The treatment of HCC often requires the expertise of multiple medical professionals. Your care may consist of a multidisciplinary team that includes an oncologist, gastroenterologist, hepatologist, interventional radiologist, radiation oncologist, surgical oncologist and transplant surgeon.
Potentially Curative: Surgery and Radio Frequency Ablation (RFA)
- Liver transplant: In this surgery, a donor provides a new or partial liver to replace the diseased liver in another person. This complicated procedure is usually recommended for Very Early Stage patients. Sometimes other treatments will be administered pretransplantation in order to shrink tumors. It is possible for tumors to recur in the liver or outside the liver.
- Resection: This surgery involves the removal of damaged tissue or entire portions of the liver. Many patients are not candidates for resection. Similar to liver transplantation, other treatments
may be administered before resection to shrink tumors.
- RFA: This treatment uses image guidance to place a needle through the skin into a liver tumor. High-frequency electrical currents pass through an electrode in the needle, creating a small region of heat that destroys the liver cancer cells.
Ablation destroys cancer cells with minimally invasive, local and variable techniques. Ablation treatments are often used when surgery is not an option and are most beneficial in patients with smaller tumors.
Embolization damages cancer cells by delivering toxic agents through the hepatic artery to the cancerous area. The goal is to block the tumor’s blood supply and thereby stop its growth.*
- Transarterial Chemoembolization (TACE) or bland Transarterial Embolization without chemotherapy (TAE): This treatment administers chemotherapy drugs into the liver tumor through the hepatic artery. This procedure is usually beneficial in patients who have tumors limited to the liver. TACE can be used to decrease the size of tumors to make surgical options possible.
- Selective Internal Radiation Therapy (SIRT): This treatment consists of microscopic glass beads filled with radioactive elements. Injected through the hepatic artery, the
beads deliver radiation directly to the liver tumors. SIRT is also known as SIR-Spheres®, TheraSphere®, Yttrium 90, Y90 and brachytherapy.
Systemic Therapy controls cancer cells and prevents the production of new cancer cells. Systemic therapies may be administered by mouth (e.g., pills) or through the vein. Patients taking such therapies may experience side effects.*
- Chemotherapy is the classic form of systemic therapy used to treat cancer. Sometimes, people use the words chemotherapy and systemic therapy interchangeably, which is incorrect. The role of chemotherapy in treating HCC is very limited. Chemotherapy is not an approved form of systemic therapy for HCC except in a few countries.
- Targeted Therapy is a form of systemic therapy that targets or attaches a specific or collection of genetic changes that may imposed in the cancer. There are several targeted therapies already approved for the treatment of HCC.
Immunotherapy works by activating your immune cells against the cancer in your body. The FDA has approved some immunotherapies for HCC.
Drugs for advanced liver cancer and their corresponding patient assistance programs
Drug company: Exelixis
Drug company: Eisai
Nexavar (sorafenib) Tablets*
Drug company: Bayer
Drug Company: Bristol-Myers Squibb
Stivarga (regorafenib) Tablets*
Drug Company: Bayer
*Indicates a palliative treatment, which is designed to provide relief but not a cure.
© September 2019