Liver Cancer
Liver Cancer Treatment
There are various treatment options available for Liver cancer, including standard treatments and those being tested in clinical trials.
Contents:
- Types of Treatment
- Treatment for Localized Liver Cancer
- Treatment for Locally Advanced or Metastatic Liver Cancer
- Treatment for Recurrent Liver Cancer
Types of Treatment
- Surveillance
- Surveillance is used for lesions smaller than 1 centimeter detected during screening, with follow-ups every 3 months. It involves closely monitoring a patient’s condition and only starting treatment if test results indicate worsening.
- Surgery
- Partial hepatectomy involves removing the cancerous part of the liver. This may include a wedge of tissue, an entire lobe, or a larger portion, along with some healthy surrounding tissue. The remaining liver tissue compensates and may regrow.
- Liver Transplant
- This is possible when the cancer is confined to the liver and a donor is available. While waiting for a donor, other treatments may be administered as needed.
- Ablation Therapy
- Ablation therapy removes or destroys tissue using different methods:
- Radiofrequency Ablation: Special needles heat the tumor with high-energy radio waves.
- Microwave Therapy: Microwaves create high temperatures to damage or kill cancer cells.
- Percutaneous Ethanol Injection: Ethanol is injected directly into the tumor to kill cancer cells.
- Cryoablation: An instrument freezes and destroys cancer cells.
- Electroporation Therapy: Electrical pulses kill cancer cells.
- Ablation therapy removes or destroys tissue using different methods:
- Embolization Therapy
- Used for patients unable to undergo surgery or ablation and whose tumor has not spread outside the liver. This therapy blocks blood flow
- Targeted Therapy
- Drugs or substances identify and attack specific cancer cells. Medications include bevacizumab, cabozantinib, lenvatinib, ramucirumab, regorafenib, and sorafenib.
- Immunotherapy
- Uses the immune system to fight cancer. Immune checkpoint inhibitors like atezolizumab (with bevacizumab or cabozantinib), durvalumab (with tremelimumab), nivolumab (with ipilimumab), and pembrolizumab may be used.
- Radiation Therapy
- External radiation therapy directs high-energy x-rays or radiation at the tumor. Techniques include:
- Conformal Radiation Therapy: Creates a 3D image of the tumor for precise targeting.
- Stereotactic Body Radiation Therapy: Aims high doses of radiation at the tumor from the same position each time.
- Proton Beam Radiation Therapy: Uses proton streams to minimize damage to healthy tissue.
- External radiation therapy directs high-energy x-rays or radiation at the tumor. Techniques include:
- Clinical Trials
Research studies aimed at improving treatments or discovering new ones. Trials can be found on NCI’s clinical trial search or ClinicalTrials.gov.
Stage 4 Liver Cancer:
Stage 4 liver cancer is an advanced cancer that has spread from the liver to other parts of the body. This stage is challenging to treat, so the focus is on managing symptoms and improving the patient’s quality of life. Treatments may include targeted therapy, immunotherapy, and chemotherapy. These treatments aim to slow the cancer’s growth and help patients feel better. While a cure is unlikely at this stage, these therapies can extend survival and provide relief from symptoms.
Treatment for Localized Liver Cancer
- Surveillance for lesions smaller than 1 centimeter
- Partial hepatectomy
- Liver transplant
- Tumor ablation using:
- Radiofrequency ablation
- Microwave therapy
- Percutaneous ethanol injection
- Cryoablation
- Radiation therapy
Treatment for Locally Advanced or Metastatic Liver Cancer
- Transarterial embolization (TAE) or transarterial chemoembolization (TACE)
- Targeted therapies (bevacizumab, cabozantinib, lenvatinib, ramucirumab, regorafenib, sorafenib)
- Immunotherapy (atezolizumab with bevacizumab or cabozantinib, durvalumab with tremelimumab, nivolumab with ipilimumab, pembrolizumab)
- Radiation therapy
Treatment for Recurrent Liver Cancer
- Total hepatectomy and liver transplant
- Partial hepatectomy
- Ablation therapy
- TACE and sorafenib for palliative care to relieve symptoms and improve quality of life
FAQ?
Risk factors include chronic hepatitis B or C infection, cirrhosis (from any cause), excessive alcohol consumption, non-alcoholic fatty liver disease (NAFLD), and exposure to aflatoxins.
Diagnosis involves imaging tests (such as ultrasound, CT scan, or MRI), blood tests (like alpha-fetoprotein), and sometimes a biopsy to confirm the type of cancer.
Treatments include surgery, liver transplantation, chemotherapy, targeted therapy, radiofrequency ablation, and palliative care depending on the stage and type of cancer.