Wilms' Tumor
Wilms 'tumor and renal (Wilms' tumor), is a cancer that arise from the kidneys and is most common in children, and is also called renal tumor priorities
(Nephroblastoma) any teenager cells initial mature stages of development the final turn into kidney cells very fabric kidney, and come the label relative to the German physician Max Wilms, who presented the first article Medical describing this tumor by the end of the nineteenth century, and a Wilms' tumor kidney about 6 to 8% of all tumors of children in most countries, and appears, in most cases Balkhms years of age, usually age between the third and fourth, and higher rates for females than for males.
And it is useful to quickly identify the kidneys before continuing to talk about this tumor, since the kidneys are vital organs of the major urinary and Tstaqran at the top of the abdominal cavity from the rear on both sides of the spine left and right, and the average total weight of the child aged 3 years about 42 grams, and is similar in general form bean and its upper and lower two parties know Baloqtab, located on the top two or Garcleoh adrenal gland, and the total installed in place connective tissue, as it is surrounded by fatty tissue works to protect, and fed renal artery and the aorta come out of the branches within a network of arterial capillaries, and renal vein leave and related vein cava inferior.
The main function of the College in purifying the blood, and get rid of excess water and salts, and waste and disposal in the form of Paul, where the body get rid of mineral salts, especially sodium chloride, and organic salts, especially urea and uric acid resulting from the metabolism of proteins, which are accumulation of toxic substances in the body leads to poisoning when malfunctioning kidneys, and on the other hand helps in maintaining the overall stability of the body's pH, and working to install the osmotic pressure of body fluids.
And contains the College of millions of specialized cells called glomeruli (glomeruli) that purify the blood and filtered, and works Kmusvah purifier, allow water, salt and small molecules out of blood, while the remaining large particles such as red blood cells and white, and proteins, and related glomeruli undulating channels called pipes College
(Nephron), passes through the blood drained after leaving the glomeruli and in turn the detention of any vehicle mission and return to the circulation, while the remaining waste pipe in the form of Paul, leave the college by the ureter to settle the bladder until the vomiting, and despite the importance of the kidneys together, However, that man can live on less than one college to complete the vital functions of the kidneys.
And Wilms' tumors represent about 95% of kidney tumors in children, while all kidney tumors in adults are almost of the type of renal cell carcinoma tissue
(Renal cell carcinoma), and it is very rare to appear Wilms' tumor in adults, or vice versa, and arises in most cases, tissue college and one is called in this case tumor unilateral (unilateral), which located next to one of the body, and shows the kidneys together when between 5 to 10% of cases, and is called in this case Palmzdug or bilateral (bilateral), and is diagnosed when most of the cases after Tdkhmh clearly (but also before moving to other places), where the tumor mass in average at diagnosis of about 230 grams, twice the weight of the same faculty several times, and on the other hand can be cancer cells in this tumor be transmitted to the tissues and vital organs other body, and used to be moving to the lungs in most recorded cases, and may shift the small percentage of cases to the liver or brain or bones, in addition to a transfer to other college course.
In addition to Wilms' tumor, there is a rare types of kidney tumors that may appear in children, and is a tumor cell medium kidney (mesoblastic nephroma), the most common types of benign kidney disease common in children, and the tumor Algarni specific cells College (Clear cell sarcoma of kidney), and tumor planned college
(Rhabdoid tumor of kidney), they are two types of cancer rare in children, and Adrjan within the category of tumors with risk bad (poor risk) that they moved outside the perimeter of the college, and it should be noted that these tumors were classified in the past within the tumors and Wilms' before being Koram classified separately, despite the similarity of treatment plans and processors, but more intense and severe.
About risk factors for the emergence of Wilms' tumor
The term risk factors (Risk factors) to the factors and circumstances that increase the likelihood of the risk of any disease, such as cancer, when any person, and there are risk factors for each type of tumor, and may include risk factors and genetic any associated characteristics of genes, in addition to factors linked to the environment or lifestyle and living conditions, and although the factors on the pattern of living, such as smoking and poor nutrition or alcohol consumption are important factors in many of the tumors in adults, but its impact is none or weak when dealing with tumors of children, and with regard to risk factors on the environment, researchers have not found any link between the emergence of Wilms' tumor and environmental factors both before the baby is born or after.
