Over the last forty years the results of treatment for Wilms' tumours (which are also called nephroblastomas) has improved quite dramatically so that nowadays more than 9 out of 10 children with this cancer are cured. This is largely the result of combining three different types of treatment: surgery, chemotherapy and sometimes radiotherapy.

Over the last forty years the results of treatment for Wilms' tumours (which are also called nephroblastomas) has improved quite dramatically so that nowadays more than 9 out of 10 children with this cancer are cured. This is largely the result of combining three different types of treatment: surgery, chemotherapy and sometimes radiotherapy.

Surgery forms the cornerstone of treatment, with an operation to remove the affected kidney. The operation also allows removal of a number of nearby lymph nodes (glands), and examination of major blood vessels, and surrounding organs, to check for signs of spread of the cancer.

The operation is often followed by a course of radiotherapy, either to the area where the kidney was (the renal bed) or to the whole of the belly. Sometimes, if scans and x-rays have shown secondary cancers in the lungs, then radiotherapy might also be given to the chest.

Wilms tumours are usually sensitive to a number of different chemotherapy drugs, including actinomycin, vincristine, doxorubicin (Adriamycin), cyclophosphamide and carboplatin. Chemotherapy is nearly always given to prevent, or treat, any spread of the cancer beyond the kidney area. Chemotherapy may last from 2-9 months depending on how far the tumour has spread and its appearance under the microscope.

In the UK, chemotherapy is usually given before surgery in order to reduce the size of the tumour, and make the operation easier, and safer. Most countries in Europe treat it in the same way.

The operation is sometimes followed by a course of radiotherapy, either to the area where the kidney was (the renal bed) or to the whole of the tummy. Sometimes, if scans and x-rays have shown spread to the lungs, then radiotherapy might also be given to the chest.

In recent years it has been realised that the amount of treatment needed, especially the number of chemotherapy drugs, and the need for radiotherapy to achieve a cure, vary considerably from one child to another. Things like whether the cancer has spread or not, and the appearances of individual tumours under the microscope, can now be used to tailor treatment more precisely to the needs of each child. This helps to ensure that not only is the most effective therapy given, but also that side-effects are kept to a minimum.