A ‘One in a Million’ Chance of Survival at Age 3, 50 Surgeries and Two Liver Transplants Later, This Childhood Cancer Survivor Just Graduated with a Master’s in Medical Physics

Surviving Childhood Cancer

• At age 3, Andrew Rogers was given one week to live following a liver cancer diagnosis — now a little over two decades later, the childhood survivor is graduating from Georgia Tech with a Master’s in Medical Physics, and spreading hope to other families facing similar odds.
• When Andrew was going through treatment at such a tender age, he could see the top of the University’s tower, and knew that he wanted to help kids like him when he grew up. His parents always instilled hope in him, and now he’s paying it forward.
• Liver cancer is often rare in children. Though there are several types, the most common type is hepatolblastoma, which is what Andrew survived.
• It is important to know that you are not a statistic. For parents of a child going through cancer, as their caregivers and top advocates, it is vital to speak up and do what is best for your child at all times, as they are unable to care for themselves. There is always hope.
• Here is SurvivorNet’s overview of liver cancer to help you learn more about this disease.

At age 3, Andrew Rogers was given one week to live following a liver cancer diagnosis — his parents were told he had a "one in a million" chance of survival. Now a little over two decades later, the childhood survivor is graduating from Georgia Tech with a Master's in Medical Physics, and spreading hope to other families facing similar odds. You are not a statistic. When Andrew was going through treatment at such a tender age, he could see the top of the Tech tower from the top public research university, and knew what he wanted to be when he grew up. RELATED : How Singer Michael Buble’s Outlook Changed During Son’s Liver Cancer Battle: 'Be More Present' "I'd go in for free because I love what I'm doing," the Atlanta native shared to Fox 5 Atlanta of his dedication to the medical field. Andrew, who received his undergraduate degree in radiation therapy from Augusta University, will now be moving on to Texas to serve his residency.

Sharing a message of hope, the 18-year-survivor — who endured 50 surgeries and two liver transplants to make it to where he is today — described the nurturing wisdom he received from his top advocates. "My parents told me that there's always a light at the end of every tunnel, and it's always going to be worth it in the end," Andrew said. "So, I will keep telling myself and everybody else that when they're going through a hard time, keep pushing." RELATED : Warning Signs—The Top Ten Childhood Cancer Symptoms that Can Be Missed "Things may be painful and stressful now," Andrew added, "But think about what you will achieve in the future and the people you will help get through battles of their own. That will always keep my motivated."

Liver Cancer: The Basics

When facing a liver cancer diagnosis there’s good news right from the start: today’s treatments offer real hope. Medical advances have led to a range of new options that improve life expectancy and sometimes even provide a cure. “We have so many treatment options available for liver cancer. That is a fact,” Dr. Miriam Eskander , a surgical oncologist and assistant Professor in the Division of Surgical Oncology at the Rutgers Robert Wood Johnson Medical School, tells SurvivorNet. RELATED : SurvivorNet's Overview of Liver Cancer “What options are available to patients typically depend on the state of the background liver, like how sick is the liver? And then second, what is the extent of spread? And so there are a lot of factors at play,” she adds. With the latest surgical techniques and therapies, patients have a strong chance of living longer, healthier lives. Even if you are faced with the challenges of late-stage disease, there are plenty of reasons to stay hopeful and pursue treatment.

Risk & Symptoms of Liver Cancer

The risk for getting liver cancer depends on a variety of factors including genetics, the environment, and lifestyle habits. “It’s usually caused by chronic inflammation in the liver — it could be because of genetics or it could be because of environmental factors [which] can lead over a lifetime to develop HCC,” Dr. Milan Kinkhabwala , professor of surgery and the director of the hepatobiliary section and transplantation at Montefiore Einstein’s Comprehensive Cancer Center, explains to SurvivorNet. RELATED : Cabometyx — A Promising New Targeted Drug Therapy for Liver Cancer Liver cancer is often rare in children, states the National Cancer Institute . Though there are several types, the most common type is hepatolblastoma, which is what Andrew survived. The Impact of a Childhood Cancer Diagnosis on the Whole Family: Jayne Wexler Shares Her Story "The other less common types of childhood liver cancer are hepatocellular carcinoma, undifferentiated embryonal sarcoma of the liver, and infantile choriocarcinoma of the liver," NCI adds.

Risk Factors for Hepatoblastoma

Children with certain syndromes or conditions are at higher risk of developing hepatoblastoma, the NCI explains. The risk factors include:

• Low birthweight
• Aicardi syndrome, which is a rare genetic disorder marked by a lack of tissue connecting the left and right halves of the brain, seizures, lesions on the back of the eye (retina), and other brain and eye abnormalities.
• Beckwith-Wiedemann syndrome, which is an overgrowth disorder where babies are large at birth and develop low blood sugar.
• Hemihyperplasia, where one side of the body or part of one side is larger than the other.
• Familial adenomatous polyposis, which is a disorder where many polyps form on the inner walls of the colon and rectum. Glycogen storage disease, in which a form of glucose has problems being stored inside the body.

