 Wilms tumor is the most common cause of kidney cancer in children. I'm Dr. Ashley Munchel, an assistant professor of pediatrics at the University of Maryland School of Medicine and a pediatric oncologist at the University of Maryland Children's Hospital. Today, we are drawing outside the lines to show you how we use a multi-disciplinary approach to treat and cure children diagnosed with Wilms tumor. Wilms tumor is a large cancerous mass that typically involves one kidney. Wilms tumor is most commonly diagnosed in children between the ages of 3 years old and 5 years old and either their parents or the pediatrician feels a large mass in their belly. Other symptoms of Wilms tumor can include abdominal distention, which means a big belly, constipation, belly pain, and in rare circumstances blood in the urine. Once we diagnosed Wilms tumor, the first step in treatment is surgery. The goal of surgery is to completely remove the tumor. The best way to do that is to have the surgeon go in and take out the entire kidney that has the tumor growing in it. Thankfully, we have two kidneys and people can live completely normal healthy lives with only one kidney. After surgery, the next step in treatment is chemotherapy. We have a lot of parents ask us, why do we have to give my child chemotherapy if we've already removed the cancer, which is a great question. The way I think about cancer is it's like a weed in your garden. If you come along with a lawn mower and cut down that weed, it looks like it's gone. However, we all know that in a week or two, if you go back, that weed was just going to grow right back. If you come along with the lawn mower, cut down that weed, and then put weed killer to kill the roots. You will hopefully prevent that weed from ever growing back. Surgery is our lawn mower and chemotherapy is our weed killer. What we know is that tiny cancer cells are floating in the bloodstream, trying to find a new place in the body to put down roots and take hold. In Wilm's tumor, the most common place that that can happen is either the other kidney or in the lungs. However, if we come along with chemotherapy and kill these little cancer cells before they can ever put down roots, we can hopefully prevent it from ever growing and coming back. So all children with Wilm's tumor require surgery and chemotherapy for treatment. Some children also require radiation therapy. With using this multidisciplinary approach of surgery, chemotherapy, and radiation, we can cure over 90% of children that are diagnosed with Wilm's tumor.