During liver cancer treatment, different healthcare professionals work together to come up with an overall treatment plan. The treatment plan combines different types of cancer treatment to get a successful cure. This group of doctors is called a "multidisciplinary team", which include:
- Medical Oncologist: a doctor who specializes in chemotherapy treatment for cancer
- Surgeon: a doctor who performs surgery as treatment for cancer
- Radiation Oncologist: a specialist who uses radiation therapy to treat cancer
- Gastroenterologist: a doctor who treats gastrointestinal tract diseases including liver diseases
Aside from doctors, nurses and nutrition specialists are also part of the team. In developing a treatment plan for your liver cancer, your doctors are likely to consider some factors before recommending any medications. These factors include:
- Whether your cancer has spread or not
- The severity of liver damage caused by the tumor or cancer
- The current damage to the liver's cancer-free area
- The patient's overall health medication preferences
- Treatment side effects
- The possibility of the medications curing liver cancer
Based on the above-mentioned factors, the treatment options for your liver cancer include:
Liver cancer surgery involves the removal of the tumor and the neighboring healthy tissues. Surgery is believed to be the best and most successful treatment option for liver cancer, especially for those patients having smaller tumors that are not larger than 5 cm. In case your liver cancer has spread beyond the liver, surgery cannot be the best treatment option. A surgical oncologist is a doctor who specializes in liver cancer treatment using surgery. The two types of surgery used to treat your liver cancer are:
Hepatectomy is a procedure that involves the removal of a certain portion of your liver bearing cancerous cells. Your surgical oncologist can only perform hepatectomy if the cancer is found in one part only, and the liver is working well. In the case of a hepatectomy surgery, the remaining part of the liver takes the overall function of the entire liver. After surgery, your liver will grow to its normal size within a period of four to six weeks. Hepatectomy surgery cannot also be performed if you have an advanced cirrhosis even if the size of the tumor is small.
This type of liver surgery is one of the most dangerous operations and should only be done by skilled or experienced surgeons. The reason is that people with liver cancer may have other liver problems. Thus, a surgeon must make sure to remove all cancerous cells in the liver and also leave behind enough liver for the body to function well. This type of surgery is also accompanied by much of bleeding since a lot of blood passes through the liver. The liver is also an organ that synthesizes some blood clotting factors, which means that damage to it can lead to a potential bleeding. Other problems associated with hepatectomy include pneumonia, infections, blood clots, and anesthesia complications.
2. Liver Transplant
In some cases, a liver transplantation is more preferred than hepatectomy. A liver transplant is only possible if your liver cancer has not spread to other body organs and there is a suitable liver donor. In general, it is used to treat individuals with small tumors not larger than 3 cm and should not have invaded the neighboring blood vessels. Liver transplantation is also not suitable for patients with a resectable liver cancer.
After a liver transplantation, the patient should be observed closely to see if there are any signs of rejection of the new liver. If there are any signs of rejection, immunosuppressive drugs are used to prevent further rejection.
Just like in hepatectomy, liver transplantation is accompanied by anesthesia complications, blood clots, bleeding, and infections. There are also some additional side effects due to the immunity of suppressive drugs, which are used to avoid the new liver rejection. These side effects include serious infections due to lowered immunity, high blood pressure, diabetes, increased hair growth, and weak bones.
Tumor ablation is a procedure that is aimed to destroy tumor cells without removing them. This process is best for patients with small-sized tumors and when surgery is not the best option. Although ablation cannot cure your cancer completely, it can be helpful for some people waiting for a liver transplant. This procedure is mostly used to treat tumors not larger than 5 cm across. Since this treatment destroys even normal untargeted cells, it is not suitable for treatment near major blood vessels.
Ablation is a procedure that is achieved by inserting a probe or a needle into your liver tumor through the skin. The probe or needle is guided into the targeted area by the use of a CT scan or ultrasound. This procedure does not require any surgery. There are different types of ablation. They are:
- Alcohol Ablation - uses concentrated alcohol to kill cancerous cells.
- Radiofrequency Ablation - uses high-energy radio waves to kill cancer cells.
- Cryotherapy - utilizes a freezing thin metal probe to kill cancerous cells.
Embolization is a treatment procedure that involves the injection of substances into your liver to prevent blood flow to the cancer cells. Since the cancerous cells are always nourished by blood from the hepatic artery, blocking any branches of the hepatic artery that feeds the tumor can help kill the cancer cells. This procedure leaves other normal cells unharmed since they are supplied with blood from the portal vein. This treatment option is suitable for very large tumors that cannot be treated with ablation or removed by surgery.
Radiotherapy is a treatment option for liver cancer that uses high-energy X-rays or other radioactive particles to destroy the cancer cells. The types of radiation therapies used to specifically treat liver cancer are:
- Stereotactic body radiation therapy (SBRT) - is a procedure that ensures that the correct dose is administered to the cancer cells and limiting the radiation on the healthy cells.
- Radioembolization - is a procedure similar to embolization, which involves an injection of a radioactive beam into the artery that supplies the tumor with blood.
After a continuous research about the changes in cancer cells, scientists have come up with newer drugs that target the changes. Targeted drugs work completely different from chemotherapy drugs. These drugs enter the bloodstream and circulate in all body parts making them potentially important and useful to treat all types of cancers. Since standard chemotherapy drugs have not been effective in some patients, doctors have preferred looking for targeted therapies.
Chemotherapy is a treatment process for liver cancer where drugs are used to kill or destroy the cancer cells. For a systemic or whole body chemotherapy, anti-cancer drugs are injected into the veins. The drugs can also be administered orally. After administration, the drugs reach all parts of your body and are useful in the treatment of cancer that has spread to different body organs. Although liver cancer has resisted most drugs, here are some chemotherapy drugs that have successfully treated liver cancer:
These drugs have been found to shrink a small portion of your liver tumor, but the response is only short-lived.
The Bottom Line
Once you are diagnosed with liver cancer, there are many treatment options you can have. They range from surgery, ablation, embolization, radiotherapy, and chemotherapy. The treatment options discussed in this article are suitable for different stages of your liver cancer. It is, therefore, important to discuss with your doctor after diagnosis to know which treatment is better for you.