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Liver cancer patient speaking with nurse

Primary liver cancer results from abnormal cell growth in the liver, while secondary (metastatic) liver cancer originates in another part of the body and spreads to the liver. Also known as hepatocellular carcinoma, primary liver cancer is often associated with cirrhosis, hepatitis B or C infection, excessive alcohol consumption or non-alcoholic fatty liver disease.

Liver cancer symptoms can include abdominal pain and swelling, unexplained weight loss, yellowing of the skin and eyes (jaundice), loss of appetite, fatigue and nausea. Treatment can vary depending on the size, location and stage of the tumor and the patient’s overall health. Common options include surgery, chemotherapy, radiation therapy, immunotherapy and targeted therapy. Because liver cancer cells do not rely on hormones to fuel their growth, liver cancer does not respond to hormone therapy.

Surgery for liver cancer

Surgical treatment options for liver cancer can include:

Liver resection

Also known as hepatectomy, this procedure may be performed if the tumor is small and localized and the rest of the liver is healthy enough to function properly after surgery. A surgeon will remove the tumor along with a slim margin of surrounding healthy tissue. The surgeon may use minimally invasive techniques or robotic assistance as appropriate.

Liver transplant

Transplantation may be considered for a patient with advanced liver cancer or cirrhosis. After removing a large part of the cancerous liver, a surgeon will replace it with a healthy donor liver. Once the donor liver is in place, the surgeon will connect it to the surrounding blood vessels and bile ducts. Typically, the transplanted liver and the portion of the original liver that was left behind will regrow rapidly, reaching normal liver volume and function within a few months.

Other treatment options, such as chemotherapy, radiation therapy, targeted therapy and/or immunotherapy may be used in combination with surgery for enhanced effectiveness, or instead of surgery if the patient is not a surgical candidate.

Chemotherapy for liver cancer

Chemotherapy is a systemic treatment that involves the intravenous or oral administration of powerful cancer-fighting drugs. After entering the bloodstream, the drugs circulate throughout the body to target and destroy rapidly dividing cells, including cancer cells. The specific drug regimen and duration of treatment can vary based on the patient’s unique circumstances.

In addition to systemic chemotherapy, transarterial chemoembolization (TACE) may be a treatment option for liver cancer. TACE involves the delivery of chemotherapy drugs directly into the blood vessels supplying the tumor, followed by the embolization (blockage) of these vessels to cut off the blood supply to the tumor.

Although chemotherapy is not considered to be curative for liver cancer, it may be administered before a hepatectomy to shrink the tumor and make it easier to remove. When used alone or in combination with other treatments, chemo can also improve liver cancer symptoms and enhance the patient’s quality of life.

Radiation therapy for liver cancer

Radiation therapy is a localized liver cancer treatment option that uses high-energy X-rays or other forms of radiation to target and destroy cancer cells. The most common type is external beam radiation therapy (EBRT), which involves the use of an external machine (linear accelerator) to precisely aim the beams directly at the tumor.

Another option may be brachytherapy, which involves the placement of a radioactive source directly into or near the tumor to deliver targeted radiation therapy. This technique allows for a high dose of radiation to be delivered precisely to the tumor while minimizing exposure to surrounding healthy tissues.

Radiation therapy may be administered before a liver resection to shrink the tumor and make it easier to remove. It can also be used to relieve symptoms and improve the patient’s quality of life if surgery is not feasible.

Immunotherapy for liver cancer

An emerging treatment option for liver cancer, immunotherapy works by harnessing the power of the body’s immune system to recognize and attack cancer cells. The most common type involves the use of immune checkpoint inhibitors, which work by blocking certain proteins found on the surface of cancer cells that inhibit the body’s immune response, such as programmed cell death protein 1 (PD-1) and programmed death-ligand 1 (PD-L1). By blocking these proteins, immune checkpoint inhibitors can help the immune system target and destroy cancer cells.

Depending on the stage and extent of the liver cancer and the patient’s overall health and treatment goals, immunotherapy may be used alone or in combination with other treatments, such as chemotherapy, targeted therapy or radiation therapy. While it has shown promising results in some cases, not all liver cancers respond to immunotherapy. Through ongoing research and clinical trials, scientists continue to explore ways to improve response rates.

liver cancer patient in exam room

Targeted therapy for liver cancer

Targeted therapy involves the use of drugs that specifically target certain molecular pathways or proteins involved in cancer growth and progression. For liver cancer, targeted therapy may be used to inhibit the activity of proteins such as vascular endothelial growth factor (VEGF), epidermal growth factor receptor (EGFR) or mammalian target of rapamycin (mTOR), all of which play a key role in tumor growth, new blood vessel formation (angiogenesis) and metastasis. Drugs such as sorafenib, lenvatinib, regorafenib and cabozantinib are examples of targeted therapy agents approved for treating advanced hepatocellular carcinoma.

Clinical trials for liver cancer

Clinical trials for liver cancer are essential for advancing the standard of care and improving treatment outcomes. These important research studies allow scientists to investigate new therapies, treatment combinations and strategies for managing liver cancer, including surgery, liver-directed therapies such as radiofrequency ablation and transarterial chemoembolization, chemotherapy, targeted therapy, immunotherapy and other novel approaches. Clinical trials may also focus on identifying biomarkers for predicting treatment response, developing personalized treatment plans and improving the understanding of liver cancer biology.

Participation in a clinical trial can provide a patient with access to cutting-edge treatments that are not yet available in other settings, along with an opportunity to contribute to medical knowledge and advancements in liver cancer treatment.

Frequently asked questions (FAQs) about liver cancer treatment

The following FAQs-related articles provide additional information about liver cancer treatment:

Benefit from world-class care at Moffitt Cancer Center

In addition to offering the latest treatment options for liver cancer, Moffitt has been actively involved in liver cancer research for several decades, and we have a robust portfolio of clinical trials. In recognition of our longstanding commitment to scientific leadership, the National Cancer Institute has designated Moffitt a Comprehensive Cancer Center.

If you would like to explore your treatment options for liver cancer with a specialist in our Gastrointestinal Oncology Program, you can request an appointment by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.

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