The most common type of primary liver cancer is hepatocellular carcinoma, which starts in the main type of liver cell (hepatocyte). This form of the disease accounts for nearly all cases of liver cancer. Other forms, such as intrahepatic cholangiocarcinoma, start in the bile ducts or other parts of the liver and are less common.
Liver cancer often spreads to other organs in the abdomen, including the lungs and stomach. If your cancer is advanced and has spread beyond the liver, you may be referred to an experienced team at another center for more treatment options.
For people with secondary liver cancer, a special type of radiation called stereotactic body radiation therapy (SBRT) may be used to treat a single large or several small tumors. During this treatment, you lie very still on a table while a machine directs beams of radiation from many angles to the tumor site. Using imaging tests, such as CT scans or MRI, the radiation oncologist can accurately target the cancerous cells and spare surrounding liver tissue.
During SBRT, you may receive up to five treatments over the course of one or two weeks. Prior to treatment, you’ll have a CT scan and an MRI to help doctors determine the best treatment plan for you. Your doctor may also insert tiny markers into the area of your liver near the tumor to guide the SBRT machine and keep the tumours from moving during treatment.
Another treatment option is to block the blood supply to the tumour through a procedure called embolization or radioembolization. During embolization, your doctor injects particles that are designed to decrease the flow of blood to the tumour or plug its blood supply, while a different blood vessel provides nourishment to the healthy liver cells.
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For some liver cancers, doctors use targeted therapy to stop them growing or spreading. These drugs are specially designed to target specific proteins on cancer cells, or the genes they contain. They may be used alone or in combination with other treatments.
Scientists have developed many targeted therapies. Some are available in pill form, and others are given by injection or intravenous (IV) drip. They are usually given in a hospital or clinic, and may be used alone or together with surgery and radiation therapy.
Some types of targeted therapy prevent a cancer from growing new blood vessels that supply it with oxygen and nutrients. This is called anti-angiogenic therapy. These medicines include monoclonal antibodies that target a protein found on some cancer cells (e.g., trastuzumab, cetuximab) and small-molecule drugs that enter cells to interfere with their functions, such as tyrosine kinase inhibitors (imatinib, Osimertinib).
Other targeted therapies block the growth of cancer cells by stopping signals that help them grow or spread. They can also starve cancer cells of hormones they need to survive or kill them directly. Some are monoclonal antibodies that act like immunotherapy to allow your immune system to attack cancer cells, such as ipilimumab and nivolumab.
A small number of targeted therapy medicines cause side effects, which vary from person to person. Common ones include tiredness, itching and rash on the palms and soles of your feet (hand-foot syndrome), headaches, nausea and diarrhoea. Some can cause high liver enzymes, damage the heart muscle or increase your sensitivity to sunlight.
Targeted therapy isn’t suitable for all cancers. If your cancer is localized unresectable or has spread to other parts of the body, it may be better to have surgery, radiotherapy or chemotherapy instead. Your doctor will discuss which treatment is best for you. They will take into account the stage of your cancer, whether it is early or advanced, and your general health. They will also talk to you about how targeted therapy works and the chances of success. They might recommend genetic testing to find out if your tumour has the right targets for targeted therapy.
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The liver removes harmful substances from your blood, produces enzymes and bile that help digest food, and turns fat, protein, and carbohydrates into nutrients for your body. Cancer is uncontrolled growth of abnormal cells that may affect the liver or spread to other parts of the body. There are two types of liver cancer: primary, which starts in the liver; and secondary, which spreads to the liver from another part of the body.
Embolization (em-BOL-i-zay-shun) is a procedure done by interventional radiologists to treat tumors or vascular malformations that can’t be removed surgically or would be difficult to remove surgically. The procedure is less invasive than surgery and has fewer complications. It also results in less blood loss and does not require a hospital stay.
During this procedure, an interventional radiologist guides a thin, hollow tube called a catheter into the blood vessel that supplies the area of the tumor or vascular malformation. Then, using x-ray pictures to guide the catheter, he or she puts a small amount of liquid tissue adhesives or plugging objects into the blood vessel to block it.
A special type of embolization procedure is used to treat hepatocellular carcinoma and chole duct cancer (cholangiocarcinoma). During this treatment, doctors put gelfoam or small beads into the arteries that supply the tumor or vascular malformation. They also insert a soft metal coil into the hepatic artery to clog or block it.
לפני ההליך, רופא ישאל אותך על בריאותך ותסמיני העבר שלך. לאחר מכן תיעשה בדיקה גופנית. תיעשה גם בדיקה לבדיקת תפקודי הכבד שלך. רמת וירוס הפטיטיס B שלך תיבדק. לבסוף, תילקח בדיקת דם לחיפוש סמן סרטן בשם אלפא-פטופרוטאין (AFP). רמות גבוהות של AFP בדם יכולות להיות סימן לסרטן או למצבים מסוימים שאינם סרטניים, כגון שחמת הכבד והפטיטיס.
