Follow-up after treatment for Wilms tumour
Follow-up care lets the healthcare team keep track of your childʼs health for a period of time after treatment ends. This care is often shared among the cancer specialists and your childʼs family doctor. They will help your child recover from treatment side effects and watch your child for any signs that the cancer has come back (recurred).
Follow-up care may not seem that important, especially if treatment was long or very hard. Follow-up care may seem stressful because it is a reminder of cancer and treatment, or because you are worried about what a test may reveal. But itʼs an important part of cancer care. Talk to your childʼs healthcare team about follow-up and why it matters. The healthcare team is there to help.
Follow-up is important because there is a chance the cancer can come back and late side effects from treatment can develop. Initial follow-up focuses on assessing if Wilms tumour has come back and making sure that the child has recovered from treatment. In the long term, follow-up looks for late effects of treatments for Wilms tumour. People who have a childhood cancer may be followed in aftercare programs for the rest of their lives. The Children’s Oncology Group (COG) provides long-term follow-up guidelines for childhood cancer survivors. Some centres across Canada have transition clinics set up to follow the survivors of childhood cancer. These clinics help prepare survivors who are reaching early adulthood to successfully manage their own healthcare.
Schedule for follow-up visits
Donʼt wait until the next scheduled appointment to report any new symptoms and symptoms that donʼt go away. Tell the healthcare team about:
-
a lump in the
abdomen - swelling of the abdomen
- pain in the abdomen
- blood in the urine (called hematuria)
- fever
- weight loss
The chance that Wilms tumour will come back (recur) is greatest within 2 years, so your child will need close follow-up during this time. The risk of recurrence depends on the type of Wilms tumour (whether it has a favourable or anaplastic histology) and the stage at diagnosis. When Wilms tumour recurs, it is often in the area where the primary tumour was removed (called the tumour bed), or in the lungs or the liver.
Follow-up visits for Wilms tumour are usually scheduled:
- every 3 months for 2 years after diagnosis
- then every 6 months for another 2 years
- then once every 2 years
If your child has an
During follow-up visits
During a follow-up visit, your child’s healthcare team will usually ask questions about the side effects of treatment and how your child and family are coping. They may also ask about how your child is developing and if there are any signs that Wilms tumour has come back.
Your child’s doctor may do a physical exam, including:
- feeling the abdomen for signs of a tumour in the kidney area (called a local recurrence) or in the liver
- listening to the lungs for any signs of cancer that has spread to the lungs (called lung metastasis)
-
feeling the
thyroid for any growths (if radiation therapy was given to the chest) - measuring blood pressure
Tests are often part of follow-up care. Your child may have:
- an abdominal ultrasound
- a CT scan
- an MRI
- a chest x-ray
- a complete blood count (CBC)
- kidney function tests, such as blood or urine tests or glomerular filtration rate (GFR), to see how well the kidneys are working
- liver function tests, such as alanine aminotransferase (ALT) or aspartate aminotransferase (AST), to see how well the liver is working
- thyroid function tests, such as thyroid-stimulating hormone (TSH) and free thyroxine (T4), if radiation therapy was given to the chest
- heart function tests, such as an echocardiogram (echo) or electrocardiogram (ECG), if the chemotherapy drug doxorubicin was given
- hearing tests if the chemotherapy drug carboplatin was given
If the cancer has come back, the healthcare team will discuss a plan for treatment and care.
Find out more about follow-up
Find out more about the Children’s Oncology Group long-term follow-up guidelines.
The following are questions that you can ask the healthcare team about follow-up after treatment for cancer. Choose the questions that fit your child's situation and add questions of your own. You may find it helpful to take the list to the next appointment and to write down the answers.
- What is the schedule for follow-up visits?
- How often is follow-up scheduled with the cancer specialist?
- Who is responsible for follow-up visits?
- What will happen at a follow-up visit?
- What tests are done on a regular basis? How often are they done?
- Are there any symptoms that should be reported right away? Who do I call?
- Who can help my child cope with long-term side effects of treatment?
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