Early diagnosis of liver cancer is important to successful treatment. As with most types of cancer, the earlier the cancer is discovered, the better a patient's chances for survival.
There are numerous factors that are considered in assessing which treatment option is best suited for a patient, such as medical history, current health condition, clinical and diagnostic test results and patient preference.
Based on the final assessment, your physician will recommend an individualized treatment plan that may include: surgery (where part or all, of the kidney is removed), tumor ablation, embolization, targeted therapy, chemotherapy and/or radiation therapy. Some patients will benefit from a combined approach that may include surgical removal in addition to targeted therapy, radiation therapy, chemotherapy and research protocols (clinical trials).
Surgery is an option for people with an early stage of liver cancer. The surgeon may remove the whole liver or only the part that has cancer. If the whole liver is removed, it's replaced with healthy liver tissue from a donor. You and your surgeon can talk about the types of surgery and which may be right for you.
Surgery to remove part of the liver is called partial hepatectomy. A person with liver cancer may have part of the liver removed if lab tests show that the liver is working well and if there is no evidence that the cancer has spread to nearby lymph nodes or to other parts of the body.
A liver transplant is an option if the tumors are small, the disease has not spread outside the liver, and suitable donated liver tissue can be found. Donated liver tissue comes from a deceased person or a live donor. If the donor is living, the tissue is part of a liver, rather than a whole liver. While you wait for donated liver tissue to become available, the health care team monitors your health and provides other treatments.
When healthy liver tissue from a donor is available, the transplant surgeon removes your entire liver (total hepatectomy) and replaces it with the donated tissue. After surgery, your health care team will give you medicine to help control your pain. You may need to stay in the hospital for several weeks. During that time, your health care team monitors how well your body is accepting the new liver tissue. You'll take medicine to prevent your body's immune system from rejecting the new liver.
Methods of ablation destroy the cancer in the liver. They are treatments to control liver cancer and extend life. They may be used for people waiting for a liver transplant. Or they may be used for people who can't have surgery or a liver transplant. Surgery to remove the tumor may not be possible because of cirrhosis or other conditions that cause poor liver function, the location of the tumor within the liver, or other health problems. Examples of ablative technology include:
- Radiofrequency Ablation
- Percutaneous ethanol injection
For those who can't have surgery or a liver transplant, embolization or chemoembolization may be an option. The doctor inserts a tiny catheter into an artery in your leg and moves the catheter into the hepatic artery. For embolization, the doctor injects tiny sponges or other particles into the catheter. The particles block the flow of blood through the artery. Depending on the type of particles used, the blockage may be temporary or permanent.
People with liver cancer who can't have surgery or a liver transplant may receive a drug called targeted therapy. Sorafenib (Nexavar) tablets were the first targeted therapy approved for liver cancer. Targeted therapy slows the growth of liver tumors. It also reduces their blood supply. The drug is taken by mouth.
Radiation therapy uses high-energy rays to kill cancer cells. It may be an option for a few people who can't have surgery. Sometimes it's used with other approaches. Radiation therapy also may be used to help relieve pain from liver cancer that has spread to the bones. Doctors use two types of radiation therapy to treat liver cancer:
- External Radiation Therapy: The radiation comes from a large machine. The machine aims beams of radiation at the chest and abdomen.
- Internal Radiation Therapy: The radiation comes from tiny radioactive spheres. A doctor uses a catheter to inject the tiny spheres into your hepatic artery. The spheres destroy the blood supply to the liver tumor.
Chemotherapy, the use of drugs to kill cancer cells, is sometimes used to treat liver cancer. Drugs are usually given by vein (intravenous). The drugs enter the bloodstream and travel throughout your body.
Chemotherapy may be given in an outpatient part of the hospital, at the doctor's office, or at home. Rarely, you may need to stay in the hospital.
Clinical trials are carefully controlled research studies in which cancer patients help doctors and scientists find ways to improve health and cancer care, and to make sure the treatments are safe and effective. Each study is designed to address and answer specific scientific questions and to find better ways to prevent, diagnose or treat cancer. A clinical trial is one of the final stages resulting from the research conducted during intensive and lengthy laboratory studies.
If you are interested in finding out more about these studies, visit our Clinical Trials Guide for general information and a listing of currently open clinical trials.