Childhood Liver Cancer
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Description
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What is childhood liver cancer?
Childhood liver cancer, also called hepatoma, is a rare disease in which cancer
(malignant) cells are found in the tissues of your child’s liver. The liver is
one of the largest organs in the body, filling the upper right side of the
abdomen and protected by the rib cage. The liver has many functions. It plays
an important role in changing food into energy and also filters and stores
blood.
Primary liver cancer is different from cancer that has spread from another
place in the body to the liver (liver metastases). (Refer to the PDQ summary
on Adult Primary Liver Cancer Treatment for more information.)
There are two types of cancer that start in the liver (hepatoblastoma and
hepatocellular cancer), based on how the cancer cells look under a microscope.
Hepatoblastoma is more common in young children before age 3 and may be caused
by an abnormal gene. Children of families whose members carry a gene related
to a certain kind of colon cancer may be more likely to develop hepatoblastoma
(genes carry the hereditary information that you get from your parents).
Children infected with hepatitis B or C (viral infections of the liver) are
more likely than other children to get hepatocellular cancer. Immunization to
prevent hepatitis B may decrease the chance of developing hepatocellular
cancer. Hepatocellular cancer is found in children from birth to 19 years of
age.
If your child has symptoms, your child’s doctor may order special x-rays, such
as a CT scan or a liver scan. If a lump is seen on an x-ray, your child’s
doctor may remove a small amount of tissue from the liver using a needle
inserted into the abdomen. This is called a needle biopsy and is usually done
using an x-ray to guide the doctor. Your child’s doctor will have the tissue
looked at under the microscope to see if there are any cancer cells.
Your child’s chance of recovery (prognosis) and choice of treatment depend on
the stage of your child’s cancer (whether it is just in the liver or has spread
to other places), how the cancer cells look under a microscope (the histology),
and your child’s general state of health.
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Stage Explanation
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Stages of childhood liver cancer
Once liver cancer is found, more tests will be done to find out if the cancer
cells have spread to other parts of the body. This is called staging. Your
child’s doctor needs to know the stage of disease in order to plan treatment.
The following stages are used for childhood liver cancer:
Stage I
Stage I childhood liver cancer means the cancer can be removed with surgery.
Stage II
Stage II childhood liver cancer means that most of the cancer may be removed in
an operation but very small (microscopic) amounts of cancer are left in the
liver following surgery.
Stage III
Stage III childhood liver cancer means that some of the cancer may be removed
in an operation, but some of the tumor cannot be removed and remains either in
the abdomen or in the lymph nodes.
Stage IV
Stage IV childhood liver cancer means the cancer has spread to other parts of
the body.
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Recurrent
Recurrent disease means that the cancer has come back (recurred) after it has
been treated. It may come back in the liver or in another part of the body.
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Treatment Option Overview
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How childhood liver cancer is treated
There are treatments for all children with liver cancer. Four kinds of
treatment are used:
- Surgery (taking out the cancer in an operation).
- Chemotherapy (using drugs to kill cancer cells).
- Radiation therapy (using high-dose x-rays to kill cancer cells).
- Liver transplantation (replacing the liver with a donated liver).
Surgery may be used to take out the cancer and part of the liver where the
cancer is found. Sometimes the entire liver may be surgically removed and
replaced by a liver transplant from a donor. Surgery may also be used to
remove cancer that may spread to other parts of the body such as to the tissues
surrounding the liver, to the lungs, or to the brain.
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be given to
your child before surgery to help reduce the size of the liver cancer. Your
child may be given chemotherapy after surgery to kill any remaining cells.
Chemotherapy given after surgery when the doctor has removed the cancer is
called adjuvant chemotherapy. Chemotherapy for childhood liver cancer is
usually put into the body through a needle in a vein or artery. This type of
chemotherapy is called a systemic treatment because the drug enters the
bloodstream, travels through the body, and can kill cancer cells outside the
liver. In another type of chemotherapy, called direct infusion chemotherapy,
drugs are injected directly into the blood vessels that go into the liver.
