Liver Cancer Treatment
Liver cancer begins in the cells of your liver. And if you have been diagnosed with liver cancer, you probably have many questions about the treatments available to you.
Making Liver Cancer Treatment Decisions
You don’t have to make a quick decision about treatment because it is important to give yourself time to understand your options. It is also important you ask questions about anything you don’t understand.
If you want a second opinion, and more time to make a decision, ask your doctor for help on where to start. Getting a second opinion will give you more information and allow you to think further about what treatments might help you best.
Liver Cancer Treatment Considerations
Your doctor will likely develop a treatment plan based on certain factors, including:
- How much of your liver has been affected by the cancer
- Whether the cancer is spreading
- Your preferences
- Your overall health
- Any possibility of damage to the healthy parts of your liver
Your doctor will then discuss your treatment options, the benefit of each treatment, and any side effects or potential complications.
How Is Liver Cancer Treated?
The main treatments for liver cancer are:
- Surgery and liver transplant
- Biological therapy
- Chemotherapy
- Radiation Therapy
- Localized treatments, such as radiofrequency ablation and cryoablation
Surgery and Liver Transplant
If the cancer is isolated to the liver, surgery is the best treatment option for you. Liver cancer surgery can remove up to 80 percent of your affected liver. Your doctor is more likely to recommend surgery if you do not have cirrhosis.
Liver cirrhosis is a serious condition where normal tissue is replaced by scar tissue. The main causes of cirrhosis are excessive alcohol consumption, viral hepatitis, and non-alcoholic fatty liver disease (fat in the liver).
Liver transplant surgery involves removing your diseased liver and replacing it with part of a liver from a healthy donor. For some people, a liver transplant is the only option to treat liver cancer.
Biological Therapy
Biological therapies change the way cells work and help the body control growth of advanced liver cancer or cancer that has spread to other body parts.
A commonly used biological therapy drug, sorafenib, blocks signals that promote cancer cell growth. Available in pill form, it may also help relieve some of the symptoms of liver cancer, including pain.
Sorafenib can cause some harsh side effects, including diarrhea, soreness in the hands and feet, skin changes, fatigue, hair loss, and increased blood pressure. Your doctor can prescribe a medication to control some of the side effects.
Another targeted drug therapy is regorafenib, which works to block proteins that promote cancer growth. This drug is considered when sorafenib is unsuccessful. It is available is pill form.
Much like sorafenib, side effects are harsh and sometimes severe. Less common serious side effects include liver damage, bleeding, blood flow problems, and holes in the stomach and intestines.
Chemotherapy
Chemotherapy drugs work to destroy cancer cells. Whole body chemotherapy is administrated into a vein or given by mouth.
These drugs enter the bloodstream and reach every part of the body and are especially helpful if the cancer has spread to nearby organs.
Liver cancer can be resistant to chemotherapy. While chemotherapy drugs, such as doxorubicin (Adriamycin), 5-fluorouracil, and cisplatin have been successful in treating some tumors, their response is not long lasting.
Even a combination of chemotherapy drugs have not helped patients live longer.
A better chemotherapy option is intra-arterial chemotherapy (IAC) where the tumor in the liver directly receives the drug and the liver breaks the drug down. IAC also has fewer side effects than traditional chemotherapy.
By delivering chemotherapy drugs directly to the tumor, exposure to healthy tissues is limited. This method maximizes cancer-killing effects of chemotherapy drugs and improves survival rates for liver cancer patients.
One Chinese study examined IAC and survival rates for liver cancer. Liver cancer study participants either received two or more courses of pre-operative IAC, one course of pre-operative IAC, or no pre-operative chemotherapy.
After five years, the disease-free survival rates were 51 percent for patients who received two or more rounds of chemotherapy, 35.5 percent for those who received one round, and 21 percent for those who received no IAC.
Radiation Therapy
Radiation therapy is a common treatment for many types of cancer. It uses high-energy particles, such as gamma rays, to destroy cancer cells.
Some radiation therapy delivery methods are:
- External beam: This type of radiation therapy uses a machine to direct radiation outside of the body to the cancerous cells inside the body.
- Internal radiation: This method of radiation therapy utilizes a catheter to place radioactive materials directly to or near the tumor.
- Systemic radiation: Systemic therapy involves swallowing or injecting into a vein a radioactive substance that travels through the bloodstream and locates and destroys cancer cells.
With these types of radiation therapy delivery systems, treatment can better target tumors. These methods also reduce exposure of radiation to healthy cells.
Depending on your situation, your doctor may prescribe radiation therapy alone or with other treatments. Radiation may be damaging to the body and cause unpleasant side effects, including skin changes, nausea, and fatigue.
Your doctor can prescribe treatments to reduce side effects and improve your life quality.
Localized Treatments
Localized treatments, such as radiofrequency ablation and cryoablation, treat cancer cells and the surrounding areas directly.
With radiofrequency ablation, your doctor uses a needle, directed by ultrasound, to reach cancer cells and heat them so they are destroyed.
Cryoablation freezes cancer cells to destroy them. Using ultrasound as a guide, you doctor will use an instrument containing liquid nitrogen inserted directly into the liver tumors.
Stopping Liver Cancer Treatment or Choosing No Treatment
It is your choice whether you want to stop treatments or not pursue any treatments. You may want to stop treatment if therapies aren’t working or forgo treatments because your cancer is so far advanced and treatment likely won’t help you.
Regardless of your reasoning for not pursing treatment, it is important to discuss your feelings and concerns with your doctors before you decide. Even if you are not treating the cancer, you can still ask for medication to treat pain and other symptoms of liver cancer.