Types of treatment for infantile choriocarcinoma of the liver
There are different types of treatment for children with infantile choriocarcinoma of the liver. You and your child’s care team will work together to decide treatment. Many factors will be considered, such as your child’s overall health and whether the cancer is newly diagnosed or has come back.
A pediatric oncologist, a doctor who specializes in treating children with cancer, will oversee treatment. The pediatric oncologist works with other healthcare providers who are experts in treating children with infantile choriocarcinoma of the liver and who specialize in certain areas of medicine. It is especially important to have a pediatric surgeon with experience in liver surgery who can send patients to a liver transplant program if needed. This may include the following specialists and others:
- pediatrician
- radiation oncologist
- pathologist
- pediatric nurse specialist
- rehabilitation specialist
- psychologist
- social worker
- nutritionist
- child-life specialist
Your child’s treatment plan will include information about the cancer, the goals of treatment, treatment options, and the possible side effects. It will be helpful to talk with your child’s care team before treatment begins about what to expect.
Surgery
When possible, the cancer is removed by surgery. The types of surgery that may be done are:
- Partial hepatectomy removes the part of the liver where cancer is found by surgery. The part removed may be a wedge of tissue, an entire lobe, or a larger part of the liver, along with some of the healthy tissue around it. The remaining liver tissue takes over the functions of the liver and may regrow.
- Liver transplant is the removal of the entire liver by surgery, followed by a transplant of a healthy liver from a donor. A liver transplant may be done when the cancer is in the liver only, and a donated liver can be found. If the patient has to wait for a donated liver, other treatment is given as needed.
Chemotherapy is sometimes given before surgery to shrink the tumor and make it easier to remove. This is called neoadjuvant therapy.
Chemotherapy
Chemotherapy (also called chemo) uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given alone or with other types of treatment.
For infantile choriocarcinoma of the liver, the chemotherapy is injected into a vein. When given this way, the drugs enter the bloodstream and can reach cancer cells throughout the body.
Chemotherapy drugs used to treat infantile chorciocarcinoma of the liver are:
- bleomycin
- cisplatin
- etoposide
- methotrexate
Combinations of these drugs may be used. Other chemotherapy drugs not listed here may also be used.
Clinical trials
A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. Because cancer in children is rare, taking part in a clinical trial should be considered.
Targeted therapy
Targeted therapy uses drugs or other substances to block the action of specific enzymes, proteins, or other molecules involved in the growth and spread of cancer cells. Targeted therapy is being studied for the treatment of infantile choriocarcinoma of the liver that has come back after treatment.
Treatment of infantile choriocarcinoma of the liver
Treatment of newly diagnosed infantile choriocarcinoma of the liver may include the following:
- Chemotherapy may be given before surgery to help shrink the tumor so that it can be more easily removed.
- Surgery to remove the tumor. Chemotherapy may be given after surgery.
- Chemotherapy may be given before liver transplant if surgery to remove the tumor is not possible.
Sometimes infantile choriocarcinoma of the liver continues to grow or recur (comes back) after treatment. The cancer may come back in the liver or in other parts of the body. Your child's doctor will work with you to plan treatment if your child is diagnosed with recurrent infantile choriocarcinoma of the liver.
Side effects and late effects of treatment
Problems from cancer treatment that begin 6 months or later after treatment and continue for months or years are called late effects. Late effects of cancer treatment may include the following:
- physical problems that affect hearing
- changes in mood, feelings, thinking, learning, or memory
- second cancers (new types of cancer)
Some late effects may be treated or controlled. It is important to talk with your child's doctors about the long-term effects cancer treatment can have on your child.
Follow-up care
As your child goes through treatment, they will have follow-up tests or check-ups. Some of the tests that were done to diagnose the cancer or to find out the treatment group may be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your child's condition has changed, or if the cancer has come back.