Sometimes a special treatment called chemo-embolization is used to treat
childhood liver cancer. Chemotherapy drugs are injected into the main artery
of the liver with substances that block or slow the flow of blood into the
cancer. This lengthens the time the drugs have to kill the cancer cells and it
also prevents the cancer cells from getting oxygen or other materials that they
need to grow.
Radiation therapy uses x-rays or other high-energy rays to kill cancer cells
and shrink tumors. Radiation may come from a machine outside the body
(external radiation therapy) or from putting materials that produce radiation
(radioisotopes) through thin plastic tubes in the area where the cancer cells
are found (internal radiation therapy).
If surgery to remove the tumor is not possible, your child may undergo liver
transplantation to replace the diseased liver with a healthy one from a donor.
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Treatment by stage
Treatments for childhood liver cancer depend on the type (hepatoblastoma or
hepatocellular carcinoma) and stage of your child’s disease and your child’s
age and general health.
Your child may receive treatment that is considered standard based on its
effectiveness in a number of patients in past studies, or you may choose to
have your child take part in a clinical trial. Not all patients are cured with
standard therapy and some standard treatments may have more side effects than
are desired. For these reasons, clinical trials are designed to test new
treatments and to find better ways to treat cancer patients. Clinical trials
are ongoing in many parts of the country for most stages of childhood liver
cancer. If you want more information, call the Cancer Information Service at
1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
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Stage I and II Childhood Liver Cancer
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Stage I and II Hepatoblastoma
Your child’s treatment will probably be complete removal of the liver cancer by
surgery followed by adjuvant chemotherapy.
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Stage I and II Hepatocellular Carcinoma
Your child’s treatment will probably be complete removal of the liver cancer by
surgery followed by adjuvant chemotherapy.
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Stage III Childhood Liver Cancer
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Stage III Hepatoblastoma
Your child’s treatment may be one or more of the following:
- Chemotherapy to reduce the size of the tumor followed by surgery to
remove as much of the cancer as possible.
- Chemotherapy.
- Radiation therapy.
- Direct infusion of drugs into blood vessels going into the liver.
- Liver transplant: Surgical removal of the liver followed by replacement
with a donor’s liver.
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Stage III Hepatocellular Carcinoma
Your child’s treatment will probably be chemotherapy to reduce the size of the
tumor followed by surgery to remove as much of the cancer as possible. (Refer
to the PDQ summary on Adult Primary Liver Cancer Treatment for more
information.)
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Stage IV Childhood Liver Cancer
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Stage IV Hepatoblastoma
Your child’s treatment may be one or more of the following:
- Chemotherapy to reduce the size of the tumor followed by surgery to
remove as much of the cancer as possible followed by chemotherapy.
- Surgical removal of cancer that has spread to the lungs.
- Chemotherapy.
- Radiation therapy followed by additional surgery.
- Direct infusion of chemotherapy drugs into blood vessels going into the
liver.
- Chemotherapy drugs injected into the main liver artery with substances
that block or slow the flow of blood (chemo-embolization chemotherapy).
- Liver transplant: Surgical removal of the liver followed by
replacement with a donor’s liver.
- Clinical trials are testing new therapies and may be considered for
your child.
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Stage IV Hepatocellular Carcinoma
Your child’s treatment will probably be chemotherapy to reduce the size of the
tumor followed by surgery to remove as much of the cancer as possible. (Refer
to the PDQ summary on Adult Primary Liver Cancer Treatment for more
information.)
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Recurrent Childhood Liver Cancer
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Recurrent Hepatoblastoma
Treatment depends on where the cancer recurred and how the cancer was treated
before. Treatment may include additional surgery. Clinical trials are testing
new therapies and may be considered for your child.
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Recurrent Hepatocellular Carcinoma
Clinical trials are testing new therapies and may be considered for your child.
(Refer to the PDQ summary on Adult Primary Liver Cancer Treatment for more
information.)
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Changes to This Summary (01/21/2004)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Editorial changes were made to this summary.
This information is provided from the PDQ® database in collaboration with the NCI.
