Surgery

Surgery is the most prevalent form of treatment for Wilms’ tumor wherein the doctor might remove the cancerous growth employing one of the below stated procedures.

• Partial Nephrectomy – This procedure is conducted for removal of the cancer and a section of the kidney that is situated around it.  It usually is done in just rare cases when there is damage done to the other kidney or has previously been taken out.
• Simple Nephrectomy – This procedure involves the complete removal of the kidney. The other kidney would then take on the role of purifying the blood.
• Radical Nephrectomy – In this procedure there is total removal of kidney, adjoining tissues and some of the lymph nodes.

Chemotherapy

Chemotherapy is the usage of drugs administered in either pill form or intravenously for annihilating cancer cells. Chemotherapy is also known as systemic treatment as the drugs on entry into the bloodstream, pass through the body and can stamp out cancer cells all through the body .When chemotherapy is offered as a post-operative procedure then it is known as adjuvant therapy.

In case elevated doses of chemotherapy are employed for killing the cancer cells, then the high doses could mar the blood-producing tissue present in the bones or bone marrow. If elevated doses of chemotherapy are required for treating the cancer, then the bone marrow might be extracted from the bones prior to therapy and kept in the freezer till its need arises. Subsequent to chemotherapy, the bone marrow is intravenously reinstated. This is known as autologous bone marrow reinfusion.

Radiation Therapy

Radiation therapy makes use of X-rays or other forms of high-power rays for annihilating cancer cells and shrinking the tumors. Radiation done for treating Wilms’ tumor generally is given through a machine located outside the body, also known as radiation therapy. Radiation might either be employed prior to or following surgery and chemotherapy.

Some patients tend to develop a second, altered form of the cancer after several years due to the outcome of being treated with chemotherapy and radiation. On-going clinical trials are intended at ascertaining whether chemotherapy and radiation could be employed in lower doses.

Stage-Wise Treatment

Treatment offered is dependent on the stage of the tumor, cell type or histology and the child’s overall health condition and age. A standardised treatment is adopted on the basis of its efficacy in several patients in earlier studies or investigational. The doctor might suggest that the child partake in a clinical trial – a research project that involves new investigational treatments. Several patients do not seem to be cured using standard therapy and there may be undue number of side effects experienced with some of the standard treatments. Due to these reasons, clinical trials are intended for testing novel, better treatment alternatives.

Stage I – In case the tumor bears a ‘favourable’ cell type or the child is having anaplastic Wilms’ tumor, then surgery for removal of cancer would be the probable line of treatment followed by chemotherapy. Surgery and subsequently radiation therapy and chemotherapy would be the probable line of treatment in case the child is having either clear cell sarcoma of the kidney or rhabdoid tumor.

Stage II – In case the tumor bears a ‘favourable’ cell type, the treatment would mostly involve surgery for removal of cancer, after which chemotherapy would be given. In case the child is having an ‘unfavourable’ cell type like anaplasia, clear cell sarcoma or rhabdoid tumor of the kidney, then the treatment might include surgery that would be followed by radiation therapy and chemotherapy.

Stage III – The treatment would possibly be surgery after which radiation therapy and chemotherapy would be given. At times, it is not possible to remove the cancer via surgery as it is located in close proximity to vital organs or blood vessels or due to its overbearingly large size. In such situations, only biopsy is conducted following which chemotherapy might be suggested that may or may not include radiation. Subsequent to the cancer being minimised by treatment, surgery would be conducted, that would be followed by further chemotherapy and radiation therapy sessions.

Stage IV – The line of treatment would generally be surgery that would be followed by radiation therapy and chemotherapy. In case there has been cancer metastasis or the cancer spreading to the lungs, then further chemotherapy sessions might be given.

Stage V – If cancer has metastasized to both the lungs, generally it is unfeasible to remove both the kidneys. A portion of the cancer from both the kidneys and adjacent lymph nodes might be removed for checking the presence of cancer. Subsequent to surgery, chemotherapy is conducted for shrinking the tumor. Following reduction of the cancer, a second operative procedure might be conducted for removing major parts of the cancer, while attempting to leave as much part of the kidneys as possible. Surgery might be followed by additional chemotherapy and radiation therapy.

Persistent – In case the cancer has relapsed in the child, the treatment offered would depend on the treatment previously offered, the amount of time transpired following the last treatment, the type of the cancer cells and the location of its re-emergence. Based on these factors, treatment would comprise of surgery, radiation therapy and chemotherapy.

