Liver Cancer Treatment

Liver cancer treatment is limited by several factors. Symptoms do not generally appear until the hepatoma is significantly advanced, so diagnosis often occurs too late to be of use. Cirrhosis is often present, making surgery and other aggressive treatment risky.

Only ten percent of people survive for three years after a hepatoma diagnosis. Five years after diagnosis, the number of survivors shrinks to four percent. For most people, hepatic cancer is fatal within months of diagnosis.

Traditionally, surgery and the possibility of a liver transplant have provided the best chance for survival. New treatments concentrate on lengthening life expectancy and improving palliative care.

Surgery and Liver Transplantation

If the tumor is small enough, surgical removal of the mass may be attempted with a procedure known as resection. If all visible evidence of the tumor is removed, chances of survival improve to approximately 25 percent. Often, however, removing the entire tumor is impossible. Cirrhosis also complicates surgery. While the liver is a highly resilient organ, when damaged by extensive cirrhosis it may not have enough healthy tissue left to function after surgery.

A liver transplant is possible, but transplantation does not play a large role in liver cancer treatment. Given the late diagnosis of most cases of hepatic cancer, the tumor has often metastasized or spread to other organs by the time treatment is considered. If this is the case, a liver transplant doesn’t help. The sad but inescapable fact is that the small number of liver donors limits this possibility as a viable treatment.

Chemotherapy and Radiation Therapy

Chemotherapy has limited effects on hepatomas. Treatment can extend life by a few months and, in some cases, shrink larger tumors enough for surgical removal. Radiation therapy offers brief relief of symptoms, but hepatomas resist traditional radiation therapy. Side effects of chemotherapy include anemia, nausea and hair loss.

In spite of the limited value of traditional chemo and radiation therapy, new approaches are offering some hope. Selective internal radiation therapy (SIRT) delivers a high radiation dose directly to the tumor without harming surrounding healthy tissue. The doctor uses a catheter to insert radioactive spheres that target only cancerous tissue. Clinical trials indicate SIRT can improve symptoms and prolong life.

Chemoembolization with the chemotherapy drug doxorubicin also shows some promise. The drug is delivered through a catheter, along with tiny particles. The particles block blood vessels leading into the tumor, temporarily “sealing in” the drug. Using chemoembolization, doxorubicin may remain in the tumor for a month or more.

Radiofrequency Ablation

Radiofrequency ablation is a new therapy that uses alternating electric current to kill cancerous cells. The electricity heats the cells until they dry up and die. An electrode is inserted into the tumor by catheter, allowing the tumor to be heated without harming healthy cells. Radiofrequency ablation may provide relief to people who don’t qualify for surgery.

Preventive Medicine: Pegasys, Interferon and Hepatitis C

A promising development in the field of liver cancer prevention is the antiviral drug Pegasys®, which is based on interferon, an antiviral substance naturally produced by the body. Synthetic interferon does not remain in the human body for long and older versions of the drug had to be injected twice daily. Pegasys (peginterferon alfa-2a), however, can keep interferon levels stable for up to a week.

Pegasys is used to treat chronic hepatitis C, which causes cirrhosis, a potential precursor to liver cancer. Recent studies indicate that hepatitis C sufferers treated with Pegasys are three times less likely to develop liver tumors.

Prevention

A number of preventive measures can minimize the chance of developing hepatic cancer. Vaccination against hepatitis B is important, especially if you’re already infected with hepatitis C. Alcohol abuse and the use of illegal intravenous drugs and used needles should be avoided. If you fall into one of the main risk groups, regular screenings for liver cancer may help detect tumors at an early stage.

Resources

American Cancer Society. (2001). Interferon may prevent liver cancer in people with hepatitis C.

American Cancer Society. (updated 2005). What is liver cancer?

Coomer, J. (2002, November). New radiation therapy offers promising results at VUMC. The Reporter (Vanderbilt Medical Center).

Frey, R. J. (2005). Liver cancer. Gale Encyclopedia of Medicine.

Griffin Hospital. (nd). What is radiofrequency ablation?

National Cancer Institute. (2002). Chemoembolization may help some patients with inoperable liver cancer.

National Library of Medicine. (updated 2004). Hepatocellular carcinoma. MedlinePlus Medical Encyclopedia.

Society of Interventional Radiology. (nd). Treatments.