A liver cancer diagnosis can be scary, and patients may sometimes feel as if they are being bombarded with so much information that it's hard to stay focused on selecting a treatment plan. With treatments for liver cancer varying by stage and patient profile, it helps to be informed before meeting with surgeons, oncologists and other care providers to plan a successful outcome.
Surgery is an often-used treatment for liver cancer and can range from removal of the tumor to partial removal of the liver — hepatectomy — or the transplantation of a new liver. Depending on the stage of cancer, surgery offers varying rates of success. When used to remove smaller tumors that have not spread to surrounding tissues and organs, surgery is often successful and the only treatment needed.
Transplantation may be indicated when there is significant damage to the liver. Once a suitable donor is found, the cancer-damaged liver is removed, and a donated whole or partial liver is transplanted. While transplants can offer successful treatment, finding a donor can be difficult, and transplant lists can be long, giving the cancer time to worsen and metastasize and lowering the chances for a successful outcome.
Radiation is used to destroy cancer cells in and on the liver and utilizes high energy rays — typically X-rays. The radiation can be applied either externally or internally through injection or alongside surgery, depending on the stage of cancer and location being treated. Treatments are usually done on a schedule via outpatient services.
While effective, radiation is not without side effects. The most common effects of radiation include nausea, fatigue and skin changes. Care must be taken with the use of radiation, as the rays can easily destroy healthy liver tissue along with the disease.
Chemotherapy and Chemoembolization
Chemotherapy drugs stop cancer cells from being able to grow. When delivered systemically — by pill or IV — chemotherapy is effective in the treatment of liver cancer that has spread to other organs, but many drugs have been shown to have little positive effect on liver cancer cells. Chemotherapy is usually given on an outpatient schedule.
Regional chemotherapy requires the surgical placement of a pump in the patient's body to deliver the drug directly to the vessels that feed the tumor, while chemoembolization is the injection of the cancer-killing drugs directly into the hepatic artery, after which the flow of blood to the artery is blocked in the hopes the cancer is destroyed.
The side effects of chemotherapy can vary greatly depending on the patient, as well as the dose and type of medication given. The most common side effects are hair loss, nausea, fatigue and loss of appetite.
Often, doctors decide to use more than one of these treatments to create an effective plan for a cure. Surgery may be combined with radiation, chemotherapy or both, and treatments such as immunotherapy — the boosting of the immune system to help fight the cancer — may also be added. Don't be afraid to ask questions and share concerns.