AFP is a protein that is secreted in normally high levels during fetal development in the uterus. Maternal Serum Alpha-fetoprotein tests (MSAFP) are often done in weeks 15 – 18 of pregnancy to rule out various fetal abnormalities such as Down’s syndrome or anencephaly.

However, AFP is also used as a tumor marker for cancers such as testicular cancer and hepatoblastoma.

In a normal human, the AFP level is usually under 10, in children with liver cancers the number can be much, much higher though a high AFP alone should not be considered a definitive diagnosis. Moreover, AFP tests are used to measure the effectiveness of a particular cancer therapy as well as to monitor patients who are off treatment.

Not a lot is known about AFP and what can influence it. However, it is thought that cancer cell growth, death, liver trauma and regeneration (as in tumor resection surgery, transplant, or injury) as well as growth spurts and some infections can cause the number to become elevated.

When using AFP as a successful post-therapy monitoring variable, oncologists tend to think of large spikes (a fluctuation of an AFP from 2.3 to 5.5 would not be cause for concern whereas a leap from an AFP of 6 to 3 6 might) as well as upward trends (three or more consecutive rising numbers such as 6 to 18 to 35) as an indication of recurrent cancer growth that could indicate further testing such as CT or PET scanning.

It is important to find adequate funding for more comprehensive research to be done on the use of AFP in diagnosing, treating, and monitoring cancers to produce successful outcomes.

 

Specific treatment for hepatoblastoma will be determined by your child's physician based on:

  • your child's age, overall health, and medical history
  • extent of the disease
  • your child's tolerance for specific medications, procedures, and therapies
  • expectations for the course of the disease
  • your opinion or preference

There are a number of treatments for liver tumors. Hepatoblastoma and hepatocellular carcinoma are treated the same way.

Surgery
An operation is performed to surgically remove the tumor and part of the liver where the cancer cells are found. If the cancer cells have spread to other parts of the body (like the tissues that surround the liver, or the lungs or brain), surgery may be used to remove the tumors from these areas.

Chemotherapy
Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy can be used before surgery to shrink the tumor so that it can be surgically removed, or it can be used after surgery to kill any remaining cancer cells.
 

Chemoembolization
Sometimes, when systemic chemotherapy doesn’t work, chemoembolization is used as a treatment. This is a treatment where chemotherapy drugs are injected into the main artery going into the liver along with “embolizing” substances. These substances block or slow the flow of blood into the tumor. This prevents nutrients from feeding the tumor, and gives the drugs more time to kill the cancer cells.

Liver transplantation
If the tumor has spread throughout the liver, or surgery to remove it cannot be performed, the liver may be replaced entirely with a portion of healthy liver from a donor or from a cavaderic source.

Surgical resection (removal) of the tumor is the most important component of therapy for the success of liver tumor treatment. Liver transplant is used when resection of the tumor is not feasible without compromising the integrity of the liver.

Different liver sources can be used:
Cadaveric donor
Living related donor

Patients who have had a liver transplant will need to take medications to suppress the immune system for the rest of their lives.
 

Hepatoblastoma is a rare and aggressive form of childhood cancer originating in the liver. Although it is not clearly known exactly how, when, or why hepatoblastoma happens, it is generally understood that some of the rapidly dividing embryonic cells that form the liver(and other organs)in utero fail to stop developing at an accelerated rate once fetal formation of the liver is complete. Some factors may increase the likelihood of this happening such as genetic disorders, exposure to toxins in utero, and/or low birth weight.

A hepatoblastoma can simply be a collection of benign cells that are similar to fetal tissue or cells can continue to divide and multiply aggressively no longer creating normal liver tissue. This rapid growth results in the formation of a cancerous liver tumor. From the tumor, cells can spread(metastasize)through the bloodstream to other parts of the liver, abdomen, or, most commonly, the lungs.

 

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