Radiotherapy to the whole abdomen for Wilms tumour for children
This page has been produced to provide information about radiotherapy to the abdomen for Wilms tumours and aims to answer some of the questions often asked by patients and their carers.
We hope you will find this helpful.
We give radiation treatment (radiotherapy) in addition to surgery and chemotherapy because the disease may come back if we do not. The treatment has to be planned with great care and it is successful for many, but unfortunately not all, patients.
The total radiation dose has to be spread out over quite a long time to make the individual treatments safe. We give treatment every day for about two to four weeks (usually excluding weekends and bank holidays). At each session, the patient spends about ten minutes in the treatment room but most of this time is spent getting them into the right position.
Radiotherapy does not hurt, the machine does not touch the patient and it is rather like having an ordinary x-ray. We have to treat the whole area accurately, which means that the patient must lie very still. We decide whether the patient lies on their front or their back depending on the best way of giving the treatment.
Lying still can be very difficult for some children, particularly young ones, so occasionally we have to use a general anaesthetic. A buzzing noise may be heard when the machine is working.
There are always side effects. We can relieve most of them but sometimes not completely. Some of the side effects happen immediately, some of them happen soon after we finish treatment and some take a longer time to show.
Nausea and vomiting may occur with this treatment but these can usually be well controlled with anti-sickness drugs.
Diarrhoea may occur but it can usually be controlled with tablets and avoiding certain foods such as fruits, some spicy foods and certain vegetables.
Side-effects after treatment
A course of radiotherapy often makes patients tired. This is most noticeable near the end of the treatment and just afterwards.
These are the hardest to predict and unfortunately, when they do happen, they are permanent.
The radiation may affect the growth of the spine and ribs in the radiation field. This is unlikely to have a significant effect on final height. The waist may be narrow and the loin area less muscular than without treatment.
The testicles are usually away from the treated area and in most cases will be unaffected by the radiotherapy. In girls the ovaries and the uterus will be in the treatment area. Infertility and the need for hormone replacement therapy is likely.
Both radiotherapy and chemotherapy may affect the kidney. As one kidney has already been removed we are careful to minimise the risk to the remaining kidney. The function of the kidney and blood pressure will be monitored at follow-up.
The radiation dose we give is low and we would not expect any long-term bowel problems. However sometimes after surgery and radiotherapy the tissue surrounding the bowel can stick together (adhesions) and this can sometimes cause symptoms requiring surgery.
We are finding that, very rarely, children who have had treatment for one tumour can develop another type of tumour some years later.
During follow-up we will be looking out for all of these problems.
Leaflet to download
You can also download a PDF leaflet of the information on this page: