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LIVER CANCER TREATMENT OPTIONS
Liver Cancer treatment varies from patient to patient. The treatment approach is adjusted to the
patient’s needs and takes in consideration the following factors:
(1) the tumor size and location,
(2) the cancer stage
(3) the general health state of the patient and
(4) the patient’s age.
The treatment options for liver cancer are:
SURGERY
Surgery, as a treatment option for liver cancer, is available only for those patients whose tumors are
no larger than 5 cm, are confined to the liver, and the cancer has not invaded the adjacent blood vessels, organs or lymph nodes.
There are four types of surgery performed in liver cancer patients:
Partial Hepatectomy is a type of surgery where only part of the liver, where the tumor is located,is removed.
There are three types of partial hepatectomy:
(1) wedge resection, where a triangle-shape slice of tissue is removed
(2) lobe resection, where only the liver lobe is removed and
(3) partial resection, where a large portion of the liver is removed.
Total Hepatectomy is a complex surgery where the entire liver is removed. This procedure is
followed by a liver transplant because the body cannot live without the liver.
Cryosurgery is a type of surgery that kills cancerous cells by freezing them. This procedure uses the advantages provided by the freezing temperature on the cells. The cells, when exposed to low
temperatures, form ice crystals inside that tear apart the cell’s body. The most common substance
used as a cooling agent is liquid nitrogen.
The nitrogen can be administrated by:
(1) by spraying it on the tissue
(2) through a tube (cryoprobe) inserted into the tissue or
(3) swabbed directly on the tissue.
Cryosurgery is a minimally invasive procedure that substantially reduces the patient recovery by minimizing the pain and scars. However, there are several risks involved when this procedure is performed such as the damage of nearby healthy tissue and nerves’ tissue.
Radiofrequency Ablation (or RFA)
- Radiofrequency Ablation (RFA) is another minimally invasive, highly successful procedure
that removes the liver tumors. Radiofrequency ablation uses radiofrequency current to kill
cancerous cells by “cooking“ them. This procedure involves several electrodes, which are placed
into the tumor either through the skin, or through small incisions in the abdomen, and send out
radiofrequency current that ablates or removes the tumor. This procedure is performed with the help
of a CT scan or ultrasound guidance.
Radiation Therapy or Radiotherapy
- Radiation Therapy or Radiotherapy is another treatment approach in the battle against liver
cancer. It uses high-energy rays or particles to destroy cancerous cells. Liver cancer patient can
receive radiation therapy through several forms.
- External Radiation Therapy uses an external device (linear accelerator) to generate high- energy
rays that focuses on the liver tumor.
- Internal Radiation Therapy uses radioactive substances sealed in seeds, wires, needles, or
catheters that are placed in the tumor tissue.
- Radiolabeled Antibodies uses radioactive substances attached to artificially made antibodies
to kill cancerous cells. Normally, the body produces different types of antibodies to fight against
infections and germs. Each type of antibody fight against a certain cells. The artificial antibodies
are designed to kill the liver cancerous cells by radiating them.
The radiation therapy side effects include:
- Feeling tired as the treatment continues.
- Skin irritation (the skin becomes red, dry, or tender in the area where the body is irradiated).
- Loss of appetite.
- Vulnerability to infection.
CHEMOTHERAPY
Chemotherapy is a systemic treatment (affects cells throughout the entire body) that uses drugs either to stop the abnormal growth and dividing process of the cancerous cells, or to kill them. This type of treatment involves either a single drug, or a combination of several drugs and it is usually administrated in cycles where a treatment period is followed by a recovery period.
The liver cancer patient can receive chemotherapy in differently forms:-
(1) as pills
(2) intravenous, as an injection into the vein or through a catheter (a thin, flexible tube) placed in the
vein when the patient needs many IV treatments, or
(3) placed directly into the tumor, treatment called regional chemotherapy (small pumps send the
drugs through the blood vessels straight in the tumor). The advantage of a regional chemotherapy
is that it reduces the harmful effects of the chemotherapy on the healthy body cells.
