What are liver cancer treatment options?
The medical treatment chosen depends upon how much the cancer has spread and the general health of the liver. For example, the extent of cirrhosis (scarring) of the liver can determine the treatment options for the cancer. Similarly, the spread and extent of spread of cancer beyond the liver tissue plays an important part in the types of liver cancer treatment options that may be most effective.
Surgery: Liver cancer can be treated sometimes with surgery to remove the part of liver with cancer. Surgical options are reserved for the smaller sizes of cancer tumors. Complications from surgery may include bleeding (which can be severe), infection, pneumonia, or side effects of anesthesia.
Liver transplant: The doctor replaces the cancerous liver with a healthy liver from another person. It is usually used in very small unresectable (inoperable or not able to be removed) liver tumors in patients with advanced cirrhosis. Liver transplantation surgery may have the same complications as noted above for surgery. Also, complications from medications related to a liver transplant may include possible rejection of the liver transplant, infection due to suppression of the immune system, high blood pressure, high cholesterol, diabetes, weakening of the kidneys and bones, and an increase in body hair.
Ablation therapy: This is a procedure that can kill cancer cells in the liver without any surgery. The doctor can kill cancer cells using heat, laser, or by injecting a special alcohol or acid directly into the cancer. This technique also may be used in palliative care when the cancer is unresectable.
Embolization: Blocking the blood supply to the cancer can be done using a procedure called embolization. This technique uses a catheter to inject particles or beads that can block blood vessels that feed the cancer. Starving the cancer of the blood supply prevents the growth of the cancer. When this technique uses chemotherapy and synthetic material, it is sometimes called chemoembolization, as it blocks off the blood supply and traps the chemotherapy agent in a tumor. This technique is usually used on patients with large liver cancer for palliation. Complications of embolization include fever, abdominal pain, nausea, and vomiting.
Radiation therapy: Radiation uses high-energy rays directed to the cancer to kill cancer cells. Normal liver cells are also very sensitive to radiation. Complications of radiation therapy include skin irritation near the treatment site, fatigue, nausea, and vomiting.
Chemotherapy: Chemotherapy uses a medicine that kills cancer cells. The medicine can be given by mouth or by injecting it into a vein or artery feeding the liver. People can have a variety of side effects from chemotherapy, depending on the medications used and the patient's individual response. Complications of chemotherapy include fatigue, easy bruising, hair loss, nausea and vomiting, swollen legs, diarrhea, and mouth sores. These side effects are usually temporary.
Targeted agent: Sorafenib (Nexavar) is an oral medication that can prolong survival (up to 3 months) in patients with advanced liver cancer. Side effects of sorafenib (Nexavar) include fatigue, rash, high blood pressure, sores on the hands and feet, and loss of appetite.
Clinical trial: A clinical trial is a way to receive specific treatments in a carefully controlled way to determine whether a new therapy approach is safe, effective, and better than existing therapies. A new treatment may be a drug, a device, a different way to do a surgery, a combination of two or more drugs, or methods of treatment or even diet. The government maintains a web site at ClinicalTrials.gov where more information on trials related to liver cancer can be found. The research from clinical trials, including the statistics supporting the effectiveness of the intervention being tested, is important in the introduction of new treatment methods and ways to change the standard of medical care for all types of liver cancer.