Liver Cancer treatment
Treatment of liver cancer is based on several factors, including the type of cancer
(primary or metastatic); stage (early or advanced); the location of other primary cancers
or metastases in the patient's body; the patient's age; and other coexisting diseases,
including cirrhosis. For many patients, treatment of liver cancer is primarily intended to
relieve the pain caused by the cancer but cannot cure it.
Surgery as a liver cancer treatment
Few liver cancers in adults can be cured by surgery because they are usually too
advanced by the time they are discovered. If the cancer is contained within one lobe of
the liver, and if the patient does not have either cirrhosis, jaundice, or ascites,
surgery is the best treatment option. Patients who can have their entire tumor removed have the best chance for survival.
Unfortunately, only about 5% of patients with metastatic cancer (from primary tumors in
the colon or rectum) fall into this group. If the entire visible tumor can be removed,
about 25% of patients will be cured. The operation that is performed is called a partial
hepatectomy, or partial removal of the liver. The surgeon will remove either an entire
lobe of the liver (a lobectomy) or cut out the area around the tumor (a wedge resection).
Chemotherapy as a liver cancer treatment
Some patients with metastatic cancer of the liver can have their lives prolonged for a
few months by chemotherapy, although cure is not possible. If the tumor cannot be removed
by surgery, a tube (catheter) can be placed in the main artery of the liver and an
implantable infusion pump can be installed. The pump allows much higher concentrations of
the cancer drug to be carried to the tumor than is possible with chemotherapy carried
through the bloodstream. The drug that is used for infusion pump therapy is usually
floxuridine (FUDR), given for 14-day periods alternating with 14-day rests. Systemic
chemotherapy can also be used to treat liver cancer. The medications usually used are 5-
fluorouracil (Adrucil, Efudex) or methotrexate (MTX, Mexate). Systemic chemotherapy does
not, however, significantly lengthen the patient's survival time.
Radiation therapy as a liver cancer treatment
Radiation therapy is the use of high-energy rays or x rays to kill cancer cells or to
shrink tumors. Its use in liver cancer, however, is only to give brief relief from some of
the symptoms. Liver cancers are not sensitive to radiation, and radiation therapy will not
prolong the patient's life.
Liver transplantation as a liver cancer treatment
Removal of the entire liver (total hepatectomy) and liver transplantation are used very
rarely in treating liver cancer as of 1998. This is because very few patients are eligible
for this procedure, either because the cancer has spread beyond the liver or because there
are no suitable donors. Further research in the field of transplant immunology may make
liver transplantation a possible treatment method for more patients in the future.
Prognosis
Liver cancer has a very poor prognosis because it is often not diagnosed until it has
metastasized. Fewer than 10% of patients survive three years after the initial diagnosis;
the overall five-year survival rate for patients with hepatomas is around 4%. Most
patients with primary liver cancer die within several months of diagnosis. Patients with
liver cancers that metastasized from cancers in the colon live slightly longer than those
whose cancers spread from cancers in the stomach or pancreas. |