Important Things All Parents Need To Know About Pediatric Kidney Cancer

With proper and timely diagnosis of this childhood cancer, along with access to care and a robust treatment plan, pediatric kidney cancer can be defeated.

Parents are always worried about the health and well-being of their children. Doctors suggest that the best way to ensure children are leading healthy and disease-free lives is by being aware of some common and uncommon diseases, including pediatric cancers. Knowing the signs and symptoms, getting a disease diagnosed and beginning treatment promptly can save little lives. In this article, we look at pediatric kidney cancer, what it essentially means, and other important things parents need to know.

What Are Pediatric Cancers?

These cancers occur in childhood. Dr Kavitha Vijayakumar, AVP and lab operations, Metropolis Healthcare Ltd, Tamil Nadu, Andhra Pradesh and Telangana warns that every year around 50,000 new pediatric cancer cases are diagnosed in India.

Everything To Know About Wilms Tumor

Dr Kavitha explains that Wilms tumor is the most common renal tumor in children, which is usually seen between the ages of two and four years. These tumors comprise 5-6 per cent of childhood cancers.

“Unlike adult tumors, Wilms tumor is not associated with known environmental risk factors,” the doctor states, adding that a few genetic syndromes associated with Wilms tumor are:

WAGR syndrome;
Denys-Drash syndrome;
Beckwith-Wiedemann syndrome

Genetic alterations and a few birth defects are associated with the development of Wilms tumor, she says. “Other rare paediatric renal tumors include renal clear cell sarcoma and renal cell carcinoma.”

Signs And Symptoms Of Wilms Tumor

The expert says children with Wilms tumor usually present with the following signs and symptoms:

Palpable mass in the abdomen — identified by the parents or primary pediatrician.
Blood in the urine.
Pain in the flank region.
Incidental finding following a blunt injury.

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Diagnosis

Diagnosis is done through a series of imaging and laboratory tests, the expert says. “Ultrasound scanning and MRI can identify the lesion, including its size. Laboratory tests to be done include: renal function tests, complete urine analysis, coagulation profile, and cytogenetic tests to detect genetic abnormalities.”

In some cases, renal biopsy may be required to identify the ‘histologic subtype’. “Molecular studies are done on the biopsy block to confirm genetic alteration. The diagnosis, however, is made after clinical and radiological investigations. Histological diagnosis is made after the surgery,” the health expert points out.

Treatment Plan

Treatment plan requires the participation of a multidisciplinary team comprising a pediatric surgeon, pediatric urologist, radiation oncologist, medical oncologist, and a pathologist. Treatment is decided based on:

The presence of tumor in one or both kidneys;
The age of the child;
The dimensions of the tumor;
The stage of the disease

“Wilms tumor can be treated when a diagnosis is made early. There are two treatment options: primary surgery (nephrectomy with lymph node dissection) followed by chemotherapy and radiotherapy depending on the histological subtype; preoperative chemotherapy to reduce tumor spillage, followed by nephrectomy,” Dr Kavitha explains.

She concludes by saying that renal clear cell sarcoma is the ‘second most common renal pediatric cancer’. “It occurs in children between three and five years of age, more commonly in males. It is aggressive, with the potential to spread and relapse following treatment.”