Liver Cancer: Treatment Choices
Several types of treatment can be used for liver cancer. Which may work best for you? It depends on a number of factors. These include the type, size, location, and stage of your cancer. Other important factors include your age and overall health, how well the rest of your liver is working, and what side effects you’ll find acceptable.
Learning about your treatment options
You may have questions and concerns about your treatment options. You may also want to know how you’ll feel and function after treatment, and if you’ll have to change your normal activities.
Your healthcare provider is the best person to answer your questions. He or she can tell you what your treatment choices are, how successful they’re expected to be, and what the risks and side effects are. Your healthcare provider may recommend a certain treatment. Or he or she may offer more than one, and ask you to decide which one you’d like to use. It can be hard to make this decision. It’s important to take the time you need to make the best decision.
Deciding on the best plan may take some time. Talk with your healthcare provider about how much time you can take to explore your options. You may want to get another opinion before deciding on your treatment plan. In fact, some insurance companies may require a second opinion. You may want to involve your family and friends in this process.
Understanding the goals of treatment for liver cancer
For some liver cancers, the goal of treatment is to cure the cancer. If a cure isn’t possible, treatment may be used to shrink the cancer or keep it under control. Treatment can also improve your quality of life by helping to control the symptoms of the disease. The goals of liver cancer treatment can include one or more of these things:
Remove the cancer in the liver (or the entire liver)
Kill or stop the growth or spread of liver cancer cells
Prevent or delay the cancer's return
Ease symptoms from the cancer, such as pain
Types of treatment for liver cancer
Several types of treatment can be used for liver cancer. Your treatment depends on the stage (extent) of the cancer and other factors. Each treatment has its own goals. Here is an overview of each type of treatment.
Surgery offers the best chance to cure liver cancer. Unfortunately, only a small percentage of people can have surgery. If the cancer is small and in only one part of the liver (and the rest of the liver is healthy enough), the part of the liver with the cancer can be removed. This surgery is called a hepatectomy. Another option might be to remove the entire liver and replace it with a liver transplant.
Tumor ablation and embolization
These techniques can be used to treat some tumors in the liver. Ablation involves using heat (such as in radiofrequency ablation or RFA), cold (cryoablation), or other methods to destroy tumors rather than removing them. For embolization, a substance is injected into a blood vessel. Its goal is to cut off a tumor's blood supply. Sometimes this is combined with radiation (radioembolization) or chemotherapy (chemoembolization).
Radiation uses high-energy X-rays to kill cancer cells. It’s used mainly when surgery or other treatments aren't good options.
This type of treatment uses medicines that target proteins or cell functions that help cancer cells grow. It’s used mainly for advanced liver cancers that can't be treated with other methods.
The goal of chemotherapy is to stop cancer from growing or spreading. It does this by using medicines to kill the cells or stop them from dividing. Chemotherapy can be used to treat advanced liver cancer. In most cases it isn’t as helpful as targeted therapy.
Your healthcare provider may suggest treatments that help ease your symptoms, but don’t treat the cancer. These can sometimes be used along with other treatments. Or your healthcare provider may suggest supportive care if he or she believes that available treatments are more likely to do you more harm than good.
Researchers are also studying other treatments that could help the body's immune system fight the cancer. These are called immunotherapy techniques.
Clinical trials for new treatments
Researchers are always looking for new ways to treat liver cancer. These new methods are tested in clinical trials. Talk with your healthcare provider to find out if there are any clinical trials you should consider.
Talking with your healthcare provider
At first, thinking about treatment options may seem overwhelming. Talk with your healthcare team and loved ones. Make a list of questions. Consider the benefits and side effects of each option. Talk about your concerns with your healthcare provider before making a decision.
March 21, 2017
Overview Of Treatment Approaches For Hepatocellular Carcinoma. UpToDate.
Alteri, Rick, MD,LoCicero, Richard, MD