Pediatric Genitourinary Cancer

Genitourinary cancer affects the reproductive organs and urinary (renal) system. These cancers are rare in children – only about 10% of childhood cancers are genitourinary. Genitourinary cancer can affect a child’s:

• Kidneys: These organs filter blood and remove excess waste and fluid from the body through urine.
• Ureter: This tube carries urine from the kidneys to the bladder.
• Bladder: This organ stores urine.
• Ovaries: These female reproductive organs produce and release eggs. The ovaries also make the female hormones estrogen and progesterone.
• Testicles (testes): These male reproductive glands produce and store sperm. They also make testosterone, a hormone.

The most common types of pediatric genitourinary cancer include:

Wilms tumor

Wilms tumors are the most common type of childhood kidney cancer. Nearly 90% of children who have kidney cancer have Wilms tumors (also called nephroblastoma). These tumors can form in one or both kidneys. They tend to appear before a child’s fifth birthday and are almost always detected by age 10.

Germ cell tumors

Germ cell tumors typically form in a boy’s testicles or a girl’s ovaries, but rarely may arise outside of these organs. Germ cell tumors are most common in adolescence but can occur at any age. These tumors may be benign (non-cancerous) or malignant (cancerous).

Small tumors rarely cause symptoms. As tumors grow larger, your child might experience these symptoms:

• Abdominal pain and swelling
• Blood in urine
• Constipation
• Fatigue
• Fever
• Loss of appetite and weight loss
• Nausea and vomiting
• Shortness of breath
• Abnormal mass/growth of the testicle
• Mass felt in the abdomen
• Pale skin caused by anemia (low red blood cell count)

We perform many of the same tests to diagnose Wilms tumors, germ cell tumors and other genitourinary cancers. Tests include:

• Blood tests: Tests may be done to measure blood cell counts or certain protein or hormone levels that may be elevated in some forms of germ cell tumors.
• Urine tests: A urinalysis helps gauge kidney function.
• Pediatric CT (computed tomography): This test creates images that helps doctors detect tumors inside the kidney, reproductive organs, pelvis and other parts of the body.
• Pediatric magnetic resonance imaging (MRI): This scan produces detailed 3D images of organs and surrounding soft tissues. It can help determine whether the cancer has spread.
• Pediatric ultrasound (sonogram): This scan produces 3D images of organs. It can detect tumors in the bladder, kidneys, testicles, ovaries and other organs.

With proper treatment, the survival rate for children with genitourinary cancers is as high as 90%. Each child has a dedicated care team that includes urologists, pathologists, general surgeons and radiologists who meet monthly to review your child’s treatment plan and progress. Treatment may involve a combination of approaches including:

Chemotherapy

Your child may receive chemotherapy before surgery to shrink the tumor (called neoadjuvant chemo) or after surgery to eliminate lingering cancer cells.

Surgery

We specialize in advanced surgical procedures to treat these cancers. When possible, we use minimally invasive techniques that require smaller incisions. As a result, your child experiences less pain and scarring and recovers faster.

Radiation therapy

A small number of children may require radiation therapy as part of their initial therapy or if the cancer spreads or comes back (recurrence).

Providers who practice at Children's Health see a large number of children with genitourinary cancers every year. Families seek us out for our depth of experience treating these diseases and our high treatment success rates.

Additional programs and support

In addition to comprehensive treatments, our patients have access to the largest childhood cancer survivor program, ACE, in North Texas, featuring lifelong care to help your child stay healthy long-term. We’re also home to a cancer genetics program for children who have a family history of genitourinary cancers or a genetic condition that increases cancer risk.