Genetic risk factors
Found to scientists for decades, that man may inherit from parents on some changes and imbalances blades genetic DNA of the cells, which in turn cause disease with the characteristics and genetic spread in the family-specific, such as Naaourah (hemophilia) any hemophilia, and sickle cell anemia (sickle cell anemia) , and in this context, it was noted that no similar cases of Wilms' tumor within the perimeter of the family with the ratio ranging between 1 to 2% of cases of children with this tumor, and doctors believe that these children may have inherited some genetic anomaly for a parent, increasing the proportion of risk for the emergence of Wilms 'tumor they have, and from here called this category of cases the family (familial cases) as distinct from individual cases of sporadic without a relation (sporadic cases) or random, and on the other hand it was also noted that the Wilms' tumor bilateral appears greater in such cases .
Birth defects from birth
There is a strong link between the emergence of Wilms' tumor and some types of birth defects (birth defects) at birth, where there are such defects in about 15% of pediatric patients with this tumor, and appear mostly in the syndromes (syndromes), and can be defined the syndrome as a group concurrent symptoms and signs, and abnormalities or disabilities or other anomalies, which appear in most cases combined in the same patient, and the syndrome is usually attributed to the doctor, who described the beginning, such as a Mongolian Down syndrome (down's syndrome).
And of syndromes associated with Wilms' tumor, which increases the proportion of risk in children with them:
Syndrome and wages (WAGR)
And this term stands for the letters of the English first names of the four medical diseases associated with this syndrome are:
Wilms 'tumor (Wilms' tumor), and the reason for the absence of the iris (Aniridia) any loss of partial or full of the iris (the colored part of the eye), and abnormalities of the urogenital system (Genitourinary tract abnormalities), the presence of defects or deformities kidneys or urinary tract or male or scrotum or clitoris or the testicles or ovaries, and finally illness mental retardation (mental Retardation).
And medical statistics indicate high levels of risk for the emergence of Wilms' tumor syndrome in children with wages and about 30%.
Beckwith Weidman syndrome (Beckwith-Wiedemann syndrome)
Grow internal organs, such as the liver and spleen, in children with this syndrome sizes enlarged and unusual, and shows that the tongue is common, and the usual also appear, including bug hyper big midterm (hemihypertrophy), swelling of the arm or a man or both of the next one of the body, in addition to the non-uniformity in physical growth, and is the proportion of risk for the emergence of Wilms' tumor among these children is particularly high.
Syndrome Deddach Denis (Denys-Drash syndrome)
Stop genital male children with this syndrome for growth and development, and this includes the male and the testicles and scrotum, and it is common to get confused on the parents as calculate-born female, and for unknown reasons disrupted the kidneys in these children and depend on the performance of its functions, and can therefore be established Wilms tumor and damaged the college.
About the emergence of Wilms' tumors
We need to understand how the emergence of cancer cells, knowledge of some basic information about genes (genes) and the genetic characteristics, Valmorth is a part of the DNA Alrebonowi (deoxyribonucleic acid DNA) carries the characteristics of specific genetic and has a vital function specific, and an example set of genes color of the eyes and skin , or blood group, and this acid is a chemical that carries instructions for the system and the life cycle of cells, and the control of all its activities, and is the type of changes anomalies in the DNA of the genes influencing factor in determining the type of disease that may affect humans, and genes are parts of chromosomes (chromosomes), which can be likened to a band of linear DNA Mazfor high length, containing thousands of genes lined end to end, and the DNA is organized strictly in the 23 pairs of chromosomes, inherits half of each pair from one parent .
On the other hand may inherit one some of the changes the anomalous (or defects), DNA from his parents, which explains the appearance of some illnesses are common in some families, and called these changes Balthorat or changes the root of the structure (mutations), which also arise for reasons incomprehensible and unjustified, like many other forms of disturbance that affects this acid, which can be summarized in the following points:
Distraction of the chromosomes and the exchange sites (Translocation) between the two parts of the DNA, that is, a section of DNA Besbga a homeless HOS Besbga different and asymmetric with him, and this imbalance in particular is responsible for the emergence of some types of leukemia where it appears exchange in chromosomes of different When each of them.
