Liver Cancer
There are two forms of liver cancer. Cancer that starts in the liver is called
primary liver cancer, or hepatocellular carcinoma (HCC). Cancer that spreads to the liver from
another organ is called
metastatic liver cancer. HCC accounts for most liver cancers, and it occurs more often in men
than women.
Screening
Certain people are at higher risk for developing HCC, including those who
have hepatitis or cirrhosis. The most common causes of liver cancer are
chronic infection with either
hepatitis B or
hepatitis C or
cirrhosis. Cirrhosis is another word for the scar tissue that develops when the
liver has been damaged by long-term infection with hepatitis or alcohol
use. Cirrhosis is not cancer itself, but the presence of cirrhosis greatly
increases the risk for developing liver cancer. In fact, any person with
cirrhosis should undergo screening to check for liver cancer on a regular
basis. Current guidelines recommend an
ultrasound of the liver every six months in patients with cirrhosis.
If an ultrasound shows a suspicious area in the liver, either a CT scan
or MRI is obtained next. These imaging tests can accurately diagnose liver
cancer based on the way it looks and reacts to intravenous dye. Biopsies
are rarely needed to diagnose liver cancer. Although there is no blood
test that can be used to detect liver cancer, a blood test called AFP
(alpha-fetoprotein) can help confirm the diagnosis if the level is high.
Treatments
Partial hepatectomy
In this procedure, the surgeon removes the part of the liver that contains
the mass, as well as a margin of normal healthy tissue. Following surgery,
the remaining liver grows in size to replace the lost volume, restoring
normal function.
Laparoscopic hepatectomy
Many liver resections can be performed laparoscopically, depending on tumor
size and location.
Liver transplantation
In cases where a liver transplantation is the best option, our surgeons
collaborate closely with physicians at nearby transplant centers to facilitate
treatment. All patients are cared for by a closely coordinated multidisciplinary
treatment group.
Radiofrequency/microwave ablation
Ablation is performed using a special probe that burns the cancer in the
liver to destroy it. This technique can be used to treat small tumors
as an alternative to surgical removal or can be used to avoid surgery
in patients who are not candidates.
Transarterial chemoembolization (TACE)
In this procedure, interventional radiologists gain access to the patient's
arterial system via the groin and then advance a catheter into the artery
supplying the liver. Medication and particles are injected directly into
the blood vessel that supplies the tumor in order to destroy it and control
its growth.