Treatment of primary and metastatic liver cancer can be similar; however, your treatment plan will be personalized to your needs. One or more of these approaches may be part of your plan.
Surgical removal of your tumor(s) is often the first line of treatment. Doctors refer to this operation as liver resection or partial hepatectomy. During this procedure, the surgeon removes the diseased portion of the liver and leaves enough liver behind for it to continue to function. When possible, the liver is accessed through small incisions in the abdomen. This minimally invasive approach is called laparoscopic surgery or robotic surgery. These approaches may reduce your pain and scarring and shorten the time you stay in the hospital. These operations may be performed for primary and metastatic liver cancer.
A liver transplant may be an option if you are diagnosed with primary liver cancer, specifically hepatocellular carcinoma. On rare occasions, it may be performed for hilar cholangiocarcinoma if you meet specific requirements. During this procedure, your surgeon removes the diseased liver and replaces it with a healthy liver from a donor.
Systemic chemotherapy floods the whole body with chemotherapy. The drugs are administered through an IV or through a port that is inserted in your chest. Systemic chemotherapy is prescribed for primary or metastatic liver cancer.
Embolization is the delivery of small beads or material into the arteries that directly feed the tumor. Ultimately, they choke off the blood supply, which results in cancer cell death.
Chemoembolization refers to pellets or beads that block or reduce blood flow to the tumor, but also slowly release chemotherapy directly to the tumor site. The tiny materials are injected through a catheter into a blood vessel that supplies the tumor.
Radioembolization is similar to chemoembolization, however, in this case, the tiny pellets or beads are bound to radioactive material that is injected through a catheter into a blood vessel that supplies the tumor. The beads block or reduce blood flow to the cancerous tumor, and also deliver radiation directly to the tumor.
A pump is surgically implanted in the abdominal wall and a catheter is used to deliver doses of chemotherapy hundreds of times higher than systemic chemotherapy through the hepatic artery, which directly feeds tumors in the liver. It is given in combination with systemic chemotherapy but it does not increase the side effects. Hepatic artery infusion is used to treat metastatic colorectal cancer to the liver, as well as primary liver cancer (intrahepatic cholangiocarcinoma) that cannot be surgically removed.
Targeted therapy may be given based on specific genetic and molecular changes in the tumor. It blocks proteins in cells that cause cancer or promote tumor growth.
Stereotactic body radiation therapy (SBRT) targets high-energy radiation directly at the tumor to shrink the tumor and kill the remaining cancer cells. SBRT minimizes radiation exposure and damage to the surrounding healthy tissue.
This procedure involves the insertion of a needle to deliver high-energy microwaves directly to the tumor to destroy cancer cells. It may be performed by an interventional radiologist or in the operating room. It is used to treat primary and metastatic liver cancer.
Radio waves heat and destroy cancer cells. It may be prescribed to treat small primary liver tumors that are inoperable because of underlying liver disease. This treatment is used less frequently but may be recommended to help manage pain and discomfort from liver cancer.