Reflection or the coup (inversion), which means that part of the chromosome is inverted, and overlay in reflected light it is still linked to the same chromosome.
Addendum (addition) of any part of the chromosome (chromosome or the whole) has doubled and many copies of it are located the cell, and is referred to with reference number chromosome positive (+7, for example).
Loss or erasure (deletion) of some of the clips DNA Besbga specific, and referred to as the chromosome number with a negative sign, eg -7 means that there is a missing part of chromosome VII.
And there are multiple types and so many of the genes, and each of them vital functions and characteristics of specific genetic, and contains some of the types of instructions and codes of genetic control in the mechanism of growth and division, and thus the mechanism replication and reproduction for the production of new cells, and from These genes certain urges and modify operations cell division, called idiomatically genes tumor (oncogenes), and genes other slow and inhibit the division and reproduction, or give instructions to the annihilation of the self of the cell when needed, and called genes inhibiting the swelling (Tumor suppressor genes).
And from here can Ttsrtun normal cells in the event of any of the mentioned types of imbalance structure of DNA (ie, changes or abnormal structure of chromosomes fugue or a reversal or erasure or addition), which in turn paid (directly or indirectly) to run without tumor gene controls (which lose the ability to control cell growth and reproduction), or invalidate the work of genes inhibiting the swelling, and end up with the emergence of a cancerous tumor, and it is important to know that, and except for genetic disorders that increase the level of risk for the emergence of some tumors (and it is not inevitable at all), scientists do not know the real reasons and confirmed that lead to an imbalance types of DNA, (which trigger or trigger) and that lead to carcinogenesis of normal cells and tumor.
And return to the syndromes mentioned above and associated with tumor Wilms, indicating that these syndromes result from the presence of imbalances genes for Babbga atheist century, include the presence of changes in abnormal slim build, and the loss of some of the provinces, where there is gene suppressor of the swelling of this chromosome that has the symbol (WT1) at children living with Dennis Deddach, and appears unstable and Mtbdla all cells of the body, while at the syndrome and the wages so the same gene is missing in part or in full, while there is turnover in cases of syndrome Beckwith, and Weidman Bmorth and throw known symbol (IGF2) or (WT2), as the line up position differently on chromosome 11, and believed that the illness caused by excessive activity, and on the other hand, changes Babbgeyen No. 17 or 19 when cases of Wilms' tumor family (which does not include people with Palmtlazmat mentioned), and noted that the turnover or loss genes to These syndromes appear in all body cells, which explains the extension of its impact on several parts of the body without being limited to the kidneys.
In spite of the existence of a clear relationship between the emergence of Wilms' tumor and between some of the syndromes, birth defects and imbalances inherited genes, but these bugs do not exist when most children with this type of cancer, and with no one able to identify and discover the exact reasons underlying behind the development of Wilms 'tumor, but that much of what has become known about the phases of the growth of the kidneys through the various stages of fetal growth, could shed light on the imbalance can be done in the processes of growth, which leads to the emergence of Wilms' tumor eventually.
As the kidneys are vital organs that arise and grow in the early stages of the life of the fetus inside the uterus, and sometimes errors occur during the stages of growth, where growth has ceased some college embryonic cells of primary (which is supposed to grow and mature into the cells renal extremely capable of performing its functions), and keep the same phase of inadequate reached, a mere embryonic stem cells, and to post-natal period, and then accumulate in the tissues of small sporadic or mass of a coherent large-scale, and used to be able to accomplish this cells later in time and during the child reaches the age of three to four years old, but when there are no such maturity, you can start these tissues (and in some way) to grow without control and steadily and gay, and statements that try to originate a huge block of small cells with a primitive composition, which may turn to growth and throw.
On the other hand are more likely overall survival of some cells in embryonic form and later to the transformation of the Wilms' tumor, where loss of gene (WT1) or (WT2) mentioned earlier, or the presence of abnormal structure; radical changes.
