There are several types of treatment for liver cancer. Liver cancer can be treated when it is found early, but the treatment is very specialized, so discuss the details thoroughly with your VA care team. Your team will recommend options based on the size and number of tumors and how well your liver is working.

Ablation

With this technique, surgeons or interventional radiologists place metal wires directly into a tumor and super-heat it, killing the cancer cells. This may be done through an operation in the abdomen where the liver can be examined directly, or it may be done through the skin.

This form of treatment can kill either small or medium-size liver tumors (often up to 5 centimeters in size). This treatment can cause stress to the liver, and sometimes patients are kept in the hospital for a day or longer for observation. This procedure is done under sedation.

Embolization or chemoembolization

With this technique, interventional radiologists pass special plastic tubes (called catheters) into the arteries of the liver, directly cutting off the blood supply to liver tumors. The catheters are usually passed up to the liver through one of the main arteries in the groin or wrist. This technique is excellent for killing several small tumors in the same area, or tumors that cannot be treated effectively by any other method. One advantage of this technique is that liver tumors get almost all their blood supply from arteries, but healthy areas of the liver get most of their blood from veins.

This treatment can involve simply cutting off blood from arteries (embolization) or putting chemotherapy medications directly into the arteries going to the tumors (chemoembolization). The technique is sometimes used immediately before a liver transplant, in an attempt to kill all the tumor cells so that they do not move into the new liver. This procedure is done under sedation.

Y90 (radioembolization: TARE or SIRT)

With this technique, interventional radiologists pass special plastic tubes (called catheters) into the arteries of the liver, directly seeding particles that deliver radiation into the tumor. The catheters are usually passed up to the liver through one of the main arteries in the groin or wrist. This technique is excellent for killing several small tumors in the same area, or tumors that cannot be treated effectively by any other method. As with embolization, liver tumors get almost all their blood supply from arteries, while healthy areas of the liver get most of their blood from veins.

The technique is sometimes used immediately before a liver transplant, in an attempt to kill all the tumor cells so that they do not move into the new liver. This procedure is done under sedation.

Surgical resection

Surgical resection involves surgeons cutting out the tumors from the liver directly. The procedure is performed with the patient unconscious in an operating room. This is a very effective treatment for liver cancer, but the surgery can be performed only if the patient's liver is functioning well enough to allow a portion of it to be removed. Surgical resection can be quite stressful to the liver because it is cut directly. Patients often remain in the hospital for monitoring for several days after receiving this treatment.

Systemic chemotherapy

Chemotherapy is treatment in which medications that are toxic to tumors are given to patients by intravenous infusion or in pill form. There are multiple medications, and some combinations of medications, that have become available for patients with liver cancer over the past few years.

External radiation therapy (SBRT)

External beams are used to target liver cancer for treatment. This is called SBRT, which is short for the external radiation used to treat liver cancer. This option can shrink the tumor and slow its growth. For the most part, treatment is given by a radiation oncologist, usually in 5 sessions every other day.

Before starting this treatment, tiny markers are injected into the liver near the cancer to make sure the correct area is being targeted. This is usually done under sedation and is confirmed by another CT scan to make sure the markers are placed correctly. The team also creates a mold that helps you remain still during the procedure. You would need to stay still in the mold for the duration of treatment, which is usually 45 to 60 minutes.

Liver transplant

A liver transplant is an effective treatment for liver cancer if the tumors are very small and are in only a few areas of the liver. Once cancer has spread to blood vessels within the liver or has moved outside the liver, it is too late to control the cancer with a transplant. The advantage of performing a transplant while liver cancer is still in an early stage is that replacing the entire liver lowers the risk of new tumors forming over time.

A transplant is a complicated form of treatment. A patient first needs to be a good candidate for a liver transplant, then be evaluated at a liver transplant center and placed on a waiting list, and finally be well enough to undergo a transplant when a donated liver becomes available. The section on Liver Transplant provides more details about being referred to a transplant center and placed on a waiting list. Patients with liver cancer who are good candidates are often given priority for a donated liver in the current U.S. national system after waiting 6 months to ensure local treatment has been effective.

How can liver cancer be avoided?

For patients with hepatitis C, successfully clearing the virus with treatment can reduce the risk of developing liver cancer and lower the chance of developing cirrhosis. For patients who already have cirrhosis, treatment can sometimes reduce the risk that liver cancer will develop.

For patients who have cirrhosis resulting from hepatitis C or alcohol use, the risk of further damage to the liver can be reduced by avoiding alcohol.

Patients with advanced cirrhosis can be evaluated for a liver transplant before liver cancer develops. Patients with hepatitis B and a high hepatitis B viral load can be treated with medications for hepatitis B; reducing the viral load will reduce the chance of developing liver cancer.