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Finding out You Have Liver Cancer: Making Treatment Decisions

separator Your liver is the largest internal organ in your body. It’s inside your rib cage, in the upper right side of your abdomen. It has a right lobe and a left lobe, and the right lobe is largest. The main functions of the liver include

  • Filtering toxins (harmful substances) out of the blood
  • Processing and storing nutrients absorbed in the intestine
  • Making bile, which allows you to digest fats in food
  • Storing sugar (also called glycogen), which the body uses for energy

In this article, we’ll discuss primary liver cancer, which begins in the liver itself.

Risk factors for liver cancer
Risk factors for liver cancer include

  • Having hepatitis B or C
  • Having cirrhosis
  • Eating foods contaminated with aflatoxin, which is a poison that comes from a fungus that can grow on foods, such as grains and nuts, that have not been stored properly. (This is less common in the U.S.)

Deciding on your treatment
You and your doctor will base your treatment for liver cancer on the stage of the disease—the size of the tumor, whether it has spread and what parts of the liver it affects—how well your liver is working and the general state of your health.

  • Surgery
    Currently, as a rule, surgery is the only way that doctors can cure liver cancer. If the surgeon can remove the entire tumor, chances of survival are highest. Unfortunately, many times it’s not possible to remove all of the cancer. This can be because the tumor is too large, or it’s located in too many different areas of the liver or because the cancer has spread to other parts of the body. And if cirrhosis of the liver is present, there may not be enough healthy tissue to make surgery an option.  Other types of surgery include ablation or embolization. During ablation, a tumor is destroyed by using high-energy radio waves, by freezing it or by directly injecting alcohol into the tumor, which can kill cancer cells. During embolization, surgeons tie the artery that supplies blood to the tumor. Embolization can also reduce blood supply to normal liver tissue, so it’s not always a good option for people who have hepatitis or cirrhosis.
  • Radiation
    Radiation therapy is sometimes used in liver cancer, but it can damage other parts of the liver, so higher doses are not useful. Sometimes, doctors use radiation in combination with chemotherapy. And in some cases, doctors can use a newer type of radiation that employs a computer to “map” the precise location of the tumor. In these cases, the radiation is aimed more specifically at the tumor itself. Higher doses can be used because damage to surrounding tissue is minimized.

When your doctor talks with you about your treatment options, be sure to ask the following questions:

  • Has my cancer spread farther than my liver? If so, what treatment options are best for me?
  • What are the goals of each treatment?
  • What are the side effects of these treatments?
  • What are the risks?
  • What do you think my chances for survival are?

New treatments are in development
The difficult thing about a diagnosis of liver cancer is that very often, tumors have reached a more advanced stage and are not easy to remove completely. Treating liver cancer is complex, but the important thing to remember is that researchers are always searching for new ways to treat it. In fact, there’s great promise in a new treatment that increases life expectancy for people with the disease. Doctors insert a drug—a combination of a fatty liquid made from poppy seed oil plus a radioactive isotope called I-131—directly into the liver via an incision in the abdomen. The radioactivity is released locally into the tumor. Clinical trials in the U.S. are expected to begin soon.

If you have liver cancer, always keep in mind that every single case is different. Do everything you can to keep yourself feeling as well as possible during your treatment. Ask your doctor or a dietitian about the kind of food that will be most beneficial for you. Consider learning some kind of relaxation technique, such as meditation or guided imagery.

Anything that will make you feel more comfortable and more relaxed is worth exploring now. Because the less anxiety you feel, the better of you’ll be as you focus on treating your disease.

The American Cancer Society; The National Cancer Institute;
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