About the symptoms and diagnosis
Difficult to detect kidney tumors early, as usual to arise and grow and reach large sizes without causing any pain to the child, and without showing any signs of ill draw attention, and the children seem healthy and exercising their activities in a natural and normal.
And symptoms vary from child to child, and the emergence of the mass is rigid and inflated abdominal cavity of the first signs and normal, and may be accompanied by some swelling and can see or feel on, and other symptoms which appear when about a quarter of cases:
Appearance of veins look swollen or wide area along the abdominal cavity.
There is blood in the urine.
The presence of pain abdominal cavity caused by pressure on the organs near the tumor.
Loss of appetite and lethargy or fatigue, or a fever.
High blood pressure.
It should be noted, should not be pressure on the position when the tumor is suspected abdominal cavity, and careful when bathing or carrying the child during the tests and diagnosis, as the pressure may lead to rupture of the tumor mass and tissue hernia, which may in turn lead to the transfer of cancer cells to other tissues in the body.
On the other hand is always advised to conduct medical examinations of periodic for children with syndromes of birth defects mentioned above to its relationship with known tumor and Wilms, and from the usual testing imaging ultrasound, at frequent intervals (every three months) until the child reaches the age of six or seven, and that in order to investigate the existence of any tumors, while the college is still early stages, and small size, and did not move to any other vital organs.
In this context it should be noted the need to conduct such tests regularly to siblings of sick children and Wilms' tumor, in the case of other relatives perimeter of the tumor in the same family were injured in the past.
When you see the symptoms on the child, which can indicate the presence of tumor kidney, the doctors perform a series of tests and laboratory tests to determine the various aspects of the tumor accurately, and conduct imaging studies of radioactive different, such as tomography (Computed tomography scan), and planning vascular
(Angiography), and magnetic planning MRI (Magnetic resonance imaging using magnetic waves to put multiple images of the body), and the planning of ultrasound (ultrasound), in addition to taking X-rays and bone planning to investigate the extent of transmission of the tumor to other sites.
And may be a surgical osteotomy (biopsy), especially when a tumor is enlarged significantly, and suspected his move to nearby tissues, in order to extract a biopsy of the tumor tissue to be examined under a microscope, to determine the kind and dynamic properties.
(Please go to a page that tests and laboratory tests to see more details on these various tests).
Classification of tumors, Wilms'
Are classified as Wilms' tumors and microscopic appearance of cells into two major types:
Tumor Btensj promising or favorable (favorable histology), and tumor Btensj is promising (unfavorable histology), where the tumor with dysplasia is promising show nuclei of cells (cell center where the DNA) are enlarged and dilated significantly distorted, and this is called change poor formation and evolution (anaplasia), distortion, and from here the more the percentage of distortion as the existing treatment difficult and less chances of recovery, while promising type when there is poor cell formation and chances of recovery are good, and medical statistics indicate that the rate of 95% cases of Wilms' tumor is located within the category of dysplasia promising.
And like other types of cancer, are classified as Wilms' tumor according to classification systems of the progress of the tumor (staging) and for identification of the quantum the cancer is located and body positions concentration and area of spread, and this is done by extracting data from the tests and laboratory tests and imaging, in addition to the tests the direct and the rest of the tumor tissue cleared following a surgery, where it is necessary to know these facts and determine the classification for planning treatments and to predict therapeutic Palmrdod expected.
And Wilms' tumor is classified according to five degrees progress in addition to recurrent tumor stage:
Grade 1
Include this category of cases where limited tumor altogether, and can eradicate the entire fabric of the tumor surgically, (or has been removed already during surgery), and was not affected by adjacent tissues, and did not extend the growth of tumor blood vessels adjacent to the College, (about 40% of the cases are within this category).
Grade 2
And include this category of cases where a capacity of tumor growth and extends to the renal pelvis or to the tissues adjacent outside, such as fatty tissue or adjacent soft tissues or blood vessels, and can completely remove surgically all placements (or has been removed already during surgery without the presence of remnants of the phenomenon) , (about 20% of cases fall into this category).
Grade 3
Include this category of tumors that have moved into the college tion to the tissues and vital organs close and confined to the abdominal cavity, and therefore can not fully eradicate the cancerous tissue, and remaining confined to the abdominal cavity after surgery, in addition to the presence of one of the following facts:
Transmission of cancer to the lymph nodes adjacent to the abdominal cavity or pelvis, but not beyond that, such as chest lymph glands.
