The treatment chosen depends upon how much the cancer has spread and the general health of the liver. For example, the extent of cirrhosis (scarring) of the liver can determine the treatment options for the cancer. Similarly, the spread and extent of spread of cancer beyond the liver tissue plays an important part in treatment options.
Surgery: Liver cancer can be treated sometimes with surgery to remove the part of liver with cancer. Surgical options are reserved for smaller sizes of cancer tumors.
Liver transplant: The doctor replaces the cancerous liver with a healthy liver from another person. It is usually used in very small unresectable (not able to be removed) liver tumors in patients with advanced cirrhosis.
Ablation therapy: This is a procedure that can kill cancer cells in the liver without any surgery. The doctor can kill cancer cells using heat, laser, or injecting a special alcohol or acid directly into the cancer. This technique may be used in palliation when the cancer is unresectable.
Embolization: Blocking the blood supply to the cancer can be done using a procedure called embolization. This technique uses a catheter to inject particles or beads that can block blood vessels that feed the cancer. Starving the cancer of the blood supply prevents the growth of the cancer. This technique is usually used on patients with large liver cancer for palliation.
Radiation therapy: Radiation uses high-energy rays directed to the cancer to kill cancer cells.
Chemotherapy: Chemotherapy uses a medicine that kills cancer cells. The medicine can be given by mouth or by injecting it into a vein.
Sorafenib is an oral medication that can prolong survival (up to 3 months) in patients with advanced liver cancer.
What is the follow-up after treatment for liver cancer?
Patients are advised to follow up with the doctor for lab tests and office visits. Patients with chronic liver disease should avoid alcohol and any drugs that can harm the liver. Patients with liver transplants will need to take antirejection drugs for the rest of their life to prevent their body from rejecting the new liver.
What is the prognosis of liver cancer? What are the survival rates for liver cancer?
The prognosis for liver cancer depends on multiple factors such as the size of the liver cancer, the number of lesions, the presence of spread beyond the liver, the health of the surrounding liver tissue, and the general health of the patient.
The overall five-year survival rate for all stages of liver cancer is 15%. One of the reasons for this low survival rate is that many people with liver cancer also have other underlying medical conditions such as cirrhosis. However, the five-year survival rate can vary depending on how much the liver cancer has spread.
If the liver cancer is localized (confined to the liver), the five-year survival rate is 28%. If the liver cancer is regional (has grown into nearby organs), the five-year survival rate is 7%. Once the liver cancer is distant (spread to distant organs or tissues), the five-year survival rate is as low as two years.
Survival rate can also be affected by the available treatments. Liver cancers that can be surgically removed have an improved five-year survival rate of over 50%. When caught in the earliest stages, and the liver is transplanted, the five-year survival rate can be as high as 70%.
Are there alternative and complementary therapies for liver cancer?
Currently, there are no approved alternative or complementary treatment options for liver cancer. Research on the use of complementary and alternative medicine for liver cancer is limited. Studies suggest that certain alternative therapies may offer benefits for people being treated for all types of cancer, including liver cancer. Some alternative treatments have been found to alleviate unwanted side effects of conventional cancer treatments such as nausea and vomiting.
Acupuncture: Studies have shown acupuncture can help with nausea and vomiting among people with cancer.
Herbal therapy: Milk thistle has been used for centuries to treat liver problems. Mistletoe may also show promise in liver cancer in experimental studies.
Some herbal preparations, such as those mentioned above, may be helpful in treating symptoms associated with liver cancer. Even so, people who have liver cancer need to take extra precautions before taking an herbal remedy.
A person with cancer of the liver may have a harder time processing alcohol than people without liver disease and should avoid alcohol-containing products. Since many herbal preparations in extract form are alcohol-based, people with liver cancer should always check the ingredients for the presence of any alcohol before taking these herbs.
Additionally, some herbal supplements, such as gingko biloba, can cause excess bleeding. Because the liver releases important substances that help the blood to clot, liver cancer can decrease the body's ability to stave off bleeding. As a result, people with liver cancer should discuss any new medications, including herbal supplements, with their doctor before taking them.