In carefully selected patients, resecting
(cutting out) the cancer from the liver
may be an option. Sometimes the surgeon
may perform the operation with several
small incisions, either laparoscopically or
robotically. Most of the patients receiving
these less-invasive approaches will return
home in 24 - 48 hours. If traditional, open
surgery is required, patients should expect
a three- to five-day hospital stay.
If the cancer cannot be cut out, less-invasive
procedures for burning away the liver cancer
may be performed. Radiofrequency and
microwave are two ablative (burning)
therapies. With ablative therapy, a needle is
placed into or around the cancer, and heat
is used to treat the cancer. This technique
saves more of the surrounding liver tissue.
Patients usually return home the same day after having an ablation to treat liver cancer.
Additional options for patients with difficult to
reach cancers or for patients who are not surgical
candidates utilize interventional radiologists who
specialize in less-invasive procedures including:
In chemoembolization, microscopic glass beads
coated in chemotherapy are injected into the
blood vessel that supplies the cancer. This delivers
a local dose of chemotherapy to the tumor
without the side effects associated with traditional
chemotherapy. The beads keep the chemotherapy
trapped in the cancer instead of circulating in the
blood system, and this starves the tumor of its blood
supply. Side effects may include nausea, pain and
fatigue. Patients generally go home the same day or
the next morning after receiving chemoembolization treatment.
Y90/yttrium-90/directed radiation bead therapy
Patients with large tumors, multiple tumors in the
same region of the liver, and/or tumor within the
portal vein (a large vein of the liver) can potentially
receive radiation bead therapy. These beads are
coated with radiation instead of chemotherapy.
This procedure is used after a detailed mapping
that determines how much radiation will go through
the liver and on to other areas of the body. If the
amount of radiation going to the lungs or other
areas is too much, radiation bead therapy is not safe
to use. If the mapping determines a safe path for the
radiation, radiation beads are injected into the blood
vessel of the tumor. These radiation coated beads
implant into the tumor and work to destroy the
This is a chemotherapy pill that may be used
alone or in combination with other treatments.
The most common side effects include diarrhea,
fatigue, rash, pain or peeling of the palms or soles
of the feet.
Immunotherapy (nivolumab or pembrolizumab)
These other medical options are used as
alternatives for those liver cancer patients previously treated
A liver transplant may be an option for select liver
cancer patients who meet strict medical, surgical,
social and tumor-size criteria. A very thorough
work up is required for potential candidates.
Living donor liver transplantation, an operation in
which a healthy person donates a portion of his
or her liver to the recipient, should be considered
for approved candidates. A living donor liver
transplant offers organ availability more quickly,
which allows the patient to avoid progression of
cancer and its life-threatening complications.
radiation treatment (SBRT)
These are different terms for the same thing.
This technique uses high-dose pinpoint beams
of radiation to treat the liver cancer. In some cases,
fiducials (small gold ball markers) will be placed into
the tumor to accurately identify the targeted area
of cancer. Approximately a week later, the patient
receives three to five days of radiation treatments.
Most patients do not experience the side effects of
typical radiation treatments.
High energy beams from positively charged
particles, or protons, are used to treat the liver cancer tumor.
With proton therapy, larger doses can be applied
while sparing surrounding tissue. Some of the
common side effects include fatigue, nausea,
skin redness, pain and soreness near the