General Symptoms of Liver Cancer

Generally speaking, symptoms of liver cancer are often nonspecific, meaning that they can overlap with those of various other conditions. This is why it’s so important to see a doctor to determine a diagnosis. Recovery, Pain Management and More — What to Expect After Surgery for Liver Cancer Symptoms of liver cancer can include:

• Jaundice (yellowing of skin and whites of the eyes)
• Intensely itchy skin
• White or clay-like stool (also known as acholia)
• Dark urine (also known as choluria)
• Fatigue
• Abdominal pain (on the right side, just below the ribs)
• Unexplained weight loss
• Fever
• Night sweats

Abdominal discomfort associated with liver cancer is typically concentrated on the right side near the rib cage, where the liver is situated within the body. Abdominal swelling may indicate liver failure or advanced cancer. Bilirubin is a yellow substance produced when the body breaks down old red blood cells. It’s what gives the digestive fluid called bile its color. Jaundice, evidenced by yellowing of the eyes or darkened urine, is a result of increased bilirubin levels in the bloodstream.

How Is Liver Cancer Diagnosed?

Liver cancer often shows no symptoms in its early stages. Tumors are usually too small to be felt from the outside. Detecting these tiny spots on the liver requires special techniques administered by skilled specialists. If you’re experiencing symptoms of liver cancer, your doctor will start with an initial physical exam. The exam will include:

• Abdomen check to examine the liver, spleen, and nearby organs
• Check for fluid buildup in your abdomen (ascites)
• Skin and eye exam for signs of jaundice

RELATED : How the Immunotherapy Drug Combination of Imfinzi and Imjudo Is Changing the Game for Advanced Liver Cancer Patients If your doctor suspects liver cancer, you may need follow up tests to confirm the diagnosis, which can include:

• Ultrasound: This machine uses sound waves to create a computer image and can detect tumors. This is often the first test used to look at the liver.
• Blood tests: These tests are used to detect substances like alpha-fetoprotein (AFP).
• CAT scan: These scans use X-ray technology that makes detailed images of your body and can give specific information about the size, shape, and location of any tumors in the liver or elsewhere in the abdomen, as well as nearby blood vessels.
• MRI scan: These scans provide detailed images of liver cancers, sometimes using contrast material and X-rays of the bile ducts.
• Genomic/Molecular Profiling: These tests can identify specific biomarkers to help determine the best treatment options and clinical trials for liver cancer.
• Biopsy: This involves removing a small sample of tissue from the tumor to examine it under a microscope.

Different biopsy techniques include:

• Fine needle aspiration (FNA): A thin needle is used to take a small tissue sample from the liver.
• Core biopsy: Similar to FNA, but a thicker needle is used to remove larger samples.
• Percutaneous biopsy: Using ultrasound or a CT scan, the doctors can find the tumor and use a fine needle to take a tiny sample of tissue.
• Laparoscopy: A small incision is made in the abdomen, and a thin tube with a camera is used to view and obtain a tissue sample.
• Surgical biopsy: Tissue is taken during a surgical procedure.

Treating Advanced Liver Cancer

Advanced liver cancer means that the disease has progressed beyond the point where it can’t be surgically removed or cured with localized treatments. Instead, the focus shifts to managing symptoms, slowing the progression of the disease, and improving the quality of life for as long as possible. While the prognosis for advanced liver cancer can be daunting, there is hope. Treatment options are increasing. Currently, treatment options may include:

• Chemotherapy
• Targeted Therapy
• Immunotherapy
• Radiation Therapy
• Clinical Trials

As doctors learn more about cancer, more drugs that target specific markers that help cancer grow or spread are becoming available. RELATED : Advanced Liver Cancer Diagnosis, Treatment, and Symptom Management An example of a targeted drug for advanced liver cancer is Cabometyx. It is a medication that has been successful in helping some liver cancer patients live longer by slowing down the growth of their tumors. It works by blocking special proteins known as enzymes that help cancer cells grow. Clinical trials are also an important consideration, Dr. Eskander says. “The National Comprehensive Cancer Network believes that the best management for any patient with cancer is in a clinical trial. So I want to say that upfront,” she says. “But clinical trials are not the last resort – they can actually be a first resort. And so I bring them up early. I include them in the list of treatment options I have for a patient.”

Questions to Ask Your Doctor

• What type of liver cancer do I have/does my child have?
• What stage is the cancer?
• What are the treatment options?
• How will we manage treatment side effects?
• How much of the treatment will be covered by insurance and how much will need to be paid out of pocket?

Contributing: SurvivorNet Staff