כדי לברר אם הסרטן שלך נמצא בחלקים אחרים של הכבד או באיברים אחרים, ייעשו בדיקות אחרות. אלה כוללים:
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Your doctor will want to find out how far the tumor has grown, a process called staging. This will help your doctor determine your treatment options.
You may need surgery to remove the cancer and a margin of healthy liver tissue. You might also need a liver transplant. Ablation treatments that use heat or cold to destroy cancer cells are another option.
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Surgical removal (resection) of the tumor is an important treatment for primary liver cancers. If a tumor is small and confined, this surgery can cure the patient. If a tumor is very large or has spread, it’s harder to treat with surgery alone. It’s often treated with a combination of therapies. Surgery may be followed by chemotherapy, using heat to destroy cancer cells (ablation), targeted medicines and radiation therapy. The combination of treatments works best for many people.
Depending on the type of cancer and how well the liver is working, surgeons can remove all or part of the liver. The most common type of primary liver cancer is hepatocellular carcinoma, or hepatoma. Hepatomas start in the hepatocytes, which are the main liver cells. Some hepatomas grow slowly and are found only in one area of the liver. Others grow quickly and are found all over the liver.
If hepatomas are found in the early stages, they can be removed with few complications and have good survival rates. However, the five-year survival rate for hepatomas that have spread to other parts of the body is much lower.
A hepatocellular carcinoma that has spread to other parts of the body is called secondary liver cancer or metastatic disease. Several types of cancer can spread to the liver, including lymphoma and leukemia, as well as cancers from the lungs, breasts, pancreas, and stomach.
In some cases, the doctors at City of Hope can remove the primary liver cancer and metastases in a single operation. This results in shorter hospital stays and less blood loss compared to removing them separately.
Minimally invasive surgery can also help improve the survival of people with hepatocellular carcinoma who have cirrhosis or biliary tract abnormalities. In some patients, doctors can use a technique called portal vein embolization to block blood flow to the area of the liver with the cancer. This helps to shrink the cancer and prevent it from growing or spreading, and can be used in conjunction with a liver resection. In addition, the surgery team can perform laparoscopic surgery, which uses smaller incisions and allows for faster recovery and fewer complications.
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The liver is a large organ in your abdomen that makes proteins to help your blood clot and removes harmful substances from the body. Cancer starts in the liver cells and can spread to other parts of the body. Radiation may be used to destroy cancer cells or to control symptoms when surgery isn’t possible or hasn’t helped.
You’ll lie still on a treatment table while a machine focuses beams of radiation at a precise point in your body. You may need several sessions over one or two weeks. A specialized type of radiation, called stereotactic body radiotherapy (SBRT), precisely targets multiple beams of radiation at the same time and spares surrounding tissue. This procedure is often more effective than standard external beam radiation therapy and may require fewer sessions.
Radiation is also used in combination with other treatments to reduce the size of a tumor and kill cancer cells. For example, if you have a liver tumor that is causing bile to back up into your esophagus or gallbladder, your doctor might recommend an operation to remove the gallbladder and use radiation to destroy any remaining cancerous cells in the liver.
Your doctor can find the location of a tumor in your liver with imaging tests, such as abdominal ultrasounds or CT scans. These images produce detailed pictures of your abdomen and can help doctors spot a tumor’s shape, size, location, and whether it has spread to other tissues. They can also identify the cause of your liver cancer, such as a genetic mutation or an infection. You may need a biopsy to confirm the diagnosis.
For small primary liver tumors, your doctor may recommend a non-surgical procedure to shrink them or stop them from growing. These procedures use heat or extreme cold to destroy cancer cells. They are usually done as outpatient procedures and have shorter hospital stays than surgeries. Examples include radiofrequency ablation, which uses electric current to heat and destroy tumors, and cryoablation, in which your doctor places an instrument containing liquid nitrogen directly onto the liver tumors using imaging guidance.
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A cancer cell needs specific molecules to survive, multiply and spread. A targeted therapy drug attacks these molecules or the genes that create them. This stops the cancer cells from working and stops them from spreading.
Doctors use a special type of targeted therapy to treat some types of liver cancer, such as hepatocellular carcinoma (HCC). Doctors may also use targeted therapies to prevent or delay the recurrence of a tumor after other treatments have worked.
One of the main targeted therapies for HCC targets a protein that helps cancer cells grow and divide. Another targeted therapy blocks a chemical that encourages cancer cells to form new blood vessels. These drugs stop the growth of cancerous tissue and cut off its supply of nutrients.
Other targeted therapies work to change how DNA is made, so that the cancer cells die or are unable to grow. They may also prevent the formation of blood vessels that cancerous cells need to live.
Some of these medications are given by mouth, while others are delivered directly into the liver via a catheter or tube placed in the hepatic vein. Some are part of a combination therapy with surgery or radiation, while others are used alone.
