How liver cancer took away a 7-year-old’s childhood

Liver cancer, a disease in which cells in the liver abnormally grow, commonly affects adults, but a rare type of the disease has burdened seven-year-old Lucas Alarma.

Hepatoblastoma is a very rare cancer in the liver that commonly affects babies and children.

Lucas was three years old when he suffered from abdominal pains and fever in 2022.

His mother, Rea Alarma, recounted that his pediatrician prescribed antibiotics as his case was initially suspected to be a urinary tract infection. But after 10 days of still being weak, they went back to the pediatrician.

“Kinakapa po ‘yung tiyan niya (Lucas), [inaawat] niya po ‘yung kamay ng doktor. Tapos, lumabas din po sa CBC (complete blood count) niya, mababa po ‘yung hemoglobin. Ang sabi po sa akin, dalhin ko na raw po sa pinakamalaking hospital kasi ‘yung baga din niya noon, may tubig na,” Rea narrated to Rappler.

(During the check-up, the doctor was touching his belly and he was trying to stop it. His CBC had shown that he had low hemoglobin. The doctor told me to bring him to a bigger hospital because at the time, his lung also had water.)

Rea brought Lucas to the National Children’s Hospital in Quezon City. There, he was diagnosed with hepatoblastoma.

PATIENT. Three-year-old Lucas Alarma during his admission at the National Children’s Hospital in Quezon City in 2022. Credit: Rea Alarma (Photo posted with parental consent)

At the time, the doctor told Rea that her child might die “any time.”

“Bilang magulang, parang gumuho na ‘yung mundo kasi hindi naman siya lumalabas ng bahay, ta’s breastfeed ako sa kanya ta’s ganu’ng sakit ‘yung ibibigay,” she said.

(As a parent, it seemed like the world crumbled because he was not going out of the house, I was breastfeeding him, and yet that was the kind of disease he got.)

Rea noted that her husband’s family has a history of liver cancer.

After his diagnosis, Lucas underwent a 10-cycle course of chemotherapy, a drug treatment that kills cancer cells and stops them from growing. In 2023, he had a six-cycle course.

In 2024, Lucas underwent surgery to remove a lump on his liver. In the process, he lost his gallbladder and a part of his liver. He had another six-cycle course of chemotherapy following the operation.

POST-SURGERY. Lucas Alarma rests at the National Children’s Hospital in March 2024 after his surgery. Credit: Rea Alarma (Photo posted with parental consent)

Lucas’ illness, Rea lamented, had prevented him from doing what a normal kid does. He was constrained to stay in his home and at the hospital, only occasionally going out when there were events.

“Bawal lumabas, mahina ‘yung immune system niya…. Minsan, side effect po ng chemo niya, nilalagnat na. ‘Pag nilagnat na po ‘yun, dudugo na ‘yung ilong niya. Tapos, ‘pag ‘di niya kinaya, susuka na,” the mother said.

(He could not go out before because his immune system is weak…. There were times when he got fever as a side effect of the chemotherapy. Back then, when he got fever, his nose would bleed. When he could not take it, he vomits.)

“Nung 2024, in-enroll ko siya [sa school] kaso nag-a-absent nga po dahil dumudugo nga ‘yung ilong niya. Kaya sabi ng doktor, hindi daw po muna puwede hangga’t nagki-chemo siya,” she said.

(In 2024, I enrolled him in a school but he was absent most of the time because of his nosebleeds. The doctor recommended he stop schooling while he was undergoing chemotherapy.)

Fortunately, in the latter part of 2024, Lucas was in a better condition after three years of chemotherapy and a medical operation, defying the doctor’s estimate on his life expectancy.

Lucas’ doctor decided to stop his chemotherapy, but he is still being monitored as there is a chance his disease could worsen.

Lucas Alarma poses for a photo in January 2025, four months after his last chemotherapy session. Credit: Rea Alarma (Photo posted with parental consent)

From a limited routine between his home and the hospital, Lucas has stepped out to wider grounds.

He began going to school in 2025 and is taking kindergarten classes.

Rea likewise said he has also made some friends.

“Buti po ngayon, sa awa po ng Diyos, nakakapag-explore na siya,” she said. “Sana tuloy-tuloy na po ‘yung paggaling niya para magawa niya ‘yung mga ginagawa ng normal na bata.”

(Now, in God’s mercy, he is already able to explore. I hope his healing will be continuous so he can do what other normal kids do.)

Liver cancer, its causes and symptoms

Aside from hepatoblastoma, there are other kinds of liver cancer: hepatocellular carcinoma, cholangiocarcinoma, and hepatic angiosarcoma.

Hepatocellular carcinoma, the most common type of liver cancer, begins in the main cell type of the liver. Cholangiocarcinoma stems from the cells lining the bile ducts, or the tubes that carry bile from the liver to the gallbladder. Hepatic angiosarcoma starts in the blood vessels of the liver.

According to the Global Cancer Observatory, liver cancer is the fourth most common cancer in the Philippines with 12,544 new cases in 2022. Data also showed it is the third cause of cancer deaths in the same year with 11,653 fatalities.

The “leading cause of liver cancer” is hepatitis or liver inflammation, the World Health Organization said. Chronic Hepatitis B and C virus infection are the usual drivers of liver cancer.

The Hepatology Society of the Philippines (HSP) said excessive alcohol consumption may also lead to scarring of the liver, called cirrhosis, which may trigger liver cancer.

Another factor that could result in liver cancer is metabolic dysfunction-associated steatotic liver disease, a condition where fat builds up in the liver due to excess weight or other metabolic conditions.

If a person has a liver cancer, he/she may experience the following symptoms:

• unexplained weight loss
• loss of appetite
• swollen abdomen
• upper abdominal pain
• dizziness and vomiting
• fatigue
• jaundice or yellowish eyes and skin
• pale and chalky stool

A person who exhibits symptoms of liver cancer should immediately seek medical consultation.

The HSP said early stages of liver cancer, oftentimes, do not manifest symptoms.

Maintain a healthy liver

As the Philippines commemorates the Liver Cancer and Viral Hepatitis Prevention Month this January, the Department of Health (DOH) has advised the public to keep their livers healthy.

One of the ways to take care of one’s liver is vaccination against hepatitis B. To date, there is no vaccine for hepatitis C.

The DOH warned against the use of contaminated needles to avoid the contraction of the virus.

The health agency also pushed to practice a healthy lifestyle, such as having a proper diet and exercising, and avoiding excessive alcohol consumption.

A regular check-up would also help to assess one’s liver condition, the DOH said. – Rappler.com