Presence of cancer cells at the edges of cleared tissue surgically, which confirms the survival of some of the tumor tissue after surgery.
The presence of remnants of the tumor tissue along the lining of the abdominal cavity.
(About 20% of cases fall into this category).
4 °
And this classification include tumors that have moved through the blood circulation to vital organs far from the kidneys, such as the lungs, liver or bones or lymph nodes, (about 10% of cases fall into this category).
Degrees 5
Included in this category kidneys tumors that appeared together in the same time, (about 5% of cases fall into this category).
Recurrent tumors (Recurrent)
And this classification include tumors that have emerged and returned after receiving treatment, and may return in the same position of its inception, the original position or another body.
On the treatment of Wilms' tumors
There are treatments for all cases of this type of tumor in children and most of them are curable, with rates of healing of the five-year record of child patients tumor and Wilms' more than 90% (rate indicates the five years to the proportion of patients who live at least five years since diagnosed with cancer specific Of course, many people recover fully and live much more, and uses this rate is usually a sign at the statistical cancer cases), and have contributed to the dramatic developments in the different treatments over the past decades to achieve such a high percentage, and the dependent child's chances of healing and treatment options on several factors combined, the most important tumor size and extent of concentration, and the manifestation of its cells under a microscope and the type of dysplasia, and the degree and extent of progress, in addition to the child's age and general health condition.
And surgery is the first line of treatment and primary Wilms' tumors, followed by chemotherapy or radiation therapy, and treatment plans vary of course depending on the situation and the classification of the tumor, and the following paragraphs profile for different treatments and treatment plans according to the classification of the tumor.
Surgery
Plans include the treatment standard procedure surgery extirpation therapy initially and primarily, followed by radiation therapy or chemotherapy, according to the classification of the tumor, and target treatment to remove the original tumor first, even in case of transmission of cancer to places far away, and usually begin radiation therapy or surgery further, when some keep cancer cells after the first surgery, and may begin treatments in some cases to receive doses of chemotherapy or radiotherapy or a combination of both common, in order to shrink a tumor before surgical direct action, especially when the tumor enlarged and expanding in scope, and therefore can not be removed, or when be moving to nearby blood vessels or other vital tissues, or when both his kidneys.
And there are several types of surgical extirpation of the kidney (nephrectomy), and performed to treat kidney tumors, including operations eradication Simple (Simple nephrectomy), where is the eradication of the affected kidney only, and bear the college other burdens and vital functions, of course, while the longer operations eradication root of the Faculty of
(Radical nephrectomy) the most common and is performed routinely, as is the eradication of the tumor with the entire college, including the ureter and adrenal gland in Boallagha, and the fatty tissue around it, and may be sometimes eradicate the lymph nodes adjacent to the College, while the longer operations eradication partial (Partial nephrectomy), the most complicated, as the tumor tissue is removed and part of the college around the most accurate as possible, and are made in some special cases, such as the presence of other problems altogether, or loss of previous eradication operations.
And is often examined the liver and sound macro and close to vital organs during surgery, and biopsies of any suspected member of the analysis and to investigate the extent of transmission of tumor cells, including lung imaging studies have shown that such a possibility.
(Please go to a page that surgery to see more details on the surgical aspects of the work).
Chemotherapy
Chemotherapy is the treatment using special drugs known drug chemical anti-cancer, the elimination of cancer cells and destroy them, and so disrupt and undermine the coordinated biological processes within them, and come the main advantage of this treatment in his ability to deal with tumors of mobile and deployed, whereas the radiation therapy or work on the surgical treatment of specific placements administration, confined tumors, its effectiveness and return premium to the fact that cancer cells, in a way, is more sensitive and more susceptible to chemicals than normal cells. And may be used as a treatment only in some cases, or part of a treatment program integrated includes several treatments in common, and the decision is made by using this treatment, the balance between effectiveness and side effects and complications of the future, and between the seriousness of cancer, and of course Vamadaafath and its acceptable compared to the same disease, in addition to the positive therapeutic yield significantly.
