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Liver Cancer : Treatment Choices, Part 2
by National Cancer Institute

(Page 4 of 5)

Advanced cancer

Advanced cancer is cancer that is found in both lobes of the liver or that has spread to other parts of the body. Although advanced liver cancer cannot be cured, some patients receive anticancer therapy to try to slow the progress of the disease. Others discuss the possible benefits and side effects and decide they do not want to have anticancer therapy. In either case, patients receive palliative care to reduce their pain and control other symptoms.

Treatment for advanced liver cancer may involve chemotherapy, radiation therapy, or both:

Chemotherapy uses drugs to kill cancer cells. The patient may receive one drug or a combination of drugs. The doctor may use chemoembolization or hepatic arterial infusion. Or the doctor may give systemic therapy, meaning that the drugs are injected into a vein and flow through the bloodstream to nearly every part of the body. The doctor may call this intravenous or IV chemotherapy. Usually chemotherapy is an outpatient treatment given at the hospital, clinic, or at the doctor's office. However, depending on which drugs are given and the patient's general health, the patient may need to stay in the hospital.

Radiation therapy (also called radiotherapy) uses high-energy rays to kill cancer cells. Radiation therapy is local therapy, meaning that it affects cancer cells only in the treated area. A large machine outside the body directs radiation to the tumor area.

Recurrent cancer

Recurrent cancer means the disease has come back after the initial treatment. Even when a tumor in the liver seems to have been completely removed or destroyed, the disease sometimes returns because undetected cancer cells remained somewhere in the body after treatment. Most recurrences occur within the first 2 years of treatment. The patient may have surgery or a combination of treatments for recurrent liver cancer. These are some questions a person may want to ask the doctor before treatment begins:

  • Is there any evidence the cancer has spread? What is the stage of the disease?
  • Do I need any more tests to determine whether I can have surgery?
  • What are my treatment choices? Which do you recommend for me? Why?
  • What are the expected benefits of each kind of treatment?
  • What are the risks and possible side effects of each treatment?
  • Will I need to stay in the hospital?
  • How will you treat my pain?
  • What is the treatment likely to cost? Is this treatment covered by my insurance plan?
  • How will treatment affect my normal activities?
  • Would a clinical trial (research study) be appropriate for me?

People do not need to ask all of their questions or understand all of the answers at once. They will have other chances to ask the health care team to explain things that are not clear and to ask for more information.

Side Effects of Treatment

Because cancer treatment may damage healthy cells and tissues, unwanted side effects often occur. Side effects depend on many factors, including the type and extent of the treatment. Side effects may not be the same for each person, and they may even change from one treatment session to the next. The health care team will explain the possible side effects of treatment and how they will help the patient manage them.

Surgery

It takes time to heal after surgery, and the time needed to recover is different for each person. Patients are often uncomfortable during the first few days. However, medicine can usually control their pain. Patients should feel free to discuss pain relief with the doctor or nurse. It is common to feel tired or weak for a while. Also, patients may have diarrhea and a feeling of fullness in the abdomen. The health care team watches the patient for signs of bleeding, infection, liver failure, or other problems requiring immediate treatment.

After a liver transplant, the patient may need to stay in the hospital for several weeks. During that time, the health care team checks for signs of how well the patient's body is accepting the new liver. The patient takes drugs to prevent the body from rejecting the new liver. These drugs may cause puffiness in the face, high blood pressure, or an increase in body hair.

Cryosurgery

Because a smaller incision is needed for cryosurgery than for traditional surgery, recovery after cryosurgery is generally faster and less painful. Also, infection and bleeding are not as likely.

Percutaneous Ethanol Injection

Patients may have fever and pain after percutaneous ethanol injection. The doctor can suggest medicines to relieve these problems.

Chemoembolization and Hepatic Arterial Infusion

Chemoembolization and hepatic arterial infusion cause fewer side effects than systemic chemotherapy because the drugs do not flow through the entire body. Chemoembolization sometimes causes nausea, vomiting, fever, and abdominal pain. The doctor can give medications to help lessen these problems. Some patients may feel very tired for several weeks after the treatment.

Side effects from hepatic arterial infusion include infection and problems with the pump device. Sometimes the device may have to be removed.

Systemic Chemotherapy

The side effects of chemotherapy depend mainly on the drugs and the doses the patient receives. As with other types of treatment, side effects are different for each patient.

Systemic chemotherapy affects rapidly dividing cells throughout the body, including blood cells. Blood cells fight infection, help the blood to clot, and carry oxygen to all parts of the body. When anticancer drugs damage blood cells, patients are more likely to get infections, may bruise or bleed easily, and may have less energy. Cells in hair roots and cells that line the digestive tract also divide rapidly. As a result, patients may lose their hair and may have other side effects such as poor appetite, nausea and vomiting, or mouth sores. Usually, these side effects go away gradually during the recovery periods between treatments or after treatment is complete. The health care team can suggest ways to relieve side effects.

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About the Author

www.nci.nih.gov
The National Cancer Institute's research programs are extensive and contain many innovative initiatives. I invite you to explore our Web site to find out more about the exciting work being conducted here at NCI and by NCI-supported scientists throughout the country.

More by National Cancer Institute
  In this article
» Liver Cancer: What You Need To Know
» Diagnosis, Staging, Treatment
» Treatment Choices
» Treatment Choices, Part 2
» Treatment Choices, Part 3
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