There are several types of regional chemotherapy:
- Hepatic Artery Chemoembolization. This treatment uses an anticancer drug that once injected
into the hepatic artery blocks the blood flow that goes to the liver. This blockage can be temporary
or permanent (depending on the drug used), and allows the drug to kill the cancerous cells while
the tumor stops receiving the blood supply rich in oxygen and nutrients. However, this approach
does not harm the rest of the liver, which continues to receive blood from the portal vein.
The most common side effects of hepatic artery chemoembilization are: nausea, vomiting, fever,
abdominal pains, tiredness, infections or problems with the pump devices (used to administrate the
treatment).
- Hepatic Arterial Infusion is a treatment option where chemotherapeutic agents are infused in the
hepatic artery. The drugs are periodically administrated through a catheter inserted into the artery.
In this way, the treatment is directed straight into the liver.
- Isolated Liver Perfusion is an experimental technique used only in clinical trials. The purpose of
this treatment is to expose the liver to a high dose of chemotherapeutic agents while the liver blood
supply is temporary stopped. This treatment is possible only after a complex surgery where
catheters are inserted into the hepatic artery, portal vein, and hepatic veins.
Chemotherapy’s side effects include:
- Increased vulnerability to infections.
- Easy brushing and bleeding.
- Lack of energy.
- Temporary hair loss.
- Mouth sores.
- Nausea and vomiting.
- Loss of appetite.
Percutaneous Ethanol Injection
- Percutaneous Erhanol Injection is an innovative, low morbidity procedure where the cancer is
killed with ethanol (alcohol). This substance is administrated into the tumor through a needle. The
alcohol destroys the tumor by dehydrating the cancerous cell and altering the cellular protein
structure. The most common side effects of this treatment are fever and pain caused by the alcohol
leakage on the surface of the liver and into the abdominal cavity.
Portal Vein Embolization
- Portal Vein Embolization is a treatment approach where the portal vein blood supply is blocked.
This treatment has two benefits:
(1) substantially reduces one part of the liver (where usually the tumor is located) and
(2) causes the remaining liver to grow. Portal vein embolization is a pre-operatory step for those
patients that need surgery but the tumor either is to big to be removed, or the tissue that requires
to be removed is to big while the healthy liver tissue left behind is to small.
Interstitial Laser Photocoagulation and Microwave
- are two additional treatment approaches that directly injure or kill the tumor cells. These two
treatments do not work as well as other types of cancer treatment in killing big tumors. Interstitial
laser photocoagulation uses a thin optical fiber (which is inserted in the center of the tumor) and a
laser device. When the laser light is emitted, the cancerous cells undergo a thermal necrosis.
Interstitial macrowave is a thermal type therapy which kills the tumor by heating them to a high
temperature (50 degrees C) for an extended period of time.
Biologic Therapy
- also called immunotherapy is a type of treatment used to improve the body’s natural defenses.
This treatment uses the body’s immune system either to fight against cancer, or to decrease the
side effects caused by the cancer treatment. Biologic therapy uses substances produced in
laboratory that copy those naturally produced by the body to boost, direct, or restore the natural
defenses of the body.
Liver Transplant
- Liver Transplant is a solution for those patients that suffer from hepatocellular carcinoma in
advanced stages,when other treatment option do not work. This surgical procedure involves two
steps. The healthier liver is removed from a donor (a person that is brain dead) and then implanted
into a patient whose own liver does not function normally.
The main side effects of a liver transplant include:
- High risk for infections.
- Bleeding (caused by the new liver's inability to produce enough blood clothing proteins).
- Clotting in the main blood vessels that provides the liver with blood.
- Rejection (the new liver is not accepted by the body).
Liver disease is a deadly SILENT KILLER. The best way to prevent liver disease is by taking early preventive measures while early detection is best way to treat it. Please consult your doctor for best advice and opinions.
Disclaimer: The information provided is for educational and communication purpose only, for use in the maintenance and promotion of good health and should not be construed as personal medical advice or presented with the intention of diagnosing any disease or condition or prescribing any treatment. Bio Healthcare Enterprise shall hold No responsibility or liability on any untoward effects or incidents which may arise as a result of any misinterpretation of this information. | 
