Liver Cancer (Hepatocellular Carcinoma) Treatment
Once a diagnosis of liver cancer is confirmed, you will begin treatment immediately. A number of factors are considered when planning liver cancer treatment. These include:
- Size, number and location of tumors
- If the tumors metastasized (spread to other organs)
- Severity of liver disease
- If you are a candidate for liver transplantation
- Your general health
The goal of treatment is to prolong your life without compromising your quality of life.
While chemotherapy and radiation therapy treat cancer, they are not effective against liver cancer. Treatment options include:
Liver Cancer Treatment: Surgical Resection
For non-cirrhotic patients with liver cancer, surgery is the treatment of choice. Surgical resection, in which your surgeon removes the cancerous part of the liver, offers the best possibility for a cure.
This option works best when the cancer is detected early and has not spread, either within the liver or to other organs. Once the cancer is removed, a healthy liver can regenerate, returning to normal size within six months. However, if the liver is cirrhotic, its ability to regenerate is limited.
Not all patients are candidates for resection. Resection is not recommended if:
- The tumor has spread to other parts of the liver or the body
- The size of the tumor or its location near major blood vessels means it is dangerous to remove
- Cirrhosis or other disease limits the ability to operate or remove part of the liver
- Other medical conditions make surgery unsafe
There are a number of different surgical options for liver resection:
- Resecting the entire lobe (either right or left)
- Resecting more than one lobe (extended lobectomy)
- Removing part of a lobe (segmental resection)
A liver is divided into eight sections, and the resection is based on those sections.
What to expect from a liver resection:
- You will be placed under general anesthesia.
- Your surgeon will make an incision on the right side of your body below your rib cage, and then remove the cancerous portion of the liver.
- The surgery will take anywhere from two to five hours.
- You will be hospitalized for four to six days.,
Liver Cancer Treatment: Liver Transplantation
If you have small tumors or advanced cirrhosis, a liver transplant is usually recommended. During a liver transplantation, your surgeon removes your entire liver and replaces it with a healthy one. The liver may come from a donor who has died, or a healthy person may donate part of his or her liver for you. If you receive a liver transplant, you will need to take anti-rejection medication for the rest of your life. Learn more about liver transplantation.
Liver Cancer Treatment: Transarterial Chemoembolization
Transarterial chemoembolization (TACE) is an interventional radiological therapy. It is the most commonly performed procedure to treat liver tumors that are inoperable or for patients with liver cancer who are waiting for liver transplant.
Chemoembolization delivers a high concentration of drugs to the tumor and stops blood flow to it. This procedure deprives the tumor of its oxygen supply while delivering drugs to the tumor. The medication may be present for as long as a month after the procedure. However, most of the drug is trapped in the liver, so it cannot damage other organs in your body.
Chemoembolization may be used to treat patients with other cancers that have spread to the liver.
Liver Cancer Treatment: Radio Frequency Ablation
The goal of radio frequency ablation (RFA) is to destroy the cancerous tissue by applying heat. When the temperature is greater than 90 degrees Celsius, the tumor begins to break down. RFA can be performed percutaneously (through the skin) or during surgery. During radio frequency ablation:
- Your doctor uses an ultrasound machine to guide a needle deep into the lesion.
Radiofrequency ablation (RFA) in hepatocellular carcinoma (Click to Enlarge)
- The needle deploys a number of electrodes.
- The generator is activated to achieve a high temperature within the tumor.
Liver Cancer Treatment: Oral Medication
There is one FDA-approved oral medication to treat liver cancer. This medication does not cure liver cancer, but it prolongs patient survival. It is used in patients whose liver cancer can’t be resected or transplanted. It may be used in association with other treatments, such as TACE. Your doctor will explain more about this medication if you are a candidate for it.
Liver Cancer Prevention
Unfortunately, many patients with liver cancer are diagnosed at a late stage, when it is nearly impossible to cure the cancer. Regular screening for liver cancer may improve outcomes by detecting small tumors in the early stages. High-risk patients, including carriers for hepatitis B and those with hepatitis C or hemochromatosis, should receive regular screenings. Receiving a hepatitis B vaccination is another important step toward prevention.