Liver Cancer Treatment Options
Purpose of primary liver cancer treatment
Treatment of primary liver cancer can have two goals: the healing of liver cancer or life extension and/or reduction of complaints. If a treatment has the goal of healing, it is called a curative treatment. In addition to the main treatment, there are additional treatments, adjuvant treatments. For example, if a tumor is taken away by surgery, you may receive additional treatment later. This treatment aims at combating any residues. If the condition is not curable, a palliative treatment can be started. This type of treatment focuses on life extension and/or reduction of complaints.
Treatment of primary liver cancer options
When drawing up a treatment plan for primary liver cancer, several factors are important: the stage of the condition, place, size, and shape of the tumor and your physical condition. Depending on these factors, there are several treatment options for primary liver cancer:
- Radiofrequency ablation
- Surgery
- Chemoembolization
- Liver transplant
- Radioembolization
- Systemic anti-cancer therapy
- Radiotherapy
Radiofrequency ablation
Primary liver cancer can also be treated with radiofrequency ablation. During radiofrequency ablation (RFA) a needle is placed in the tumor. Using an echo or CT scan, the exact location of the tumor is determined. The needle is then heated to about 80 degrees, which also warms the cancer cells. Against this temperature, cancer cells are not resistant and therefore they die away.
RFA is usually performed as a curative treatment for primary liver cancer. RFA can also be combined with radioembolization or chemoembolization. This is usually a palliative treatment.
Surgery
Depending on the location and extent of the cancer and the liver function, surgery may take place at times. The purpose of a surgery is to remove the tumor. In primary liver cancer, this in practice often means removing the part of the liver where the tumor is located. This is called partial hepatectomy. A surgery of primary liver cancer is often a curative treatment.
A large part of the liver can be removed during surgery because the liver has a large spare capacity. The liver also recovers very quickly and can perform well in a relatively short period of time.
A surgery at primary liver cancer is a major treatment. It is therefore important that the condition of the patient is good. After surgery, you are often admitted to the hospital for a few days.
During surgery, fluid can accumulate temporarily in the abdominal cavity. Therefore, the surgeon sometimes leaves one or more snakes in the surgical wound. These hoses drain the excess moisture.
Chemoembolization
A fairly new technique for treatment of primary liver cancer is embolization. This is a technique whereby blood supply to the cancer cells is terminated. Many small balls are often used, which contain anticancer drugs. This treatment is called transarterial chemoembolization (TACE). Through an artery in the groin, a thin snake is pushed into the liver until the artery that supplies the tumor of blood is reached. Then, the cell-curing drugs, cytostatics, are injected into the form of small spheres through the tube. As a consequence, the tumor does not get any oxygen and nutrients. The cytostatics also help to damage and ultimately kill the cancer cells. TACE is mainly used as palliative treatment.
Liver transplant
When liver cancer is detected early in a person with a malignant liver, it is sometimes useful to perform liver transplantation. After extensive research, the patient who is undergoing liver transplant is placed on a waiting list. Liver transplantation is basically a curative treatment for primary liver cancer.
Radioembolization
As with chemoembolization, the blood supply to the cancer cells is terminated by radioembolization. In radioembolization, a radioactive substance is injected instead of cell-curing drugs. This treatment is also called Selective Internal Radiation Therapy, SIRT.
These radioactively charged particles enter the blood vessels into the liver and emit radioactive radiation. This irradiates the tumor closely and allows the tumor to be reduced. Radioembolization is performed mainly in larger tumors and is usually used as palliative treatment.
Systemic therapy
Systemic therapies are drugs that spread throughout the body to reduce the growth of cancer cells or kill the cancer cells. Systemic therapy is a collective name for chemotherapy, hormonal therapy, and immunotherapy.
Sorafenib is a form of systemic therapy and is currently the only anti-cancer drug proven to be effective in treating advanced liver cancer. Sorafenib is a small molecule that blocks the action of a number of proteins. These proteins give important signals to cells that make the cells grow or create new blood vessels. Thus, when the action of these proteins is blocked, the tumor does not grow further. Sorafenib is used as a palliative treatment for primary liver cancer.
Radiotherapy
During radiotherapy, the tumor is radiantly radiated from the outside. Cancer cells may be worse off the radiation than healthy cells. Because of the radioactive radiation, the tumor cells thus become damaged and die. By radiotherapy, tumor growth is reduced and there is a possibility that the tumor also becomes smaller. Radiotherapy is performed as palliative treatment of primary liver cancer.
The radiation is directed to the tumor or metastases as much as possible. However, healthy cells cannot be irradiated. This will cause side effects. In general, radiotherapy often causes fatigue. In addition, the irradiated skin may become red. This is often associated with itching and burning sensation. In the area of the stomach irradiation, patients often get nausea. Your radiotherapist can prescribe medication for this. Additionally, you may suffer from your intestines.
*Image source : Health.mil
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