Wilms Tumor - Childhood: Late Effects of Treatment

Approved by the Cancer.Net Editorial Board, 01/2022

ON THIS PAGE: You will find out more about side effects that can occur long after treatment for a Wilms tumor has finished. Use the menu to see other pages.

Although many children with a Wilms tumor are successfully treated for cancer, they often have an increased risk of developing other diseases or conditions later in life. This is because 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 who receive treatment for Wilms tumor usually have only 1 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 who have certain types of surgery may develop scar tissue that puts them at risk for developing a bowel obstruction throughout their lives. A bowel obstruction will cause abdominal pain and vomiting.

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

  • Lung problems. Children whose cancer had spread to their lungs and who received radiation therapy to that location 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. Scoliosis, or curvature of the spine, and underdevelopment of nearby soft tissue may happen in children who received radiation therapy. This risk depends on the location and dose of the radiation therapy.

  • Second 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 for a second cancer are whether treatment included radiation therapy and doxorubicin. For example, radiation therapy to treat a Wilms tumor that has spread to the lungs can cause an increased risk of female breast cancer.

  • Pregnancy concerns. If the person previously received abdominal radiation therapy to treat a Wilms tumor, any future pregnancy should be considered "high risk" and be closely monitored by doctors. Chemotherapy alone does not increase the risk of a miscarriage. However, receiving radiation therapy aimed at the side of the body between the rib and hip, depending on the dose, means there is a higher risk of 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. Birth defects are also more common.

  • Fertility concerns. Young girls who received radiation to their entire abdomen for a Wilms tumor may experience fertility problems when older or experience premature menopause. They need to be monitored closely during puberty and may need to be referred to a reproductive endocrinologist, which is a fertility expert.

  • Dental problems. Depending on their age when they were diagnosed and treated for a Wilms tumor, a child may experience dental issues, including problems with teeth formation, enamel issues, or missing teeth. Regular dental care is very important.

The next section in this guide is Follow-Up Care. It explains the importance of checkups after your child finishes cancer treatment. Use the menu to choose a different section to read in this guide.