugs.
Fortunately, modern radiation aims to protect children's bones. The amount of radiation therapy given to children with Wilms' tumor has decreased. Less often, children experience problems with the way their spine grows. Physical therapy is helpful to strengthen muscles around the spine.
Additional cancer is a major concern for children who have been treated for kidney cancer. The bone, breast and thyroid are carefully watched. Children who had radiation therapy or were treated with doxorubicin are at higher risk.
Children enrolled in clinical trials for treatment are followed closely throughout their life. Clinical trails are a great way to receive ongoing and careful care. You can ask your doctor if it's possible to enroll in a clinical trail.
Some patients who receive radiation in the abdominal area may not reach puberty properly. Ovarian failure and testicular failure have also occurred. This is a concern for some people.
For children with one remaining kidney, it is important to pay attention to the health of that kidney. Often, the remaining kidney can keep the body healthy. Sometimes, the remaining kidney experiences damage. Dialysis may ultimately be needed.