What Is Wilms Tumor?

Wilms or Nephroblastoma tumors are rare renal tumors and usually affect children aged 3-4 years, especially boys. The risk for this disease will decrease after the child entering the age of 5 years. In general, this tumor attacks only one part of the kidney, but it is not possible to attack both kidneys in the body. Although included in the rare category, Wilms tumor is the most common kidney tumor in children compared to other tumor types.

The cause of Wilms tumor is not known for certain. However, there are several factors that are thought to increase a child's risk of developing this condition, including medicines, chemicals consumed, and race. In addition to these three factors, Wilms tumor risk can also increase because:

• Genetic factors. Although certain genetic factors may increase a child's risk for Wilms tumor, the condition is not passed directly from parent to child. Only 1-2 percent of children with Wilms tumors who have relatives with the same condition, and that was not his parents.
• Abnormalities from birth. An estimated 10 percent of cases of Wilms tumors are due to birth defects, such as aniridia (an incomplete state of the eye lining), hemihypertrophy (the condition of one part of the body larger than the other), undescended testicles or undescended testicles in the bladder ) or hypospadias (the urinary tract of the penis is not in the proper position).
• Illness or syndrome. Some diseases or syndromes can also trigger, among them the WAGR syndrome (a mixture of conditions ranging from anirida, genital abnormalities, urinary system, and mental retardation), Denys-Drash syndrome (or a combination of renal disease and abnormalities in male testicles) or Beckwith- Wiedemann (including abdominal organs protruding at the base of the umbilical cord, macroglossia and enlarged internal organs). In addition, some syndromes such as Frasier's syndrome, Perlman, Sotos, Simpson-Golabi-Behmel, Bloom, Li-Fraumeni and Edward's syndrome can also be a trigger for the disease.

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Symptoms of Wilms Tumor
In general, Wilms tumor sufferers do not show clear symptoms, but did not rule out the possibility of some symptoms such as:

• Pain, discomfort, or swelling of the abdomen.
• Fever
• Change color in urine or presence of blood in urine.
• Constipation.
• Nausea and vomiting.
• Feeling limp and tired quickly.
• Decreased appetite.
• High blood pressure to cause dizziness, chest pain, and shortness of breath.
• Unbalanced body growth.

Immediately see a doctor if you feel the symptoms of Wilms tumor to be acted on quickly.


Wilms Tumor Diagnosis
In the early stages, the doctor will usually perform a physical test and ask some related questions such as symptoms experienced, duration of symptoms are popping up and family medical history if there is a cancer or disease at birth.

If the doctor suspects Wilms tumor in the patient's body, the doctor may suggest a blood and urine test to see the patient's overall health condition. If you find further obstacles, your doctor may perform tests such as CT ( Computerized Tomography) Scan, MRI ( Magnetic Resonance Imaging) , and ultrasound to support the diagnosis.

Sometimes, if the doctor diagnoses a Wilms tumor in the patient's kidney, the doctor may perform the surgery. Surgery serves as a diagnostic enforcer, in which the results of tissue taken will be examined in the laboratory to investigate whether the tumor is benign or malignant.

In the doctor's diagnosis, there are 5 stages of Wilms tumor that can indicate the severity of the disease, namely:

• Stage 1 . Approximately 40-45 percent of cases of diagnosed Wilms tumor are still at this stage. In stage 1, the tumor is still lodged within one of the patient's kidneys and can be cured via surgery.
• Phase 2 . About 20 percent of cases of diagnosed Wilms tumors have entered this stage. In stage 2, the tumor has spread into the tissues surrounding the kidneys, including blood vessels. The operation can still be an option at this stage.
• Stage 3. Approximately 20-25 cases of diagnosed Wilms tumor already exist at this stage. In stage 3, the spread of the tumor is already widespread and begins to reach the lymph nodes around the kidneys, where not all tumor tissue can be removed by surgery.
• Stage 4. About 10 percent of Wilms diagnosed tumor cases are present at this stage. In stage 4, the tumor is not only in the kidneys, but has spread to several other organs such as the lungs, liver, or brain.
• Stage 5. About five percent of cases of diagnosed Wilms tumors have entered this final stage. In stage 5, the patient has a tumor on both of his kidneys .

Wilms Tumor Treatment
Treatment for Wilms tumor is usually a combination of surgery and chemotherapy. However, treatment options may differ for each person, depending on the condition and degree of severity of the illness. Here are a number of treatment methods commonly done by doctors to treat Wilms tumor:

• Operation. There are two surgical options that your doctor may do to remove the tumor, namely partial nephrectomy and radical nephrectomy . In partial nephrectomy, the doctor will remove all tumors and some tissues around the tumor. This operation is selected if the tumor is still small or if the patient's kidneys are still functioning properly. While in radical nephrectomy , the doctor will remove all the kidneys and surrounding tissues, including the urinary tract, adrenal glands, or lymph nodes. However, if the tumor attacks both kidneys, the doctor may raise the patient's kidney. The removed kidneys will then be replaced with a donor kidney, or the patient will need dialysis for life.
• Chemotherapy. If the Wilms tumor can not be removed during surgery or has a size large enough, the doctor may suggest chemotherapy. By combining a number of drugs, this therapy serves to kill cancer cells. Sometimes chemotherapy is combined with surgery, which is to shrink the tumor before surgery or kill the remnants of postoperative cancer cells. Chemotherapy is usually done in two ways, namely injections through blood vessels or taken in pill form.
• Radiation Therapy. In addition to chemotherapy, radiation therapy can also be an option especially for patients with tumors that have spread to other organs. This therapy uses a high enough radiation beam and directed at the infected part of the body in order to kill the existing cancer cells, either before or after surgery.

In general, Wilms tumor can be cured completely, but this depends on the severity of the tumor, the age and condition of the patient's own body. Do not forget to always encourage patients, especially pediatric patients, during the treatment process so as not to feel hopeless or scared through the process. In addition, some things like maintaining cleanliness, regulating diet and allowing it to live a normal life are also things to keep in mind. Talk to your doctor to find out the right way to keep and support Wilms tumor patients.


Wilms Tumor Complications
In general, the complications of cancer patients and tumors are when the tumor spreads and attacks other parts of the body (metastasis). This can lead to serious complications and should be treated further in order to be appeased.

In addition to complications due to tumors, patients who are in the process of chemotherapy treatment can also experience side effects such as hair loss, nausea, vomiting, feeling tired, diarrhea, anemia, appetite and weight loss, pain in the body, neutropenia disorders (condition of blood disorders ), sprue, bruising, sleeping difficulties, bladder problems, hypertension, discoloration of the skin and nails, and the risk of infection.

Immediately see a doctor if you experience complications, side effects, or feel unusual.

Wilms Tumor Prevention
In general, Wilms tumor can not be prevented. However, if the baby is born with certain congenital abnormalities or suffering from the syndrome associated with Wilms tumor, it is advisable to perform regular renal ultrasound examination to allow the tumor to be detected early.

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