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Treatments and drugs
By Mayo Clinic staffTreatments for primary liver cancer depend on the extent (stage) of the disease as well as your age, overall health and personal preferences.
The goal of any treatment is to eliminate the cancer completely. When that isn't possible, the focus may be on preventing the tumor from growing or spreading. In some cases only comfort care is appropriate. In this situation, the goal of treatment is not to remove or slow the disease but to help relieve symptoms, making you as comfortable as possible.
Liver cancer treatment options may include:
- Surgery to remove a portion of the liver. Your doctor may recommend partial hepatectomy to remove the liver cancer and a small portion of healthy tissue that surrounds it if your tumor is small and your liver function is good.
- Liver transplant surgery. During liver transplant surgery, your diseased liver is removed and replaced with a healthy liver from a donor. Liver transplant surgery may be an option for certain people with early-stage liver cancer.
- Freezing cancer cells. Cryoablation uses extreme cold to destroy cancer cells. During the procedure, your doctor places an instrument (cryoprobe) containing liquid nitrogen directly onto liver tumors. Ultrasound images are used to guide the cryoprobe and monitor the freezing of the cells.
- Heating cancer cells. In a procedure called radiofrequency ablation, electric current is used to heat and destroy cancer cells. Using an ultrasound or CT scan as a guide, your surgeon inserts one or more thin needles into small incisions in your abdomen. When the needles reach the tumor, they're heated with an electric current, destroying the cancer cells.
- Injecting alcohol into the tumor. During alcohol injection, pure alcohol is injected directly into tumors, either through the skin or during an operation. Alcohol causes the tumor cells to die.
- Injecting chemotherapy drugs into the liver. Chemoembolization is a type of chemotherapy treatment that supplies strong anti-cancer drugs directly to the liver. During the procedure, chemotherapy drugs are injected into the hepatic artery — the artery from which liver cancers derive their blood supply — and then the artery is blocked. This serves to cut blood flow to the cancer cells and to deliver chemotherapy drugs to the cancer cells.
- Radiation therapy. This treatment uses high-powered energy beams to destroy cancer cells and shrink tumors. During radiation therapy treatment, you lie on a table and a machine directs the energy beams at a precise point on your body. Radiation therapy for liver cancer may involve a technique called stereotactic radiosurgery that simultaneously focuses many beams of radiation at one point in the body. Radiation side effects may include fatigue, nausea and vomiting.
- Targeted drug therapy. Sorafenib (Nexavar) is a targeted drug designed to interfere with a tumor's ability to generate new blood vessels. Sorafenib has been shown to slow or stop advanced hepatocellular carcinoma from progressing for a few months longer than with no treatment. More studies are needed to understand how this and other targeted therapies may be used to control advanced liver cancer.
References
- Management of hepatocellular carcinoma: An update. Alexandria, Va.: American Association for the Study of Liver Diseases. http://www.aasld.org/practiceguidelines/Documents/Bookmarked%20Practice%20Guidelines/HCCUpdate2010.pdf. Accessed May 20, 2011.
- What you need to know about liver cancer. National Cancer Institute. http://www.cancer.gov/cancertopics/wyntk/liver/allpages/print. Accessed May 20, 2011.
- Weber S, et al. Liver and bile duct cancer. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2008:1569.
- Hepatobiliary cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed May 20, 2011.
- Hepatitis B FAQs for the public. Centers for Disease Control and Prevention. http://www.cdc.gov/hepatitis/B/bFAQ.htm. Accessed May 20, 2011.
- Hepatitis C FAQs for the public. Centers for Disease Control and Prevention. http://www.cdc.gov/hepatitis/C/cFAQ.htm. Accessed May 20, 2011.
- Moynihan TJ (expert opinion). Mayo Clinic, Rochester, Minn. June 7, 2011.
- Cirrhosis. National Institute for Diabetes, Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis/. Accessed June 8, 2011.
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