And may be called the chemotherapy treatment systemically (systemic); due to movement of drugs, chemicals via the blood to all parts of the body, and its ability to destroy cancer cells wherever notified, and may be used before the direct surgeries when solid tumors preparation for her and in order to facilitate; Bhzareth and shrink the tumor, what is known as chemotherapy Initial Assistant (Neoadjuvant), may also be used after surgery and eradication of the tumor; to eliminate any cells of a tumor is characteristic may be outstanding, and help avoid the return of cancer, what is known as chemotherapy additive (adjuvant).
And be dealt with chemotherapy drugs in ways and different channels, some of which are taken orally in the form of tablets or capsules or liquids, and most of the body is injected, the injection of different ways: by intravenous injection, intramuscular injection, injection into an artery or a major injection topically directly under the skin, and if intravenous is the most widely used method, and may use other means to assist in the injection, such as catheters (catheters), which is implanted usually chest and can be used for long periods, and is injected drugs directly into the spinal fluid cerebrospinal surrounding the spinal cord and brain, known as the injection vaginalis (intrathecal), both to eliminate tumor cells, or to protect the central nervous system and brain, and is usually injected through the lumbar spine down the spine, or via a catheter especially planted under the scalp known portfolio Omaya (Ommaya reservoir).
And usually consist of treatment programs from several repeated cycles separated by periods of recovery, and may receive the patient during each session, a combination common in many medicines chemical, or are limited to one drug, by type of tumor and the planned therapeutic approach in each case, and in general are the use of chemotherapy during the time periods prolonged to reduce how much the cancer cells gradually, to the extent that it could when the immune system control of any growth and throw, in addition to that space of time between doses are placed in order to achieve the greatest effect on cancer cells, and at the same time give the sufficient to allow cells and tissue normal to recover from the effect of drugs, chemicals, since the types of drugs of different effects to varying degrees on the cells and organs of natural sound, especially the cells and tissues fast-growing and heavy reproduction and a permanent replacement, such as bone marrow cells, and cells and tissues the digestive system, in addition to some vital organs like the liver and kidneys, which in turn leads to complications side effects, which vary in intensity and quality of the drug to another and from one person to another, and of course of treatment to another even for the same person, and depends primarily on the type and dose of the drug user and the interaction of the body about it, and these multiple effects; frustration include bone marrow (and thus decrease blood cell count), and complications of the mouth and gums (such as inflammation and ulceration, and drought), and temporary hair loss, and constipation, diarrhea, and fatigue, nausea, vomiting, loss of appetite, and feel the skin and skin, and are usually taking medication to help and take some preventive measures and support; to avoid such effects and to prevent them and to alleviate it, pre-session treatment, and during and after its completion.
And include most of the treatment plans for cases of tumors and Wilms' use of a combination of a real estate Daktinomaysan (dactinomycin) and vincristine (vincristine), as is the use of a real estate doxorubicin (doxorubicin), and Saakulovosvamaid (cyclophosphamide) in advanced cases or when a tumor Btensj is promising, and may be added Aitoboseid drug (etoposide) in some cases.
(Please go to chemotherapy, to view more details about this treatment and methods of its management and its complications).
Radiation therapy
Radiation therapy is the treatment using the different applications of ionizing radiation (ionizing radiation), to destroy cancer cells and shrink tumors, both using the elements and isotopes, or by using a stream of radiation, revived and high-energy, x-rays, or radiation such as gamma rays, or stream of neutrons or protons, and the effectiveness of the radiation is concentrated in its ability to undermine and break up the DNA of tumor cells, and is a vital and fundamental article of the various cellular functions, leading to elimination.
Radiation therapy is topical treatment, and is divided into two types; internal (Internal), radioactive elements are grown directly into the tumor tissue, or close to it, either temporarily or permanently, and external (external), where the broadcast radiation from the radiation machine shed the positions of the tumors, and may be used both types in some types of tumors, and of course, and to avoid the effects of radiation, is to take preventive measures during radiation therapy, to protect tissues and organs natural sound field processing.
