Treatment of Liver Cancer - By Stages

The liver is the second largest organ of the body and liver disease is the 10^th most common reason for death in India. The liver is also an essential organ of the body that is responsible for the metabolism and the production of important enzymes and hormones that coordinates the important functions of the body. In recent times we have seen an increasing incidence of Liver Cancer cases. These cases are majorly categorized as potentially resectable or transplantable, unresectable, inoperable with the only local disease, and advanced.

Potentially resectable or transplantable liver cancers (stage I and some stage II tumors)

Potentially resectable: If the cancer is early stage and the rest of the liver is healthy, a surgery called partial hepatectomy may help in a cure. Only a small number of people with this liver cancer are in this category. An important factor affecting the outcome of the surgery is the size of the tumor(s) and if the nearby area or blood vessels are affected or not. Larger tumors invade blood vessels present nearby and are more likely to come back in the liver or spread elsewhere after surgery.

Potentially transplantable: If the cancer is in the early stage, but the rest of the liver is not in a healthy stage, than liver transplant can be an option for the treatment. The liver transplant can also be a better option if the tumor is in a part of the liver that makes it hard to remove like large blood vessel which is nearby. Patients with the liver transplant might have to wait for a longer time for a liver to become available. While the patient is waiting, they are often given other treatments like ablation or embolization, to keep a track on disease.

Unresectable liver cancers: Unresectable type of cancers haven’t spread to lymph nodes or to the distant sites, but this cancer can’t be removed safely through the surgery. The reasons may be:

• Size of the tumor is too large.
• Presence of tumor on the site of the liver which makes it hard to remove
• Spread of tumor throughout the liver

Other treatment options can be targeted therapy, immunotherapy, and chemotherapy or radiation therapy. In some patients, these treatments may shrink the size of the tumor(s) so that surgery may become possible.

These treatments won’t cure cancer, but they can reduce symptoms and may even help the patient live longer.

Inoperable liver cancers with only local disease: These type of cancers are not in big size and in the right place to be removed but the patient is not healthy enough for surgery. Treatment options include ablation, embolization, or maybe both for the liver tumor(s). Other options may also include targeted therapy, immunotherapy, chemotherapy, and/or radiation therapy.

Advanced liver cancers: Advanced liver cancer has spread either to the lymph nodes or to other organs. Because these type of cancers are widely spread and cannot be treated through surgical option.Treatments such as radiation might also be used to help to relieve the pain and other symptoms.

Recurrent liver cancer: Cancer that comes back after treatment also is called recurrent. Recurrence can be of two types and can be local or distant i.e. It may spread in or near the same place it started or spread to organs such as the lungs or bones etc. Treatment of the recurrent liver cancer depends on many factors such as part of the body where it comes back, the type of initial treatment, and how well the liver is functioning. Some patients who have localized resectable type of cancer might be eligible for further surgery or local treatments.