Childhood Liver Cancer Treatment

Your child’s treatment will be carefully planned by a team of doctors. They will talk to you about the best treatment for the cancer. This may depend on:

• If the tumor can be removed completely by surgery
• What type of cells are in the tumor
• If the cancer has spread
• The level of alphafetoprotein (AFP) in the tumor

Hepatoblastoma and hepatocellular carcinoma are treated differently. Both require complete surgical removal for treatment to be successful. Hepatoblastoma responds well to chemotherapy, but hepatocellular carcinoma tumors are usually treated with surgery alone.

Surgery

Surgery is almost always part of the treatment for pediatric liver cancer. If all or most of the cancer can be surgically removed, the possibility of successful treatment is better.

Unfortunately, the surgeon may not be able to remove all of the tumor if it is large or has spread to other parts of the liver or the body. If this is the case, the surgeon will remove as much of the tumor as possible while keeping enough of the liver to function.

Since the liver helps with blood clotting, bleeding after surgery may be a problem. And, since the remaining liver still is damaged, the cancer may come back.

The main types of surgery for liver cancer are:

• Liver transplant: After the liver is surgically removed, it is replaced by a healthy donor organ. Liver transplant has a risk of serious infection and other health issues.
• Partial hepatectomy: The part of the liver where the tumor is located is removed surgically
• Tumor ablation: Heat (radiofrequency ablation) or extreme cold (cryosurgery or cryotherapy) is used to freeze or burn away the liver cancer. Ablation may be used when surgical removal of the tumor is not possible.

Embolization

Tiny pellets of plastic or another material are injected into the arteries that carry blood to the tumor. The pellets block blood flow, which makes it harder for liver cancer to grow.

Radiation therapy

Because radiation may destroy normal liver tissue as well as cancer cells, it can be used only in low doses for liver cancer. Radiation therapy cannot cure liver cancer, but it may be used to shrink the tumor or relieve pain.

New radiation therapy techniques and remarkable skill allow MD Anderson doctors to target tumors more precisely, delivering the maximum amount of radiation with the least damage to healthy cells.

Proton therapy

The Proton Therapy Center at MD Anderson is one of the largest and most advanced centers in the world. It’s the only proton therapy facility in the country located within a comprehensive cancer center. This means this cutting-edge therapy is backed by all the expertise and compassionate care for which MD Anderson is famous.

Proton therapy delivers high radiation doses directly to the liver cancer tumor site, with minimal damage to nearby healthy tissue. For some patients, this therapy results in a higher chance for successful treatment with less impact on the body.

Chemotherapy

Chemotherapy is often used to treat hepatoblastoma, but hepatocellular cancer doesn’t respond to it. Our experts also are working on new ways to give chemotherapy drugs directly into the liver, delivering higher doses of drugs than usually possible with fewer side effects. These include:

• Chemoembolization: A needle is inserted into an artery in the groin, and then a tiny tube is threaded into an artery leading to the liver. A high dose of medicine then is given. Afterward, the artery is blocked to prevent it from feeding blood to the liver.
• Hepatic artery infusion: A catheter (tube) is placed in the liver. Drugs are infused into a special implanted pump that delivers them continuously.

Targeted therapies

Children’s Cancer Hospital is among just a few cancer centers in the nation that are able to offer targeted therapies for some types of pediatric liver cancer. These innovative new drugs stop the growth of cancer cells by interfering with proteins and receptors or blood vessels that supply the tumor with what it needs to grow.