Pediatric Cancer Care


Cancer Care

Team-based treatment for nephroblastoma and other kidney tumors in children

Wilms’ Tumor and Other Kidney Cancers

Comprehensive Care for Pediatric Kidney Tumors

Wilms’ tumor — also known as nephroblastoma — is the most common type of kidney cancer in children. This cancer usually involves only one kidney, but in some children, it may affect both kidneys. There are also rare types of pediatric cancer that affect the kidneys. At NewYork-Presbyterian, our pediatric cancer teams understand these diseases and treat children with expertise and compassion. With prompt therapy using the latest treatments, more than 90 percent of Wilms' tumors can be cured.

Types of pediatric kidney cancer

We treat Wilms' tumor and all types of pediatric kidney cancers, including rare tumors such as:

  • Rhabdoid tumor
  • Renal medullary carcinoma
  • Renal cell carcinoma
  • Congenital mesoblastic nephroma
  • Clear cell sarcoma of the kidney

What causes Wilms' tumor?

Most children develop Wilms’ tumor due to a random change or mutation in their genes. However, about 1 to 2 percent have a family member or relative with the disease. About 15 percent were born with other conditions as well, including reproductive or urinary problems, hemihypertrophy (in which one side or part of the body is larger than the other), microcephaly (in which a child’s head is abnormally small), and other rare disorders.

Signs & symptoms of kidney tumors 

Some pediatric kidney tumors do not cause symptoms but are discovered when a parent or doctor feels a painless lump in the child's abdomen. If symptoms do develop, they may include:

  • Blood in the urine
  • Anemia (low red blood cell count, which may be accompanied by unusual bleeding or fatigue)
  •  Weight loss
  • Fever

How we diagnose Wilms' tumor

If your child has a lump or other symptoms that suggest a kidney tumor, we may perform a range of tests to determine their cause. We make sure your child is comfortable during these procedures.

  • Physical examination
  • Imaging tests such as ultrasound, CT scan, or MRI scan
  • Biopsy of tumor tissue, taking a small sample to analyze for cancer cells

We may also perform testing for rare genetic changes that predispose some children to kidney tumors. This information may be helpful to families who are concerned that other family members may have these mutations. Genetic counseling is available to all families.

Our approach to care

Pediatrics-Cancer Care-Kidney Tumor.jpgYour child's team includes pediatric surgeons, oncologists, and oncology nurses/nurse practitioners/physician assistants who collaborate with social workers, child life specialists, genetic counselors, pediatric psychologists/psychiatrists, art therapists, registered dietitians, integrative health professionals, and others to ensure that your child's experience is as comfortable as possible. If your child needs care from a doctor in another field, we offer that too, with every type of pediatric specialist available through the children's hospitals of NewYork-Presbyterian.

Wilms' tumor treatment

Wilms' tumor is grouped into two major types based on how they look under a microscope: favorable and unfavorable. This distinction helps your child's care team choose the most effective course of therapy. We customize the treatment of pediatric kidney tumors according to this grouping as well as their type, location, size, and biology. Treatment may include:

Surgery. The removal of kidney tissue is called nephrectomy. Your child may have surgery to: 

  • Remove the tumor and some surrounding kidney tissue, enabling the kidney to retain some function (partial nephrectomy, a good option for children with or predisposed to tumors in both kidneys)
  • The affected kidney alone (simple nephrectomy)
  • The entire affected kidney plus some tissues around it, adrenal gland, and nearby lymph nodes (radical nephrectomy)

Chemotherapy is used before surgery in children with very large tumors to shrink the tumor and make it easier to remove. If the tumor comes back after chemotherapy and surgery, we may give more intensive chemotherapy or new targeted treatments or recommend participation in a clinical trial of an investigational medication.

Radiation therapy is also useful for shrinking pediatric kidney tumors. It may be used in combination with surgery and chemotherapy for children whose tumors have a high risk of returning and those that came back after initial treatment. Radiation therapy care is offered at by professionals at both Columbia and Weill Cornell Medicine. 

Investigational treatments. Your child may have opportunities to participate in clinical trials of innovative treatments, conducted by Columbia University and Weill Cornell Medicine investigators. These studies are especially hopeful for families of patients whose tumors are still growing and no longer responding to other treatments.

Why choose us

If your child has been diagnosed with Wilms' tumor or a rare kidney cancer, we understand your concerns and desire to get the best treatment available. At NewYork-Presbyterian, we provide therapies based on the latest research and connect your child and family with all the resources you need. Your child's treatment is personalized to the genetic features of the tumor. And if the cancer comes back, we'll continue treating it using other approaches and investigational therapies in clinical trials if needed. Contact us to learn what we can do for your child.

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