Treatment Options

Treatment is based on the stage of the tumour; that is, its size and location, how well the liver functions, the amount of scarring, whether it can be removed surgically, and the overall health of the patient. Therapies are classified as curative or palliative. Palliative care is focused primarily on the end of life care and includes pain management, skilled psychosocial, emotional and spiritual support and comfortable living conditions at home, in hospice or in hospital. (Canadian Cancer Society)

Curative therapies include:

  • Partial surgical resection of the liver.
  • Percutaneous ethanol injection (PEI), which consists of injecting concentrated alcohol into the tumour to kill it or to stop it from growing.
  • Radiofrequency ablation (RFA) that results in the removal of the lesion by using a high frequency electrical current (Canadian Cancer Society).
  • Trans-arterial chemoembolization (TACE) that delivers chemotherapy directly into the tumour as well as a substance that leads to a blockage of the blood vessels that supply blood to the tumour. The blood supply is blocked, which causes the cancer cells to die from lack of oxygen and nutrients.  This also keeps the chemotherapy from being washed away from the cancer.
  • Drug Eluting Bead TACE (DEB-TACE) is similar to TACE, but uses tiny beads that block the blood flow to the tumour. Once in place, the beads release chemotherapy which has been placed inside the beads. Radioembolization is a minimally invasive procedure that utilizes tiny glass or resin beads that contain radioactive material.  This is a form of radiation therapy where the beads are implanted inside the tumour, radiating the tumour from the inside while sparing the normal tissue of the liver.  (Radiology Info).
  • Liver transplant is deemed the best curative treatment, with a survival rate of 75% after five years and a recurrence rate of less than 15%.[1]
  • Immuno-oncology is the use of one’s own immune system to attack the tumour cells and destroy them. However, in doing so, it might also affect normal cell structures.[2]

Palliative therapies are those that aim to improve liver function and a patient’s quality of life when other therapies are no longer working.

Palliative therapies include:

  • Targeted therapy using drugs to target specific proteins on the surface of cancer cells, which stops the growth and spread of these cells while living normal cells relatively untouched.
  • External beam radiation therapy, which is used to treat the cancer when it has spread to the bones.
  • Treatment for pain.

[1] Raza, Ali, and Gagan K Sood. “Hepatocellular Carcinoma Review: Current Treatment, and Evidence-Based Medicine.” World Journal of Gastroenterology?: WJG 20.15 (2014): 4115–4127. PMC. Web. 24 Nov. 2017.