Luka Miljus
Hepatoblastoma
Luka Miljus and his parents, Branko and Sanja, have travelled to London from their home in Serbia to attend Great Ormond Street Hospital. Five year old Luka has a malignant tumour, a hepatoblastoma, in his liver which was spotted when he had an ultrasound examination after a minor car accident. This chance discovery may have saved his life, if the tumour can be removed before the cancer has spread. Chilhood cancers are, thankfully, rare and liver cancers are even rarer; just one in two million children.
Sanja and Branko researched the best place for Luka to be treated and decided to bring him, as a private patient, to Great Ormond Street where he will be under the care of world renowned consultant oncologist Penelope Brock.
Sanja has been told that, if they follow the recommended procedures, he should have an 80-90% chance of a total cure. Dr Brock has enrolled Luka on a worldwide trial aiming to reduce the risks of the treatment itself causing harm.
The first stage of treatment for liver cancer involves several courses of chemotherapy to shrink the tumour before removing it with surgery. Usually the chemotherapy is a combination of two drugs; doxorubicin and cisplatin, with a risk of side effects, potentially damaging the heart, kidneys and hearing. Luka will receive just one drug; cisplatin, to try and avoid some of the side effects. Even with one drug there is still a chance that Luka's kidneys could fail, or he could lose his hearing.
Luka will have four courses of chemotherapy, over an eight week period. He'll then have an MRI scan to see if it's worked and whether surgery can go ahead.
Once the chemotherapy is complete, Luka needs to be sedated for the scan, but he's terrified of the anaesthetic. Eventually, he's talked around and receives the scan. The tumour has reduced, so the surgery can proceed.
Branko and Sanja Miljus
The operation will be long and complex, the tumour is in an awkward position at the back of the liver with a main vein and arteries running nearby. Professor Agostino Pierro has enlisted the help of vascular specialist Edward Kylie. They want to remove all of the cancerous cells, if any remain they could start to spread again. After five hours in theatre, the work is complete. Now, they must wait for the histology results.
Liver tumours in children increase the amount of Alpha-fetoprotein (AFP) in the blood. So these AFP levels are used to monitor the presence of cancer cells. The normal, healthy AFP level is under 20. Before treatment began, Luka's AFP count was 3,900 and now they're at 126. Sanja is delighted with the progess so far.
He will receive a further two course of cisplatin to remove any remaining cancer cells, A final blood test reveals an AFP count of 10, an MRI scan shows no sign of the tumour, so Luka is in complete remission. To everyone's relief and delight, Luka suffered no side effects from the treatment.
His health will be closely mentored for the next three years, and they are now back home in Serbia. The signs are that he been completely cured.
CREDITS: All of this information came from the UK Channel 5 "Child in a Million" documentary series
