Wilms Tumor - Childhood: Late Effects of Treatment

Approved by the Cancer.Net Editorial Board, 08/2015

ON THIS PAGE: You will find out more about side effects that can occur long after treatment for this type of tumor has finished. To see other pages, use the menu on the side of your screen.

Although many children with Wilms tumor are treated successfully, they often have an increased risk of developing other diseases or conditions later in life, as chemotherapy and radiation therapy can cause permanent damage to healthy parts of the body. Therefore, it is important that children who have received treatment for a Wilms tumor are monitored closely for possible long-term or late effects of the treatment. These may include:

  • Kidney failure. Because children treated for Wilms tumor usually have only one kidney, they have a slightly higher risk of kidney failure and will need to be monitored for the rest of their lives. They also need to keep well hydrated to help promote good kidney health. There are some medications such as codeine and ibuprofen that should only be taken in small amounts to avoid kidney damage.

  • Bowel obstruction. Children treated with certain types of surgery are at risk for developing a bowel obstruction throughout their lives from scar tissue. A bowel obstruction will cause abdominal pain and vomiting.

  • Heart problems. Children who received doxorubicin have a higher risk of developing heart abnormalities, even years after treatment has ended. Children treated with doxorubicin and radiation therapy to the lungs have an even higher risk of developing heart problems. An echocardiogram may be used to monitor the effects of doxorubicin on the heart.

  • Lung problems. Children who received radiation therapy to their lungs for a metastatic Wilms tumor are at risk for developing lung problems after treatment has ended. Pulmonary function tests can be done to see if there are any changes to the lungs.

  • Skeletal abnormalities. If radiation therapy was given, scoliosis (curvature of the spine) and underdevelopment of nearby soft tissue may occur. This risk depends on the location and dose of the radiation therapy.

  • Secondary cancer. Wilms tumor survivors have a small risk of developing another type of cancer within 15 years after the Wilms tumor was first diagnosed. The most important risk factors are whether treatment included radiation therapy and doxorubicin. For example, young girls who have radiation therapy to treat a Wilms tumor that has spread to the lungs have an increased risk of developing breast cancer.

  • Pregnancy concerns. Females who had abdominal radiation therapy for a Wilms tumor should be considered high-risk during pregnancy and monitored closely by their doctors. Chemotherapy alone does not increase the risk of miscarriage; however, women who received radiation therapy aimed at the side of the body between the rib and hip, depending on the dose, are more likely to have early labor, an unusual position of the baby’s head during birth, lower birth weight, and premature delivery (less than 36 weeks) based on National Wilms Tumor Study records. Congenital abnormalities are also more common.

The next section in this guide is Follow-up Care, and it explains the importance of check-ups after treatment has finished. Or, use the menu on the side of your screen to choose another section to continue reading this guide.