Liver Cancer Treatments

Liver cancer is a particularly deadly form of cancer affecting more than 20,000 Americans each year, according to the National Cancer Institute. Because liver cancer is rarely detected in the early stages, the disease can be difficult to treat. A number of treatment options exist, and research into the disease is ongoing.

Identification

• Liver cancer occurs when liver cells begin to grow abnormally and eventually lump together to form a tumor. Primary liver cancer, or hepatoma, occurs when the cancer starts in the liver, while secondary liver cancer results from cancer cells that have spread to the liver from another area of the body. Cancers that spread to the liver include breast, colon and lung forms. If cancer originates in another area, such as in the breast, it is known as metastatic breast cancer, rather than liver cancer.

Symptoms and Risk Factors

• Symptoms of liver cancer include fatigue, weakness, weight loss, abdominal swelling, jaundice, loss of appetite, an enlarged liver, nausea and vomiting. You may feel pain in the upper right section of the abdomen, and that pain may also be felt in your shoulder or back.
  You are more likely to develop liver cancer if you are male, older than 60, drink alcohol excessively, smoke, have bile duct disease or have been exposed to foods contaminated by alfatoxins, such as soybeans, corn and peanuts. People who have diabetes, hepatitis B, hepatitis C or cirrhosis of the liver are also more likely to develop liver cancer.

Diagnosis

• If your tumor is large enough, your doctor may be able to feel it when she examines you. If she suspects that you may have liver cancer, she will order one or more tests, including an ultrasound, computerized tomography (CAT) scan or magnetic resonance imaging (MRI). These tests will help pinpoint the location and size of the tumor. If a tumor is found, you will undergo a biopsy, a process used to remove a small sample from the suspected tumor for laboratory testing. In some cases, a blood test may be ordered to check for alpha-fetoprotein, but as not all tumors produce this protein, the test may be of limited value.

Transplantation and Surgery

• A liver transplant sounds like the ideal treatment to eradicate liver cancer, but only a small percentage of patients qualify for transplantation. Liver transplantation is used for people who have small tumors caught in the early stage of the disease. It can also be helpful for people who have bile duct tumors. When tumors are large or if there is blood vessel involvement, a transplant will not be recommended because cancer is likely to recur outside the transplanted liver. Surgical resection can be used to remove the part of the liver where the tumor is. This surgery can only be performed if the rest of the liver is healthy or has only early-stage cirrhosis.

Cryotherapy and Alcohol Injection

• Also called cryoablation or cryosurgery, this treatment method uses extreme cold to freeze and destroy cancer cells. A special probe is used to deposit liquid nitrogen on the tumor using an ultrasound image to determine the best placement. Cryotherapy may be used in conjunction with other therapies. Alcohol injections are used to dry out cancerous cells, causing eventual death of the cells. Injections may be made through the abdomen or may be done during surgery. In addition to killing cancer cells, the procedure may also be helpful in reducing symptoms associated with metastatic cancer.

Radiofrequency Ablation

• During ablation, a surgeon places thin needles into the tumor through incisions made in the abdomen. Ultrasonography or a CAT scan is used to ensure that the needles are placed correctly. When the needles are in the optimal position, they are heated with an electrical current that will destroy the cancerous cells.

Radiation and Chemotherapy

• During radiation therapy, high energy X-rays are aimed at the tumor in an effort to shrink it. Proton beam therapy is a relatively new treatment method used to deliver high amounts of radiation to a very small area. This procedure works best on small tumors. Chemotherapy uses medication to kill cancer cells. A special type of chemotherapy, called chemoemobolization, is used to inject chemotherapy compounds directly into the blood vessels in the liver in an attempt to shrink tumors and provide some relief from pain and other symptoms.