Dr. Johnny Hong
Ashley Gibson knew something was wrong with her newborn
son, Dominic, from the moment the nurse put him in her
arms. He was breathing fast, and his skin looked pale
yellow. The medical staff at Centegra Hospital-McHenry
in McHenry, Ill., attributed his distress to the
meconium he’d aspirated during the birth process.
later that night, Dominic wouldn’t nurse, and he
continued to breathe rapidly. Ashley and her husband,
Adam Gibson, asked the doctors to examine Dominic again.
The neonatologist took Dominic for a scan, and they were
gone most of the night. When the doctor came in early
the next morning without Dominic, Ashley feared the
worst. The neonatologist confirmed her worries:
Dominic’s liver was enlarged, and there was a shadow
that mean he has cancer?” Ashley asked, thinking of her
family’s long history with the disease.
necessarily,” said the doctor.
hospital’s medical team was not equipped to treat
Dominic, so they transferred him to a hospital in
Rockford, Ill. The physicians ran different tests, and
the neonatologist wrote down three possible diagnoses,
with the worst being a pediatric hepatoblastoma. “I
instantly knew that was what it was,” Ashley says, “but
I was trying to remain hopeful.”
again, the doctors told the Gibsons, who are from
Trevor, Wis., that they could not treat this type of
tumor and suggested that Dominic be transferred to
Children’s Hospital of Wisconsin. “I was comforted that
he was going to a place that would take good care of
him,” Ashley recalls. “But I was also worried, because
that’s when I knew it was a serious situation.”
Children’s, Dominic was placed in the neonatal intensive
care unit. The doctors did a biopsy, and 24 hours later
the Gibsons had a definitive diagnosis: Dominic had
liver cancer. His tumor was indeed a hepatoblastoma,
which is the most common primary liver cancer for
newborns and young children. Without any treatment, this
cancer is quite aggressive and will spread throughout
the body. The only treatment that’s curative is surgery
to remove the tumor.
Dominic’s tumor was the size of a grapefruit and
consumed almost 80 percent of his liver. At that size,
it was too big to remove. Dominic’s oncologist, Dr.
Meghen Browning, recommended chemotherapy to shrink the
tumor. The tumor responded well to the treatment, and
after just two rounds of chemotherapy, the tumor was
small enough to operate. But Browning told the family
that before scheduling surgery, she wanted to consult
with a liver specialist, Dr. Johnny Hong — and together
they’d come up with a game plan.
a professor and chair of surgery at the Medical College
of Wisconsin (MCW). Additionally, he serves as director
of the Solid Organ Transplantation Center, a joint
program of Children’s Hospital of Wisconsin, Froedtert
Hospital and the Medical College of Wisconsin. He
explains that the liver is a unique organ because it has
the ability to regrow. With a normal liver, free of
cirrhosis or any other liver disease, doctors can remove
up to 70 percent of it, and the remaining 30 percent
will regenerate. According to Hong, “Typically the
factor that determines whether the liver is able to
regrow or not is the health of the liver. Chemotherapy
is quite effective in killing cancer cells, but it also
kills normal cells.” For patients who have undergone
chemotherapy or have a diseased liver, this means that
they need 35 to 40 percent of the liver in order for it
to regrow. So even though Dominic’s tumor had shrunk
from occupying 80 percent of the liver to just 72
percent, Dominic needed more liver for the doctors to
both remove the tumor and leave him with enough to
decided they had two options for treating Dominic. The
first option was to place Dominic on the liver
transplant list. They could remove the entire liver with
all of the cancer and replace it with a brand-new one.
But Hong was wary of this. The transplant list is long,
and the livers that usually become available would be
too large for Dominic. Even a segment of a liver from a
family member might be too large for the small infant.
Because Dominic’s tumor was fast-growing, waiting for a
liver when so few are available seemed too risky.
offered a second option — he would try an innovative
technique that had never been done on a patient this
young. The technique requires two surgeries. During the
first surgery, Hong and his team cut off the blood
supply to the part of the liver that has the cancer.
This stimulates growth in the remaining part of the
liver without putting the patient at risk of having too
little liver. Then it’s a waiting game. After a week,
they check the liver through multiple image studies to
see if the healthy part of the liver is big enough to
survive on its own. If it is, they can go back in and
take out the tumor, leaving enough healthy liver for the
patient to survive.
terrified because it hadn’t been done on a baby, but I
trusted Dr. Hong because he was sure it could be done,
and I went with what he thought was best,” remembers
Ashley. Although the technique had never been attempted
on a child this small, Hong was convinced the procedure
would work. “I was confident that our success rate would
be very high given our expertise in this area,” he says.
days after the first surgery, Hong walked into Dominic’s
room with a big smile and said, “His liver grew twice as
much as we expected.” The healthy growth meant that the
team was able to take out the tumor and get good
margins. After the surgery, Hong assured the family that
he got all of the cancer cells.
Gibsons were grateful to Hong. “He reassured me that
everything was going to be OK and (that) Dominic was in
good hands, and he was,” says Ashley. Hong says that to
work with well with parents, he has to put himself in
their shoes. “In taking care of children, both you and
the parents are making the decisions for an individual
who is helpless to make their own decisions. The
pressure, oftentimes, is very, very high,” he adds.
will turn 1 year old on Aug. 24 — and he is completely
cancer-free. At this writing, he’s a healthy,
10-month-old baby who can crawl, pull himself up, and
say many words, including mama, dada and nana. At his
June visit to the pediatrician, he weighed 18 pounds, 9
ounces and measured 28 inches. In physical therapy, he’s
hitting every developmental milestone on time — and some
a bit early. Dominic is a thriving, happy baby.
surgery has also been well-received by the medical
community. Hong, Browning and their team wrote about the
surgery for the Annals of Surgery, a monthly review of
surgical science, which is a prestigious peer-reviewed
scientific journal. Hong credits the environment at MCW
for making it possible to try such an innovative
procedure. “It’s our obligation to push the envelope and
advocate for the patient,” Hong says. “Rather than
waiting for someone else to innovate and then follow
them, we are on the leading edge.”
hoping we’ll be able to save more children (with liver
cancer) moving forward,” he adds.
Kicks off Race Fundraising with First-Ever ‘Ink for the Cure’
To kick off this year’s Susan G. Komen Southeast
Wisconsin Race for the Cure, organizers hosted their first Ink for
the Cure event in late June at the Pettit National Ice Center.
Nearly 60 survivors and supporters received a free
breast cancer awareness tattoo by a variety of professional tattoo
artists. In addition to their chance to get inked up for the cause,
those who attended got the chance to meet others involved with the
race and register to run or fundraise for the Race for the Cure.
New this year, the race’s donation system allows
participants who raise $60 eligibility for a refund on their
registration fee. Those who raise over that amount are eligible to
win prizes and an entry for the grand prize too.
The 2017 Susan G. Komen Southeast Wisconsin Race for
the Cure will take place on Sunday, Sept. 24, at the Milwaukee Art
Museum grounds, 600 N. Harbor Drive. Registration and entry into the
survivor pavilion starts at 7 a.m.; the pre-race ceremony begins at
8:45 a.m.; and the run/walk kicks off at 9:15 a.m. For more
information about this year’s race, visit
— Sydney Purpora