Liver Cancer Treatment
Treatment for liver cancer, which is the unregulated growth of cells originating in the liver that can continue to spread throughout the liver and to other areas, varies by patient. Treatment options are dependent on the stage of the disease and the patient’s age, overall health and his or her personal preferences.
Liver cancer treatment options, which are described in detail below, include:
- Radiation therapy.
- Targeted drug therapy.
Sometimes alternative medicine can be used to help liver cancer patients better cope with the disease. Acupuncture, deep breathing exercise, listening to music and massage therapy are elements of alternative medicine that can help control pain for people with advanced liver cancer.
CyberKnife is a specialized alternative to surgery and traditional radiation therapy. The CyberKnife® Robotic Radiosurgery System is the most advanced system for the delivery of radiosurgery, a form of therapy that precisely targets and kills cancerous cells or tumors while greatly reducing the damage done to healthy cells.
Treatment is noninvasive, requires fewer sessions, is comfortable for the patient and is often more effective than traditional treatments. Research supports the use of CyberKnife for liver cancer.
CyberKnife is often the best or only option for patients with hard to reach or inoperable tumors. It is also an excellent option for those who would otherwise have unacceptable side effects or complications when treated by other methods. CyberKnife is also a good option for patients who have tried other treatment(s) that have failed.
Radiation therapy treatments use high-powered energy beams to destroy cancer cells and shrink tumors. Microscopic radioactive spheres can also be injected into the liver to treat tumors. This treatment method is often used when the tumor cannot be removed with surgery and the tumors are too big for ablation.
Stereotactic body radiotherapy (SBRT)
Stereotactic body radiotherapy (SBRT) is also known as stereotactic radiosurgery (SRS) or stereotactic ablative radiotherapy (SABR). SBRT uses focused radiation beams that target the cancer. CyberKnife is a form of SBRT.
External beam radiation therapy (EBRT)
A linear accelerator (a specialized X-ray machine) uses high-energy beams that are directed at the liver tumor.
Intensity-modulated radiation therapy (IMRT)
IMRT is a form of EBRT, in which hundreds of tiny high-energy beams are directed at the tumor site from multiple angles. This treatment can be delivered through CyberKnife.
Targeted drug therapy
This form of liver cancer treatment uses drugs to target the genes and proteins that allow the tumor to grow and survive. These medications interfere with a tumor’s ability to create new blood vessels, slowing the cancer’s growth and killing cancer cells. Targeted drug therapy may be used in conjunction with other treatment methods.
Chemotherapy also uses drugs that affect fast-dividing cells, which include cancerous cells but also healthy cells that are dividing fast. Targeted drug therapy is more specific in the types of cells it attacks, resulting in better destruction of cancer cells with less risk of harming healthy cells. Types of targeted drugs used to treat liver cancer include:
- Sorafenib (brand name Nexavar).
- Lenvatinib (Lenvima).
- Regorafenib (Stivarga).
- Cabozantinib (Cabometyx).
Ablation is a liver cancer treatment that destroys tumors without removing them. These treatments are sometimes used for multiple small tumors that cannot be removed with surgery. Ablation treatments can also be used when a patient is waiting for a transplant. There are a few different ablation methods.
Radiofrequency ablation uses an electric current to heat and destroy cancer cells. A CT scan or ultrasound helps guide the surgeon while inserting thin needles into the tumor, which are then heated by the current.
Cryoablation uses extreme cold to destroy cancer cells. A cryoprobe instrument containing liquid nitrogen is placed directly on the tumor(s).
Ethanol ablation, also known as percutaneous ethanol injection (PEI), injects pure alcohol directly into tumors through the skin or during an operation. This causes the tumorous cells to die.
Embolization is a treatment method that blocks the tumor’s blood supply. The medications are injected directly into the cancer site.
Also known as transarterial embolization (TAE) or “bland” hepatic artery embolization, this treatment uses a catheter to reach the liver via the hepatic artery. Small particles are injected into the artery to limit blood flow to the tumor.
Chemoembolization, also known as transarterial chemoembolization (TACE) or intra-arterial chemotherapy, is a form of chemotherapy that can be used to treat liver cancer. There are two methods of delivering the chemo with this treatment. Small beads that deliver chemo drugs are placed by the tumor in one method. The second TACE method uses a catheter to deliver chemo through the artery, then the artery is plugged up, keeping the medication where it is needed.
This treatment method is a combination of radiation therapy and embolization. Small radioactive glass or resin beads are injected into the hepatic artery and become lodged in the blood vessels near the tumor giving off small amounts of radiation.
Liver cancer surgery
The two types of surgery for liver cancer are partial removal and complete removal with a liver transplant. A partial hepatectomy is a surgical procedure that can remove the cancerous part of the liver. This treatment option is for patients who have a single liver tumor and good liver function. Prior to surgery, patients will undergo tests to make sure their liver is healthy enough for the procedure. Patients who have developed cirrhosis of the liver, or chronic liver damage, are not candidates for a partial hepatectomy, as the cirrhosis prevents the liver from regenerating.
During a liver transplant the diseased liver is removed and replaced with a healthy donor liver. This treatment is only an option for a small percentage of patients with early-stage liver cancer. Transplant surgery is sometimes preceded by radiation therapy.
Liver cancer treatment side effects & risks
Most cancer treatments can have side effects. Depending on the type of treatment, the stage of the cancer and personal factors that vary with each patient, they can include:
- Allergic reaction to medications.
- Infections from invasive procedures.
- Fatigue and nausea from chemo and radiation therapy.
- Complications from surgery and accompanying anesthesia.
- Rejection of transplanted liver.
- Recurrence of liver cancer.
- Side effects resulting from damage of the healthy liver tissue by the treatment.