While liver cancer is not among the most common types, according to the American Cancer Society, the number of cases in the United States has been increasing in recent years. As this cancer attacks the organ responsible for breaking nutrients and toxins down in the body, being diagnosed can be scary, but you do have treatment options to explore.
Treatment options for liver cancer vary by the stage the cancer is in. If you have Stage 1, which is the earliest stage of this disease, or Stage II but your liver is still healthy, you may be be able to have a surgery known as partial hepatectomy. This option, unfortunately, is limited to the smallest number of cases each year, but it can cure some patients. The size of the tumor and whether vessels nearby are affected impact the outcome of this surgery. When a tumor is large or has invaded blood vessels nearby, it's more likely that the tumor will return or spread to somewhere else after the surgery is done. Naturally, your overall health is another factor--as with any surgery--and for some people, a liver transplant may be the better choice. This is particularly true if the liver itself is damaged in many areas. Currently, there are clinical trials being done to determine if combining a partial hepatectomy with other treatment methods will provide a better outcome for patients.
An unresectable cancer means the disease hasn't spread to another places in the body or your lymph nodes, but it's not able to be removed safely with the partial hepatectomy. A person whose tumor is too big may not be able to have the surgery, just like someone whose tumor has spread across the liver or is in a place that makes it difficult to remove, such as by a large blood vessel. At this stage of the disease, you may be able to try embolization. This is a procedure in which the blood flow to the tumor is interrupted to delay its growth. There's also ablation, during which high-energy radio waves are applied to the tumor to destroy cells. Other options include chemotherapy, targeted therapy and radiation. For some people, the tumor may shrink enough with these treatments so that a transplant or partial hepatectomy become a real possibility.
If your liver cancer has spread to your lymph nodes or other parts of your body, you still have options. When a cancer is widespread, it can't be treated with surgery, but there are other liver cancer treatment methods you can try. If your liver is still able to function moderately well, your doctor may recommend a targeted therapy drug that can control the cancer growth and extend your life. Other newer targeted therapies that are still in clinical trials could be another option, as well as newer methods of radiation therapy.
When liver cancer returns after treatment, it's known as "recurrent." It can be local, which means it's in or near the place it was originally, or distant, which means it has spread elsewhere. When cancer returns after treatment, the options available depend on many things, including which type of treatment was used before, where it has come back and what the function of your liver is. If it's local and it appears it can be removed surgically, further surgery may be a choice you have. Other treatments such as embolization or ablation could be on the table. With a widespread cancer, targeted or chemotherapy are the two common treatment options.
Your doctor will review all of your treatment options, along with your medical history and current records, to make recommendations on how to proceed with your liver cancer care. Make sure you fully understand all the treatment avenues available to you, including the risks, side effects and most likely outcomes. It's important to take the time to make this decision, as it will have an impact on your outcome and life post-treatment.