Primary liver cancer, also called hepatocellular carcinoma, lead to over 18,000 deaths in the United States in 2009, according to the National Cancer Institute. Most liver cancers develop from specialized liver cells, called hepatocytes, that normally function to detoxify the body and aid and metabolism. As the cancer develops, hepatocellular carcinoma cells infiltrate and damage the liver, eventually leading to inoperable liver cancer. In many cases, doctors do not detect liver cancer until it has reached this advanced stage, and most liver cancer patients would not respond to surgery. Patients with this advanced cancer have a number of treatment alternatives to surgery.
TheraSphere
TheraSphere is a form of radiation therapy used to treat inoperable liver cancer. Radiation therapy works by exposing cancer cells to a high dose of radiation, causing structural damage to the cell. This damage prevents the cell from generating chemicals it requires to live and eventually promotes liver cancer death and tumor shrinkage. TheraSphere uses specialized glass beads to internally irradiate the liver. During the procedure, surgeons use a catheter to insert millions of radioactive glass beads into the liver. The beads accumulate in the liver tissue and provide a constant source of radiation, severely damaging the tumor cells and treating the cancer. Nordion Inc., TheraSphere's manufacturer, indicates that the therapy effectively treats liver cancer with minimal side effects.
Chemoembolization
Another potential treatment for patients with liver cancer is chemoembolization. This treatment works by cutting off the flow of blood into the tumor. The development of new blood vessels, called angiogenesis, is an essential step in cancer development; without the ability to provide a constant supply of blood to the tumor, cancer cells essentially starve and die. The National Cancer Institute explains that chemoembolization targets the cancer's need for a blood supply and uses drugs to cut off the flow of blood to the tumor. Specifically, chemoembolization uses the drug doxorubicin to disrupt blood flow to the liver, halting cancer growth in patients with inoperable liver tumors. Data published at the National Cancer Institute indicate that patients who underwent this procedure experienced longer survival times than patients who received other treatments.
Combination Chemotherapy
Many patients with inoperable liver cancer receive combination chemotherapy, treatment with multiple chemotherapy drugs to target cancer cells. Since inoperable liver cancers are typically very advanced, the cancer cells may become resistent to individual chemotherapy drugs, allowing for continued cancer growth. Combination chemotherapy uses complementary cocktails of chemotherapy agents to damage multiple structures and signals within the liver cancer cells. Although combination chemotherapy protocols are still under development, data published at the National Cancer Institute indicates that the use of combination chemotherapy with the drugs doxorubicin and bortezomib may prove more effective than either drug used alone. Future clinical research may more clearly establish the use of combination chemotherapy as an effective treatment for inoperable liver cancer.
