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Treatment

Radiation oncologistsTherapy is based on the stage of the cancer, tumor location, the health of the rest of the liver, and prognosis. It's critical to know the stage of the disease. Doctors use a number of staging systems to determine how far the cancer has advanced at diagnosis. Early-stage liver cancer is usually treated with the goal of curing the disease; later-stage cancer is treated to relieve symptoms and improve quality of life. 

Some patients' cases are discussed at a multidisciplinary tumor board — a conference attended by many doctors with different specialties that might be required for your care.

Several types of treatment could be used for liver cancer: surveillance, surgery, liver transplant, ablation, embolization, radiation, targeted therapy. Sometimes chemotherapy is used in combination with other treatments.

Surveillance

This is appropriate for tumors smaller than one centimeter. Follow-up usually occurs every three months.

Surgery

A partial hepatectomy removes the tumor and a portion of the liver surrounding it. This surgery is for patients who have a single tumor and good liver function.

Liver transplant

This may be the best option for some patients with many liver tumors. The entire liver is removed and replaced with a healthy donated organ. If a patient has to wait for a donated liver, other treatments may be given to extend survival including stereotactic body radiation therapy (SBRT, see more information below) or transarterial chemoembolization (TACE), a procedure that gives chemotherapy through a catheter directly into the hepatic artery.

If a patient qualifies for a transplant, the University of Rochester Medical Center is the only health-care institution in upstate New York with a liver transplant program. Our program is nationally renowned, and uses the most advanced technology and techniques. 

Ablation

Some types of ablation therapy for liver cancer include using special needles and high-energy radio waves to kill cancer cells (radiofrequency ablation). Other types include exposing the tumors to microwaves (microwave therapy); destroying the cancer cells with pure alcohol (percutaneous ethanol injection); and using an instrument to freeze and destroy cancer cells (cryoablation).

Embolization

This treatment blocks or slows blood flow from the hepatic artery to the tumor. Embolization therapy is for patients whose cancer has not spread beyond the liver, and who aren’t eligible for surgery or ablation therapy. When the hepatic artery is blocked during embolization therapy, the healthy portion of the liver continues to receive blood from the hepatic portal vein.  Wilmot offers a newer type of outpatient radioembolization therapy for primary liver cancer, where millions of tiny, radioactive glass beads are inserted into the branch of the hepatic artery that feeds the tumor. The beads attack the cancer without harming healthy cells.

Targeted therapy

These are newer drugs designed to target specific gene changes that result in liver cancer. They single out cancer cells without harming normal cells and usually have less severe side effects compared to chemotherapy.  Talk to your oncologists about targeted drugs that can be used to prevent the growth of blood vessels that feed liver tumors.

Radiation

Radiation therapy uses energy from radiation beams, radio isotopes, or charged particles to target tumors and eradicate cancer cells. External radiation is used for liver cancer, including stereotactic body radiation therapy (SBRT), which delivers high doses of radiation precisely to the tumor. Wilmot radiation oncologists were among the first in the nation to use SBRT and to study its effectiveness. They also developed data showing the types of cases in which SBRT works very well.

Side effects

Many cancer treatments cause side effects such as hair loss or fatigue, but people do not always experience side effects the same way. 

Wilmot's Cancer Control & Survivorship program is one of the oldest and most highly regarded research programs in the country to investigate the management of side effects. 

The American Cancer Society also offers a free online class to help patients manage the side effects of their illness.