Liver cancer : Treatments and drugs 2011

Treatments for primary liver cancer depend on the extent (stage) of the disease as well as your age, overall health and personal preferences.

The goal of any treatment is to eliminate the cancer completely. When that isn't possible, the focus may be on preventing the tumor from growing or spreading. In some cases only comfort care is appropriate. In this situation, the goal of treatment is not to remove or slow the disease but to help relieve symptoms, making you as comfortable as possible.

Liver cancer treatment options may include:

• Surgery to remove a portion of the liver. Your doctor may recommend partial hepatectomy to remove the liver cancer and a small portion of healthy tissue that surrounds it if your tumor is small and your liver function is good.
• Liver transplant surgery. During liver transplant surgery, your diseased liver is removed and replaced with a healthy liver from a donor. Liver transplant surgery may be an option for people with early-stage liver cancer who also have cirrhosis.
• Freezing cancer cells. Cryoablation uses extreme cold to destroy cancer cells. During the procedure, your doctor places an instrument (cryoprobe) containing liquid nitrogen directly onto liver tumors. Ultrasound images are used to guide the cryoprobe and monitor the freezing of the cells. Cryoablation can be the only liver cancer treatment, or it can be used along with surgery, chemotherapy or other standard treatments.
• Heating cancer cells. In a procedure called radiofrequency ablation, electric current is used to heat and destroy cancer cells. Using an ultrasound or CT scan as a guide, your surgeon inserts several thin needles into small incisions in your abdomen. When the needles reach the tumor, they're heated with an electric current, destroying the cancer cells.
• Injecting alcohol into the tumor. During alcohol injection, pure alcohol is injected directly into tumors, either through the skin or during an operation. Alcohol dries out the cells of the tumor and eventually the cells die.
• Injecting chemotherapy drugs into the liver. Chemoembolization is a type of chemotherapy treatment that supplies strong anti-cancer drugs directly to the liver. During the procedure, the hepatic artery — the artery from which liver cancers derive their blood supply — is blocked, and chemotherapy drugs are injected between the blockage and the liver.
• Radiation therapy. This treatment uses high-powered energy beams to destroy cancer cells and shrink tumors. During radiation therapy treatment, you lie on a table and a machine directs the energy beams at a precise point on your body. Radiation side effects may include fatigue, nausea and vomiting.
• Targeted drug therapy. Sorafenib (Nexavar) is a targeted drug designed to interfere with a tumor's ability to generate new blood vessels. Sorafenib has been shown to slow or stop advanced liver cancer from progressing for a few months longer than with no treatment. More studies are needed to understand how this and other targeted therapies may be used to control advanced liver cancer.

Alternative treatments may help control pain in people with advanced liver cancer. Your doctor will work to control pain with treatments and medications. But sometimes your pain may persist or you may want to avoid the side effects of pain medications.

Ask your doctor about alternative treatments that may help you cope with pain, such as:

• Acupressure
• Acupuncture
• Deep breathing
• Listening to music (music therapy)
• Massage