I had a Wilms Tumor removed in 1997. What are some of lingering effects of the cancer after treatment? (David, Male, 16, Wilms Tumor).

Wilms Tumor is one of the most common pediatric tumors in the abdomen, and the most common type of kidney tumor.  The effects experienced after treatment, like all childhood and adolescent tumors, is related to the cancer treatment.  These lingering effects of treatment are called "Late Effects" and are a very large area of investigation these days in the scientific literature.  It is very rare for the cancer itself to cause any problems after it has been treated or removed (some rare tumors cannot be fully removed, and these cancers may cause lingering problems because of pressure on internal organs or release of hormones).  Wilms Tumor is the type of tumor which we try to remove entirely, usually through a combination of surgery, chemotherapy, and radiation therapy.

The late effects from surgery are related to the part of the body where the operation was performed.  For instance, some tumors – like Wilms Tumor – may require the removal of an entire organ like a kidney or even part of the lung.  Because most people have two kidneys and different lung segments, this is usually not a problem.  However, if the remaining kidney or lung is damaged then it is more likely to lead to trouble.  Also, with abdominal surgery, there is always the increased risk of bowel obstruction (this is when part of the intestine becomes stuck in scar tissue).  The side effects of chemotherapy and radiation therapy vary by the drugs used but in general relate to endocrine (hormone) disturbances, loss of bone density, hearing loss, infertility, heart or lung problems, and vary rarely (1-5% of the time), a second type of cancer.  It is important to emphasize that these side effects are rare, do not happen to everyone, and depend on how you were treated.  Regardless of your risk, it's always a good idea to ask your doctor if you should have any worry or concerns about a particular late effect.

Now that more and more children and adolescents are being cured of cancer, the focus in the research community is to improve cancer treatment so that late effects are no longer an issue.  It is a very important goal that I think we will one day be able to achieve.

Keep those questions coming!!!