And may be the use of radiation therapy alone, treatment only, or jointly with treatments other tumors, and may use a substitute for surgery as initial therapy, when some solid tumors, may also be used by the direct action surgical known as the treatment initial Assistant (neoadjuvant therapy), order to reduce the size of the tumor; to facilitate the eradication, or is used after excision surgery as a treatment additive (adjuvant therapy); in order to eliminate any tumor cells is characteristic may be outstanding.
And, of course, for the treatment of radiation complications and side effects associated with, linked to the overall locus of treatment, and result in general from affected cells and tissues rapidly growing and replacement, and from these effects: complications of skin and skin, and fatigue, and infections and dry mouth, and hair loss, nausea, gastrointestinal problems, and thwart the bone marrow, and is taking some preventive measures and support, and taking medication assistance; to avoid such effects and to alleviate it.
In terms of tumor and Wilms, is typically used for external radiation in addition to surgery, and limited use when cases classification III and IV and V, and is not used when the first category, while at the second classification is used when a tumor is promising, and on the other hand, do not show most of the side effects mentioned when dealing with the Wilms tumor due to the low amounts of radiation used.
(Please go to radiation therapy, to view more details about this treatment and methods of administration).
On the processors according to the type and classification of tumors, Wilms'
Are arranged treatment plans according to the workers the key when the tumors, and Wilms, any degree of classification of the progress of the tumor, and the category of dysplasia (the appearance of tumor cells, microscopy) of both types promising and is promising, and in the following paragraphs an overview of the treatment plans used routinely, and, of course, do not follow these plans at all cases and different processors from one patient to another.
Grade 1
When tumors Baltnsj promising or not promising:
Begin treatments usually surgery excisional radical of the College, followed by chemotherapy using a real estate Daktinomaysan and vincristine, and the beginning are receiving this treatment a week for a period of ten weeks, and then stop for a period of two weeks to allow the tissues of the body to recover from side effects of drugs, chemicals, and then start again in the twelfth week of receiving drug cycles alternate every three weeks, and usually end processors by the end of the fifth month.
(Average four years to heal the standard in this category 98%).
Grade 2
Tumor Btensj promising:
Are processed in this category are often the same first-class processors, and (with a four-year cure rate of standard for this category about 96%).
Btensj tumor is a promising and simple deformation:
Begin processors surgery excisional radical of the college, and then receives the child doses of radiation therapy to the abdominal cavity for a period ranging between 6 to 7 days, followed by the direct receipt of chemotherapy by adding a property Dotxorobaisin (doxorubicin) to the real estate Daktinomaysan and vincristine, and continue treatment for six months, a timetable, such as mentioned above, the weekly doses during the first ten weeks and then cycles every three weeks.
Btensj tumor is a promising and deformation complex:
Handled cases in this category the same plans and the simple cases of deformity, but more intensive therapeutic doses, using drugs, vincristine and Dotxorobaisin addition to real estate Aitoboseid (etoposide) and Saakulovosvamaid (cyclophosphamide), with the use of a drug distinguished us (Mesna) to protect the bladder from the effects of the drug last.
(Average of four years of recovery standard for this category about 82%).
Grade 3
Btensj promising tumor, or is a promising and simple deformation:
Similar treatments in this category usually deal with cases of grade 2 defect is simple, any surgery excisional radical of the college followed by radiation therapy, followed by chemotherapy using the drugs Daktinomaysan and doxorubicin and the drug vincristine, and for six months, (average four years of healing the standard of the tumor promising about 95%).
Btensj tumor is a promising and complex deformity:
Begin treatment with surgery excisional radical of the college followed by radiation therapy to the abdominal cavity, followed by the start chemotherapy, which lasts for a period of six months, often using drugs vincristine and doxorubicin and Aitoboseid, and drug Saakulovosvamaid with the use of a drug distinguished us, (and the rate of four years recovery standard for this category about 82%).
And in some rare cases, the tumor mass enlarged degree prevent the eradication of safely, and in this case is extracted biopsy of the tumor tissue for examination and ascertaining the existence of properties vital to the Wilms' tumor, then start chemotherapy, and in case of failure to achieve encouraging results and No response to chemical drugs, are receiving doses of radiation therapy in order to reduce the tumor mass, which is usually achieved within six weeks, and shrink the tumor enough to allow a radical excisional surgery of the college, and, of course, be re-dose chemotherapy after surgery.
