Your Treatment Plan

Choosing a treatment plan is a major decision, so it is important to take time and think about all of the choices. Your doctor will discuss treatment options with you.

In creating your treatment plan, the most important factor to consider is the stage (extent) of the cancer. But your overall general health, your age and your personal preferences also are taken into consideration.

It is often a good idea to seek a second opinion, especially with doctors experienced in treating liver cancer. A second opinion can provide additional information and help you feel more confident about the treatment plan that is being considered.

The three main methods of cancer treatment are surgery, chemotherapy and radiation therapy. Sometimes the best treatment approach uses two or more of these methods. While curing the cancer is always the primary goal, sometimes that's not possible. The goal would then be to remove or destroy as much of the cancer as possible to prevent the tumor from growing, spreading or returning for as long as possible.

Treatment for children

Because liver cancer in children is rare, you may want to find a cancer center that has experience in dealing with this condition. It is especially important to find a pediatric surgeon and pediatric oncologist who have experience with liver cancer. You may also want to consider placing your child in a clinical trial.

Surgery

If your surgeon is able to removal all visible cancer at the time of the operation, you will have the best outlook for survival. Unfortunately, complete removal of most liver cancers is not possible. Often the cancer has spread beyond the liver, has become quite large or may be present in too many different parts of the liver. Surgery is performed only 15 percent of the time. Surgery also includes cryosurgery, which freezes the cancer using a very cold metal probe, radiofrequency ablation, which uses a heated probe applied to the tumor to burn the cancer cells, and alcohol injection (ethanol or alcohol ablation) directly into the tumor to kill the cancer cells.

For some people, a liver transplant offers a chance for cure. However, the surgery is risky and few people are good candidates for transplants.

Chemotherapy

The use of drugs to destroy cancer cells is called chemotherapy. Because these drugs not only affect the cancer cells but also target healthy cells, they may produce unwanted side effects. Chemotherapy is generally administered in cycles, meaning that you will receive the drugs for a specified period of time and then you will be given time to recover. Medications are available to help control the side effects associated with chemotherapy.

In hepatic arterial infusion, the doctor places a catheter directly into the major artery that supplies blood to the liver. Then chemotherapy drugs are injected into the catheter and directly to the liver. This method treatment does not have as many side effects as traditional methods of giving chemotherapy.

Your physician will discuss with you which chemotherapy drugs are generally used to treat your form of liver cancer. Unfortunately, liver cancer seems to be resistant to most chemotherapy drugs.

Radiation therapy

Radiation therapy uses high-energy rays to kill cancer cells. External beam radiation therapy is used with liver cancer. However, radiation therapy hasn't been shown to improve survival. Instead, the purpose of radiation therapy is to shrink the size of the cancer to help relieve pain. Liver cells are also sensitive to radiation. Therefore, radiation therapy can't be given at very high doses because the radiation also kills normal liver tissue.

Other options

Radiofrequency ablation (RFA) uses high energy radio waves to kills cancer cells. It is often used as a palliative treatment. It may be applied under sedation through the skin, with laparoscopy, or during surgery.

Chemoembolization is like hepatic arterial infusion in that chemotherapy drugs are given directly through the artery that feeds the liver. However with chemoembolization, the flow of blood is blocked for a short time. This way the chemotherapy drug stays in the tumor longer. This method shows promise in helping people live longer.

More on Liver Cancer

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This article was reviewed and updated June 2007.