Liver Cancer; Causes, Symptoms, Diagnosis, & Treatment Options

Treatment options

Management of liver cancer requires cooperation by a team of specialists, including a hepatologist, a medical oncologist, hepatobiliary surgeons, radiologists, and other specialties.

Your treatment options as a patient depend on a variety of factors. They include:

• • The characteristics of the tumor: That is, if the tumor is larger or smaller, if this is only one tumor or many, and where it is located.
  • Presence of cirrhosis: It is not only essential to evaluate if there’s cirrhosis or not. It is also important to measure the severity of the disease. Depending on this factor, patients could be candidates for liver transplantation.
  • Surgical risk: As it happens with any type of surgery, doctors should also evaluate if the patient is prepared for this type of procedure. Comorbid diseases such as heart disease and respiratory conditions should be ruled out. The extent of cirrhosis is also a determinant of surgical risk.
  • Presence of metastasis: When metastasis is already present, liver surgery will only have a limited effect. Systemic treatment is installed in these cases to take down cancer wherever it is, and not only in the liver parenchyma.

Even when doctors are sure about how to proceed in cancer therapy, they should initially deal with the consequences of cirrhosis. These patients usually have electrolyte and liquid retention problems. Some of them would also experience encephalopathy, bleeding, or even spontaneous bacterial peritonitis.

After ensuring that cirrhosis is under control, one of the most common nonoperative therapies is transcatheter arterial chemoembolization. This is an alternative to surgical treatment: selecting an artery that goes straight to the tumor and delivering chemotherapeutic drugs to that precise artery.

On the other hand, surgical therapy offers long-term improvements, sometimes a complete cure. In smaller tumors, resection is usually recommended, but only 15-30% of patients can benefit from this type of treatment.

The only chance of curing the disease is through liver transplantation in non-metastatic conditions. However, 5% of patients can receive a liver transplant because the criteria are very difficult to meet. After liver transplantation, the 5-year survival rate is higher than 75%. However, the tumor may show up once again in 5 years. This happens in 15% of cases.

To prevent recurrence and make sure that cancer is gone, patients should go through other types of treatment as well. They include:

• • Radiofrequency ablation
  • Systemic treatment with drugs that block tumor cell growth, such as sorafenib or regorafenib.
  • Chemotherapy is also an option, especially in patients with metastatic disease. The most common drug used in single therapy is doxorubicin.