4 °
Btensj promising tumor, or is a promising and simple deformation:
Identical processors in this category with the treatment of cases of degree 2 and 3 Baltnsj promising or not promising and simple deformation, ie, surgery excisional radical of the College, followed by radiation therapy to the tissue adjacent to or for the entire abdominal cavity when there are remnants of the tumor cells abdomen, in addition to the radiation of the lungs when there is transmission of cancer to them, followed by chemotherapy using the drugs Daktinomaysan and vincristine and doxorubicin for six months.
(And the rate of healing of the four years the standard of the promising tumor about 90%).
Btensj tumor is a promising and complex deformity:
And similar treatments in this category with the processors in cases of Grade 3 as dysplasia, surgery excisional radical of the College, followed by radiation therapy to the tissue adjacent to or for the entire area of the abdominal cavity when the presence of residual tumor, and the lungs when the transmission of cancer to them, followed by chemotherapy including the use of drugs vincristine and doxorubicin and Aitoboseid, and Saakulovosvamaid distinguished us with the use of a drug to protect the bladder, and therapeutic sessions run for six months, (average of four years of recovery standard for this category about 82%).
Degrees 5
Plans vary the treatment of children in this category, where there is cancer, the kidneys together, according to the considerations and circumstances of each case separately, and in general the surgeon seeks to eradicate the cancerous tissue carefully, taking into account the most conservative possible kidney tissue, and then start chemotherapy or radiation, and are usually drawn biopsies of cancerous tissue kidneys and lymph nodes adjacent to, and is beginning chemotherapy often using drugs vincristine and doxorubicin and Daktinomaysan, and the usual surgery seconds after the end of the course of treatment to investigate the presence of residual tumor, and which, when proved its presence may begin treatment cycle treatment of additional drugs, chemicals or radiation therapy, or surgery to remove cancerous tissue without the eradication of the entire college, and, of course, is the use of doses of therapeutic intense that the degree of distortion high-tissue tumor kidneys or Bahaddahma, and using drugs vincristine and doxorubicin and Aitoboseid and Saakulovosvamaid distinguished us with the real estate pro.
(Average of four years of recovery standard for this category about 73%).
Recurrent tumor
Depends chances of recovery and treatments at the return of the tumor, and mainly on the treatment plans initial received to address the original tumor, and the category of woven tumor (both types promising and is promising), and include processors usual when the tumor reflux surgery to remove tissue tumor, and radiation therapy, then additional doses of chemotherapy using the drugs doxorubicin and vincristine and Daktinomaysan.
And opportunities are better in children of patients with tumors of dysplasia of the most promising and were treated in the past Bakara vincristine and Daktinomaysan without receiving radiation treatments for abdominal cavity, while the opportunities as they weaken the existence of any of the following factors:
Weave is promising.
Was the use of primary radiation therapy treatments.
Courses included previous use of chemotherapy drug doxorubicin.
Occurrence of relapse and recurrence during a period of six months after surgery nephrectomy.
Include treatment plans in these cases, the use of intense doses of chemical drugs, often using new drugs, or receiving high-dose treatment cycles followed by a marrow transplant operations to the bone marrow as one of the options available.
After the treatments
Should of course be examined periodically after the different treatments for Wilms' tumor and eradication of the tumor, and includes clinical examination and testing imaging, such as planning, ultrasound and x-rays chest, both to investigate the return of the tumor or the fact the move to other places, in addition to the fact problems related to child growth and extent influenced by treatments, as is analysis of various blood and urine to investigate the effectiveness of the total remaining after the eradication of the kidney.
And is determined scheduling of these tests and tests based on the category of woven tumor (promising or not promising), and according to plans therapeutic procedures treatments primary, as well as the extent of the problems of side effects appeared during the sessions therapeutic, and of course should notify your physician if there are any new symptoms on the child, which may give an indication of an early return of cancer, or indicate the presence of side effects behind due to treatments received, (and please go to a page of late complications of treatments for tumors for more details about the effects of long-term cancer treatments).
