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Liver Cancer Center

Liver Cancer Treatment

Liver cancer treatment
When liver cancer has been identified and staged, your medical team can recommend one or more treatment options. At the moment, liver cancer can be cured only when it's found at an early stage (before it has spread) and only if people are healthy enough to have surgery. Doctors will also consider your age, general state of health, personal preferences and concerns about the treatments and their possible side effects when recommending treatment options. Treatment will depend upon:

  • How well your liver is working
  • The number, size, and location of tumors in your liver
  • Whether the cancer has spread outside your liver
  • Whether you have been diagnosed with cirrhosis

For people who do not qualify for surgery, other treatments may be able to improve life and feel better.

Alternative treatments

Alternative treatments can help control pain for advanced liver cancer. Ask your doctor about alternative treatments that may help you cope with pain, which might include:

  • Acupressure
  • Acupuncture
  • Deep breathing
  • Listening to music (music therapy)
  • Massage

Chemotherapy
Unfortunately, liver cancer does not respond to most chemotherapy, which uses drugs to kill cancer cells. Chemotherapy is administered directly into a vein or by mouth. Once the drugs get into the bloodstream, they spread throughout the body and are useful for cancer that has spread to distant organs. The drugs that have worked best for liver chancer include:

  • Cisplatin
  • Doxorubicin 5-fluorouracil

Clinical trials
Many doctors encourage people with liver cancer to consider taking part in a clinical trial. Clinical trials are research studies testing new treatments. They are an important option for people with all stages of liver cancer.

Liver transplant

A liver transplant is an option for people with small liver cancers but is generally reserved for people with a few small tumors that cannot be totally removed (due to location or damage). Patients often wait a long time to receive liver transplants because transplant priority is given to people diagnosed with curable diseases. For this reason, some doctors suggest a limited resection of the liver instead of a transplant.

Medical procedures

Chemoembolization - Chemoembolization combines embolization with chemotherapy.

Cryoablation / freezing cancer cells - Cryoablation uses extreme cold to destroy cancer cells. During the procedure, your doctor places a speicalized tool containing liquid nitrogen directly onto liver tumors. Ultrasound guides the procedure and monitors freezing cells.

Embolization - Embolization treats tumors that cannot be removed. During the procedure, material is placed in the artery that carries blood to the tumor to block blood flow and makes it harder for the tumor to grow.

Hyperthermia therapy - Hyperthermia exposes body tissue to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs.

Percutaneous ethanol injection - A small needle injects ethanol alcohol directly into a tumor to kill cancer cells, usually once or twice a week. Alcohol dries out the cells of the tumor and eventually the cells die.

Radioembolization - This procedure combines embolization with radiation therapy. Doctors inject small radioactive beads or oils into the artery that feeds the liver to target tumor sites for radiation.

Radiofrequency ablation / heating cancer cells - During this procedure, electric current heat sand destroys cancer cells. Doctors use ultrasound or CT scan while inserting several thin needles into the abdomen to reach the tumor(s). These needles are then heated with an electric current, destroying the cancer cells.

Tumor ablation and embolization - Ablation is a local treatment that destroys the tumor without removing it. Ablation is usually performed for people diagnosed with only a few small tumors that cannot be taken out with surgery.

Medications
Experts are currently studying changes in cells that cause cancer to develop newer drugs with different, and less severe, side effects. Like chemotherapy, these targeted medications enter the bloodstream and go throughout the body to work against cancers that have spread to distant organs.

Prevention
Public health measures that reduce exposure to known risk factors can help prevent most cases liver cancer. Below are a few suggestions for how you might be able to prevent liver cancer.

  • Avoid aflatoxins
  • Avoid cancer causing chemicals
  • Avoid hepatitis B or C infections
  • Limit alcohol use
  • Practice food safety
  • Quit smoking
  • Treat diseases that increase liver cancer risk.

Radiation treatment
Radiation may be used to shrink a liver tumor or to give relief from symptoms like pain, but it does not cure the liver cancer and usually does not help improve prognosis.

Radiation therapy uses high-energy rays (such as x-rays) to kill cancer cells and shrink tumors. During this treatment, external beams deliver radiation from outside the body to the exact location of the cancer. This treatment can't be used at very high doses to avoid damage to healthy liver tissue. Three-dimensional conformal radiation therapy (3DCRT) is a newer type of external-beam radiation treatment that uses computers to map the exact location of a tumor. This lowers the damage to normal tissue and allows higher doses to be used. When available, 3DCRT is usually preferred over standard radiation treatment.

Surgery
At this time surgery offers the only likely chance to cure liver cancer. Surgery is performed to remove a tumor(s) on the liver or do a liver transplant. Complete removal of most liver cancers is preferred, but sometimes not possible. Often the cancer is large, is found in many different parts of the liver, or has spread beyond the liver. Also, many people who are also diagnosed with cirrhosis lack enough healthy liver tissues to make surgery possible.

Choosing a treatment plan is a major decision. Take time and think about all of your choices. It may be a good idea to get a second opinion, especially from a doctor experienced in treating liver cancer. A second opinion can give you more information and help you feel more confident about the treatment plan that you pick.

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