The American Cancer Society estimates that in 2010 in the United States, over 24,000 individuals will be diagnosed with liver cancer, and over 18,000 people will die from the disease. By the time most symptoms of liver cancer appear, the disease is typically widespread and advanced. A variety of treatments are available; the stage or spread of the cancer is what guides treatment planning.
Surgery
A partial hepatectomy involves removal of part of the liver, but according to the American Cancer Society, this procedure is typically only done when complete removal of the tumor is possible while still leaving enough of the liver to be functional. By the time liver cancer is diagnosed, however, the cancer has usually spread outside the liver, making complete tumor removal impossible. For individuals with very small tumors, a liver transplant may be an option, although donor livers are typically given to patients whose diseases are more curable than liver cancer.
Embolization Therapy
Arterial embolization, also called transarterial embolization or TAE, is used to treat liver tumors that are not able to be surgically removed. TAE blocks the arteries that bring blood to the part of the liver that has the tumor, cutting off the nutrients the tumor needs in order to grow. This is done by injecting substances that block the arteries. Although TAE also cuts off blood supply to healthy liver cells, the majority of healthy cells get their nourishment from the portal vein, not the arteries. TAE can also be combined with chemotherapy or radiation therapy; these are called chemoembolization and radioembolization, respectively.
Chemotherapy
Chemotherapy uses medications to kill cancer cells or to slow down or stop growth and division of cancer cells. It can be taken by mouth, injected into a vein or placed into a body cavity. It can also be injected into the hepatic vein when used in conjunction with embolization therapy. Chemotherapy is described as systemic therapy, because if taken orally or intravenously, the drug travel through the bloodstream and can kill cancer cells throughout the body, including ones that may have spread to distant areas. Liver cancer tends to be resistant to many chemotherapy drugs, but the American Cancer Society lists several that have been shown to be effective, including doxorubicin, 5-fluorouracil and cisplatin.
Targeted Therapy
Targeted therapy includes medications that, like chemotherapy, are systemic but that specifically target various changes found only in cancer cells. This helps minimize the side effects of these medications because normal healthy cells are not affected. Sorafenib, the brand name drug Nexavar, is a targeted therapy that has been shown to slow down liver cancer progression, notes the American Cancer Society. The drug works by preventing tumors from growing blood vessels to feed the cancer and also blocking molecules that aid in liver cancer cell growth.