Clinical trials, investigative projects that involve patients, aid in assessing novel treatments, like chemotherapy drugs, novel blends of treatments and bone marrow reinfusion.

Cancer treatment is either local or systematic therapy.

• Local Therapy –Local therapies like surgery and radiation therapies help in removal and eradication of cancer that might be present in or in close proximity to the stomach. When the stomach cancer metastasizes or has proliferated to other areas of the body, then in such cases local therapy might be used for controlling the disease in those particular areas.
• Systemic Therapy – Systemic therapy like chemotherapy employ the use of drugs that enter the bloodstream and annihilate or curb the disease all through the body.

As cancer treatments mostly cause harm to the healthy tissues and cells, hence it is common to experience side effects that depend chiefly on the kind and the degree of treatment. Side effects might vary for each individual and from one treatment sitting to the other.

Prior to commencing on the treatment, the health care team would elucidate to the patient about the probable side effects and propose means to assist in managing them.

Surgery

Surgery is the widely prevalent form of stomach cancer treatment that is dependent on the extent of the disease. There are two key types of stomach cancer surgery available:

• Partial or subtotal gastrectomy – This involves removal of a section of the stomach that has the presence of the malignant form. The surgeon would additionally eliminate certain sections of the esophagus and section of the small intestine. Lymph nodes and tissues that lie in the adjacent areas might also be taken out.
• Total gastrectomy – The doctor totally removes the stomach, the adjacent lymph nodes, sections of the esophagus and small intestine, and other types of tissues located close to the tumor. The spleen might additionally be eliminated subsequent to which the esophagus is directly attached to the small intestine. By using the tissues from the intestine, the surgeon would make a new stomach.

There are bound to be concerns regarding eating following stomach cancer surgery. During the course of the surgery, a feeding tube is inserted within the small intestine that assists in providing adequate nutrition while the patient is recuperating.

The healing period would vary in each case. One might feel discomfort during the initial few days. Medications could assist in allaying the pain. Several people that have undergone stomach surgery might experience weariness or weakness for a while. Constipation or diarrhea is also reported following surgery. Such symptoms generally could be managed by varying the diet and medications. Any symptoms of bleeding, infection or other kinds of problems could also need to be treated.

Chemotherapy

This procedure involves the intravenous administration of anticancer drugs that after gaining entry within the bloodstream aid in killing the cancer cells and could majorly affect cancerous growth all through the body. However, certain drugs might be given orally.

Several persons undergo chemotherapy following surgery while in other situations radiation therapy might be administered alongside chemotherapy. The chemotherapy sessions might be given at a clinic in a hospital, the doctor’s office or at the patient’s residence. There might be others requiring hospitalization during treatment.

The side effects arising due to chemotherapy are dependent chiefly on the particular drugs and the dosage. The drugs are known to combat cancer cells and other cells that quickly proliferate.

• Blood cells – Such cells assist in combating infection, assist in blood clotting and transporting oxygen to all areas of the body. When blood cells get affected due to the drugs, the patient is more prone to infections, bruising or easy bleeding and would constantly feel weakness and fatigue.
• Hair root cells – Hair loss could occur due to chemotherapy drugs. Though there would be re-growth, the colour and texture might feel quite different.
• Cells lining the digestive tract – Chemotherapy could lead to loss in appetite, feeling nauseous, vomiting, diarrhoea or sores forming in the mouth and lip.

The drugs administered for treating stomach cancer might additionally lead to skin rashes or itchiness.

Radiation Therapy (Radiotherapy)

This procedure employs high-power beams for eradicating the cancer cells. This is a target-specific kind of treatment done using a mammoth machine that emits the radiation. The duration of the treatment is generally five days per week spanning for several weeks.

Side effects are dependent on the dosage of radiation and what part of the body is undergoing the treatment. When radiation therapy is carried out in the abdominal region, it could lead to pain and discomfort in the stomach or intestinal region. One might feel nauseous and get diarrhea. The area of the skin that is being treated might redden, dry up and might show tenderness.

One is prone to experience significant weariness during the course of the radiation therapy, particularly so in the later part of the weeks of the treatment. Though taking adequate rest is crucial, however doctors normally suggest that patients must attempt to continue staying as energetic as they possibly could.

Though the side effects arising due to radiation therapy could be agonising, the doctor would generally treat or try to curb them. Side effects normally subside after the treatment concludes.