The liver is a vital organ located below the right lung, under the ribcage. It handles a variety of functions, including detoxification, protein synthesis and a major role in the metabolism. Cancer of the liver, or hepatic cancer, is relatively rare and a distinction can be made between:
- Primary liver cancer: cancer that originated in the liver. This constitutes a minority of reported cases and is technically the only case where ‘liver cancer’ is the correct term.
- Secondary liver cancer: cancer that originated elsewhere and metastasized to the liver. Technically, this is not liver cancer, but it is often referred to as such.
The main options for liver cancer treatment are:
- Radiofrequency ablation, which is being used increasingly
Surgery is the best treatment for liver cancer when the cancer hasn’t spread yet. Two major types of surgery are performed:
- A liver transplant: which is only suggested when there are only a few tumors smaller than 3 cm (roughly 1.18 inches), or one smaller than 5 cm (approximately 1.97 inches). As most liver cancer patients are already quite ill, a liver transplant would be too big of a procedure.
- Removing the cancer: depending on the size and location of the cancer, tumors that occupy up to 80% of the liver can be removed. The liver tissue that is removed grows back in a matter of weeks (if the patient does not suffer from cirrhosis).
If the tumor cannot be safely removed by surgery, chemotherapy can be suggested. The main goal of this treatment is to slow the growth of the tumor and make the symptoms manageable. It can also be suggested before surgery, to shrink the tumor and make the surgery easier, or after the surgery, to prevent the cancer from coming back. In general, the benefits of chemotherapy for primary liver cancer are fairly limited.
Radiofrequency Ablation (RFA)
This treatment for liver cancer involves radio waves that heat up the tumor cells until they perish. It can be administered under local and general anesthesia. With the help of an ultrasound scan, the cancer is localized. Subsequently, a needle is brought directly into the tumor. Through this needle, radio waves are passed down, heating up the tumor cells until they die. In most cases, the patient can go home directly after the treatment, but in some cases a short stay in the hospital is required. Radiofrequency ablation is not always an option. When the cancer is too large, or too close to a blood vessel, it is discouraged.
Other Treatment Options
Besides these three main liver cancer treatment options, there are other possibilities which are used less frequently:
- Biological therapy: using natural substances from the body, or medication made from these substances (an example being tyrosine kinase inhibitors).
- Chemoembolization: where chemotherapy given directly to the liver is complemented with blocking the blood supply to the area of the liver containing the cancer through tiny plastic beads or gelatin.
- Percutaneous ethanol injection: where alcohol is injected into the tumor, which dehydrates the cells and stops their blood supply.
- Cryotherapy: where the tumor is frozen with liquid nitrogen. This treatment can be quite painful and is rarely used for primary liver cancer.
- American Cancer Society, Liver Cancer Overview: https://www.cancer.org/cancer/livercancer/overviewguide/liver-cancer-overview-treating-general-info
- Cancer Research UK, Types of Treatment for Liver Cancer: https://www.cancerhelp.org.uk/type/liver-cancer/treatment/which-treatment-for-liver-cancer
- National Cancer Institute, U.S. National Institutes of Health: https://www.cancer.gov/cancertopics/types/liver