Primary Liver Cancer (Hepatocellular Carcinoma) Treatment

These cancers start in hepatocyte cells and make up the majority of cases of primary liver cancer. They can begin as a single tumor or as multiple spots in the liver.

This is a rare subtype that is associated with more successful treatment outcomes than other liver cancers.

Approximately 10-20% of all liver cancers begin in the bile ducts; they are treated the same way as HCC.

These fast-growing cancers begin in blood vessels in the liver.

The main treatment for primary liver cancer is surgery, involving a partial and highly selective resection. Skilled surgeons must operate in a way that removes enough of the tumor to treat the cancer, but leaves enough of the liver to preserve its ability to function. Sometimes, surgery cannot be performed, because of the tumor’s location within the liver, advanced cirrhosis and liver failure, or the spread of the tumor outside the liver.

This innovative treatment involves inserting a needle into the center of the tumor, which guides strong radio waves to heat the cancer cells up to 100°C, thereby destroying them. Ultrasound or CT is used to guide the needle precisely. Ablation works directly and locally, without causing damage to nearby healthy tissue. Done under local anesthesia, this therapy can be used to eradicate smaller tumors that do not have a diameter greater than 5cm or when the patient is not a good candidate for surgery.

During this therapy, a catheter is inserted into the artery of the liver and chemotherapy is administered directly into the artery that is feeding the tumor. Afterwards, the artery is blocked, which results in necrosis of the cancer. The combination of administering chemo and blocking the artery increases the total effectiveness of the therapy. Local anesthesia and x-ray are used, and chemoembolization can be repeated a few times, if necessary.

Another method of this therapy injects beads that are filled with chemotherapy drugs into the liver artery, thereby reaching the tumor directly.

While chemoembolization is regarded as life-prolonging, it does not cure the cancer. This treatment may be used for cases of primary liver cancer that are not appropriate for surgery or ablation.

SIRT involves injecting small glass pellets coated with yttrium-90 (a radioactive substance; a source of beta-radiation) into the hepatic artery. These little balls get stuck in the small blood vessels of the tumor, resulting in localized irradiation and necrosis of the tumor. Using this method, a large dose of radiation is concentrated in the tumor without damaging healthy liver tissue.

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Growth inhibitors can be given to a patient with advanced primary liver cancer in which the cancer has become metastatic; these drugs affect the tumor’s ability to develop and grow. The oral drugs come in pill form and are administered as a single treatment. This therapy helps to prolong life and is generally used when other treatment options (as listed above) are unsuitable.