Liver Cancer Treatment

Liver is one of the most important organs in the human body located in the right upper part of the abdomen just beneath the diaphragm. Liver performs a wide spectrum of functions which include maintaining and regulating the storage of glycogen, production of hormones, plasma proteins, RBC decomposition, detoxification and production of bile that helps in digestion.

Liver Cancer

There are mainly two types of Liver cancer:

1. Primary Liver Cancer:

   Cancer that originates in the liver cells itself is called Primary liver cancer. There are two types of primary liver cancer:

   • Hepatocellular Carcinoma (HCC) – HCC is the most common type of liver cancer and starts from the main cells of the liver. People affected with cirrhosis are most prone to have HCC.
   • Other types of Primary liver cancer are Cholangiocarcinoma, cancer that starts in the cells lining the bile duct and Angiosarcoma, which is a rare liver cancer starting in the blood vessels.
2. Secondary Liver Cancer

   It is the cancer that has originated in the other parts of the body but has spread to liver (known as metastasis)

Symptoms of Liver Cancer:

Initially, liver cancer does not produce any signs and symptoms but when they appear, it includes weight loss, loss of appetite, pain in the upper abdomen, generalized weakness and fatigue, nausea, vomiting, yellow discolouration of skin and eyes, abdominal swelling etc.

Once liver cancer is diagnosed, it is important to know the stage of the cancer to plan appropriate treatment to get out of it in time. There are 4 stages of liver cancer.

• Stage I: Single cancer tumor confined to liver and has not spread to other parts.
• Stage II: Cancer with either a single tumor that has spread to blood vessels or multiple tumors of less than 5 cm that has not invaded blood vessels.
• Stage III: It has 3 sub stages:
  • Stage III A: cancer with more than single tumor having size of more than 5 cm but has not spread to lymph nodes or other parts.
  • Stage III B: Cancer has spread to either hepatic or portal vein but has not invaded lymph nodes or any other parts.
  • Stage III C: Cancer has spread to adjacent organs like gallbladder but has not spread to lymph nodes.
• Stage IV: 2 sub stages:
  • Stage IV A: Cancer with more than one tumor of variable size that has spread to blood vessels, lymph nodes and adjacent organs of the liver but has not affected other body parts.
  • Stage IV B: Cancer of variable size which has spread to blood vessels and organs near the liver. It may or may not have invaded the lymph nodes but has spread to other organs like lungs and bones.

Liver Cancer Causes:

Cancer occurs when DNA of the cells undergo mutation and these mutated cells then grow without control in an abnormal way giving rise to the tumor.

The exact cause of liver cancer is unknown but like other cancers there are certain risk factors that may lead to liver cancer. These are:

• Chronic infection caused by HBV or HCV virus
• Liver cirrhosis
• Inherited liver disease like Wilson’s disease and hemochromatosis
• Diabetes
• Overweight and obesity
• Excessive consumption of alcohol
• Fatty liver disease

When is Liver Cancer Treatment needed?

If you are suffering from any of the above mentioned symptoms, you should see a doctor immediately who would advise various tests for a correct diagnosis. If you are found to suffer from liver cancer, the treatment should be started immediately.

Liver Cancer Treatment Options

There are various treatment options for liver cancer. The treating doctor would suggest the best treatment for the patient or a combination of these depending upon the medical condition of the patient:

Non Surgical Procedures:

• Cryoablation:

  This entails killing the cancerous cells using an instrument called cryoprobe that delivers nitrogen which freezes and kills the cells.

• Radio Frequency ablation:

  This procedure includes insertion of the needles to reach tumor through small incision in the abdomen and then heating the needle at very high temperature with an electric current to destroy the targeted cancerous cells.

• Chemotherapy:

  Strong anti- cancer drugs are injected in the hepatic artery which is then blocked so as to cut the blood supply to the cancer cells which makes them shrink and ultimately die. This procedure is often called chemoembolization.

• Radiation therapy:

  By using the high powered energy beams, the cancer cells are targeted to shrink and die. The new advanced technique called stereotactic radiotherapy can be used to treat liver cancer.

• Targeted drug therapy:

  The drugs that interfere with the tumor function and inhibit the advancing spread of carcinoma are used to control the cancer. Sorafenib is one such drug.

Surgical Procedures:

Liver surgery is the most commonly performed procedure for liver cancer. There are mainly two types of surgical procedures:

• Partial hepatectomy: This surgery is indicated only in cases of small tumors and when the liver functions are good. During the procedure, only the tumor and the small portion of the healthy tissue around the tumor is excised as the liver has the tendency to re-grow.
• Liver transplant surgery: Liver transplant is the procedure to remove the diseased liver and replace it by a healthy and normally functioning liver from the donor.