Unlike some other cancers, liver cancer can seldom be successfully treated with traditional chemotherapy or radiation—although these treatments may be used to shrink tumors prior to surgery.
Your physician will determine the appropriate course of treatment based on several factors, including the number and size of the tumors, how well your liver is functioning, whether the cancer has spread to other areas, and your overall health.
For early-stage cancers that have not spread, your physician may recommend a partial hepatectomy, in which the cancerous portion of the liver is removed. As much as 80 percent of the liver can safely be removed; the remaining healthy tissue can take over the liver’s functions and generate new cells. Many patients are not eligible for surgical treatment because of underlying liver disease. In patients with cirrhosis, removing part of the liver can cause liver failure. In these patients, often liver transplant is recommended to treat the cancer and cure the cirrhosis.
The surgery is performed under general anesthesia and may take about 3–4 hours. Afterwards, you’ll stay in the hospital for about 5 days so your physician can monitor you. Many patients feel tired or weak after surgery, so you’ll need plenty of rest while your body recovers.
If a partial hepatectomy is not an option, your physician may consider a liver transplant, in which a diseased liver is replaced with a healthy liver from a deceased donor or part of a liver from a living donor.
In order to be eligible for liver transplant, your cancer must be contained within the liver. If the cancer has already spread to other areas of the body, liver transplant will not cure the cancer, and in fact could make it worse due to the immune suppression medications that patients are required to take after liver transplant.
To learn more about liver transplants, please visit the Liver Transplant section of our website.
Intra-Arterial Liver Tumor Treatment
For some patients with primary liver cancer and various forms of metastatic liver cancer, one effective form of therapy is an approach called intra-arterial liver tumor treatment, also called locoregional therapy.
An intra-arterial liver tumor treatment involves a small puncture in a groin artery, through which a catheter is navigated into the liver to deliver either chemotherapy or radiation. These treatments are frequently the first line of therapy for primary and metastatic liver tumors and are commonly coupled with other forms of therapy, including partial hepatectomy or liver transplant.
Radiofrequency ablation is a procedure in which probes are placed into liver tumors and heat is used to destroy the tumor cells. Many times this can be performed percutaneously, without making any incisions. In some cases, the procedure can be done using a laparascope, without open surgery, although occasionally open surgery is required.
Radiofrequency ablation uses an electrical current delivered through a special probe that is directed into the tumor, guided by ultrasound or CT scan. The probe allows the electric current to pass into the tumor without affecting surrounding skin, muscle, and blood vessels. The current generates sufficient heat to kill the tumor cells, which will eventually be replaced by scar tissue.
Radiofrequency ablation can be an option for patients with primary liver cancers or cancer metastatic to the liver who are not candidates for surgery. Tumors up to 5 cm in diameter as well as multiple tumors can be treated effectively with this technique.
TheraSphere (Yttrium Therapy)
TheraSphere is a liver cancer treatment that uses small beads containing radioactive Yttrium-90. These tiny beads are injected into the main artery of the liver and directed through the blood vessels to the tumor, where the radiation destroys the tumor cells without affecting healthy liver tissue.
The Yttrium-90 in TheraSphere turns into Zirconium-90, which is harmless in the small amounts that remain in the body. This means that most of the radioactivity is gone within about 10–12 days following treatment.
Transcatheter Arterial Chemoembolization (TACE) with Drug Eluting Beads
TACE is a palliative treatment for hepatocellular carcinoma involving tiny beads that carry chemotherapy agents such as Doxorubicin or Irinotecan. The beads are guided by X-ray directly into the tumor, cutting off its blood supply and delivering an extended dose of cancer-killing drugs. Cutting off the tumors’ blood supply both postpones their growth and prevents the chemotherapy drugs from flowing to other areas of the body.
Sorafenib (brand name Nexavar®) is an oral chemotherapy drug used to treat inoperable hepatocellular carcinoma. Sorafenib is in a class of medications called multikinase inhibitors and works by slowing the spread of cancer cells.
At the Methodist Center for Liver Disease and Transplantation, our experts are on the leading edge of research to discover new treatments for patients with liver cancer. Our Center is frequently chosen as a site for clinical trials that allow us to offer some of the most advanced treatments available to eligible patients.
To find out more about the Methodist Center for Liver Disease and Transplantation, call us at 713-441-8839 or 866-94-LIVER (866-945-4837) or send us an email.