Most patients do not show any symptoms in the early stages of liver cancer. But if cancer is diagnosed early, chances of cure will be higher with treatments like surgery or ablation techniques.
What factors are considered to determine the suitable treatment?
Each patient’s liver cancer treatment must be individualised and will depend on:
- Cancer stage
Surgery (whether it is liver transplantation or removal of part of the liver) may be able to cure the patient if the cancer is in an early stage and the rest of the liver is healthy.
- General health and fitness
The cancer specialist and his team will conduct a comprehensive health assessment, including medical history, a complete physical examination and relevant investigations so as to get an idea of the patient’s general health and fitness. He will then recommend treatment options that are suitable for the person’s current health condition.
- Availability of specialised treatment
Treatments can be used alone or in combination. When the best treatment method for your cancer, for example, is a combination of immunotherapy and targeted drugs and one of these two is not available, your doctor will recommend the second best option.
- Patient’s choice
After formulating a treatment plan based on the points above, the patient has the final say to choose what treatment he or she wants.
What are the treatment options for liver cancer?
There are five main treatments used in treating liver cancer. But when treatment is not possible or is ineffective (may be due to late stage), the patient may volunteer to participate in a trial. Even when no treatment option is available, comfort care will be given to ensure that the patient remains comfortable and dignified.
- Surgery
It is the best treatment option to cure liver cancer: surgical resection (removal of the tumour using surgery) or a liver transplant. Partial hepatectomy is the name for removing the part of the liver that has cancer. Only those who have a good liver function and adequate liver volume can go for this option.On the other hand, a transplant may be recommended for people with early cancer stage, especially patients who have severe cirrhosis or scarring of the organ. A liver transplant is commonly reserved for people with a tumour up to five centimetres in diameter or those with two or three tumours that are less than three centimetres in diameter. A transplant is not an option when the cancer has spread to other body parts. - Localised chemotherapy
It involves the injection of chemotherapy drugs (anti-cancer drugs that destroy cancer cells or stop them from multiplying) directly into the cancer instead of being injected into a vein or taken by mouth. This method delivers a higher dose of chemotherapy to the tumour while minimising side effects to the rest of the body. Localised therapy may be used for individuals with very large tumours that cannot be removed with surgery. - Localised radiotherapy
Radiation therapy or radiotherapy uses high-energy rays (or particles) to destroy cancer cells or keep them from growing further. Localised radiotherapy treats tumours in the liver by injecting small radioactive beads directly into the cancer. These beads will then lodge in the liver near the tumour and give off small amounts of radiation. This method is helpful in treating cancer that cannot be removed by surgery or ablation techniques. - Ablation techniques
It is a treatment option that destroys tumours without removing them. Ablation techniques are best used for tumours measuring less than 3 cm across. One of the most common ablation methods is radiofrequency ablation (RFA). The doctor inserts a thin, needle-like rod into the tumour through the skin. A high-frequency current is passed through its tip, which heats the tumour and destroys the cancer cells.Another method is called microwave ablation. The same process is followed. The difference is that it uses electromagnetic waves’ energy to heat and destroy the tumour.The third technique being used is alcohol ablation. This treatment uses concentrated alcohol injected through the needle directly into the tumour to destroy cancer cells. Sometimes, multiple treatments of alcohol ablation may be needed if the tumour grows again.These techniques can be used in patients with small tumours and when surgery is not recommended because of poor health or reduced function of the liver.
- Systemic treatment (targeted cancer therapy)
Because of the changes in cells that cause cancer, newer drugs are developed to target these changes. Targeted drugs work differently from chemotherapy drugs, blocking the growth and spread of cancer by interfering with specific molecules associated with cancer growth and development. It is undertaken in advanced cancer stages where other treatment options are not suitable. Sorafenib, a targeted drug, targets cancer cells by stopping them from forming new blood vessels they need in order to get bigger. There are many targeted drugs that can be used, most taken daily as an oral medication, while other drugs are given as an infusion into a vein. - Clinical trials
Clinical trials are used for all types and stages of liver cancer. Many trials focus on new treatments to learn if this treatment is safe, effective, or possibly better than the existing treatments. In addition, new drugs, different treatment combinations, and new approaches to radiotherapy and surgery are evaluated in a number of clinical trials. When all of the above treatment options are not suitable, participation in a clinical trial may be suggested by your doctor. - Palliative care (supportive care)
It is a holistic approach to help improve the quality of life for people with serious illnesses like cancer. It is focused on assisting patients in managing and relieving symptoms. You receive specialised support from healthcare providers and caregivers from various disciplines:
● Palliative care specialists
● Mental health professionals
● Pain specialists
● Pharmacists
● Nutritionists
● Social workers
This team leverages the expertise of everyone to address your physical, psychological, emotional, and social needs.
Conclusion
Getting screened for liver cancer is important because early stages do not exhibit specific symptoms. Yet, it is also most treatable when detected early. These treatment options can be used in conjunction with each other, whichever the doctor thinks is best suited to the patient.
References