Before you have some targeted therapy drugs, doctors test some of your cancer cells or blood to see if the mutations that cause the cancer are present. You may need to have additional tests, such as a hepatitis B or C test, before you begin treatment.
Depending on the targeted therapy you have, side effects may include nausea, vomiting, fatigue, mouth sores or rashes. You may need to drink extra fluids to help prevent dehydration. Some targeted therapy medications can thin your blood, increasing the risk of a blood clot. You should tell your doctor if you have any redness, swelling or pain in the calf of your leg, or if you notice any blood in your stool or urine.
Immunotherapy is a new type of treatment that uses your body’s own immune system to find and destroy cancerous cells. It can be used to treat some forms of liver cancer, such as hepatocellular tumors or non-small cell lung cancer.
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The liver is a blood-rich organ located in the upper right side of your abdomen. It helps digest food, makes proteins that help your blood clot and cleans the blood by removing harmful substances. When cancer starts in liver cells, it can spread to nearby tissues and destroy them. Cancer that begins in other areas of the body and then spreads to the liver is called metastatic disease.
There are several tests that can help diagnose liver cancer. These include blood tests, ultrasounds and CT or MRI scans that show the size of a tumor and whether it has spread to other parts of your body. Your doctor may also recommend a biopsy to confirm a diagnosis of liver cancer or to find out the stage of your cancer (how serious it is).
A liver biopsy involves inserting a thin, flexible tube with a camera through a small incision in your belly. The camera lets your doctor see the inside of your liver. Your doctor might also perform a laparoscopic biopsy, which is similar but allows your doctor to remove a small piece of tissue for examination. If you have a cancer that has spread to the liver, your doctor may order additional tests to find out the type and stage of the cancer.
Liver embolization is a treatment that can help treat some types of liver cancer. During this procedure, your doctor will inject small, gel-like particles into an artery that supplies blood to the liver. This blocks the flow of blood to the tumor and starves it of nutrients, which can kill the cancer cells. Your doctor might also inject chemotherapy drugs or tiny beads that release radiation into the hepatic artery to destroy the cancer cells. These are known as transarterial chemoembolization (TACE) or radioembolization (TARE).
You will receive sedation through an intravenous (IV) line before the procedure begins. Depending on the type of embolization, you might need to stay overnight in the hospital or you might be able to go home the same day. This procedure is performed by a specialist called an interventional radiologist who is trained to perform minimally invasive treatments.
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Liver cancer can be diagnosed by a physical exam and blood work, including measuring the levels of alpha-fetoprotein (AFP). Imaging tests such as an ultrasound, CT scan or magnetic resonance imaging (MRI) may also be done.
Doctors can use a procedure called chemoembolization to kill cancer cells in the liver. In this treatment, a physician puts a catheter into an artery in your groin and guides it into your hepatic artery.
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The liver removes harmful substances from your blood, produces enzymes that digest your food and help you grow and develop. Cancer occurs when cancerous (malignant) cells grow out of control and start to destroy healthy liver tissue. The type of cancer you have, where it started and how far it has spread will determine what treatment options are available to you.
Your specialist will recommend the best treatment for you based on a number of factors including how advanced your cancer is, whether it has spread and your symptoms. You will have regular check-ups during your treatment, and you will need to have certain tests and scans.
Chemotherapy uses drugs to kill cancerous (malignant) cells. It can be given as tablets, creams or a liquid and is usually given at a hospital or a cancer treatment center. It may be given before or after surgery, or used with other types of treatments such as radiation therapy or ablation.
Other methods to destroy cancerous cells use heat, cold or targeted medicines. These can be delivered through a thin tube called a catheter that is put into a blood vessel in your liver. Alternatively, radiation can be directed at the cancer using a specialized technique known as stereotactic body radiotherapy.
You may also be able to take part in a clinical trial of a new treatment or test. These studies are designed to improve existing treatments or find better ones. Your specialist or GP will be able to advise you about trials that are suitable for you.
The goal of treatment for some people with advanced liver cancer is to control their symptoms and help them live longer. This is called palliative care. If your doctor decides that the cancer cannot be cured, they will refer you to a team of doctors and nurses who specialise in palliative care. The doctors and nurses will work with you and your family to help ease your pain and discomfort. This treatment is usually delivered alongside curative treatments and can be stopped whenever you want to. You will have regular visits with a doctor or nurse and may need to have blood tests and other tests and scans.
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Medications used in targeted therapy can affect the way the cancer cells grow and can help prevent them from spreading. The drugs may be given by mouth (pills or capsules) or intravenously (directly into a vein).
The type of targeted therapy you receive depends on the genetic changes found in your tumor and the kind of cancer you have. Your healthcare provider will test your blood and tissue from a biopsy to find out whether you have the right genes to get the best results from this treatment.
To identify liver cancer, your doctor can order a blood test to measure a protein called carcinoembryonic antigen (CEA). The protein is released by malignant (cancerous) cells and is normally found in low levels in the body. High levels of CEA indicate that the cancer is growing rapidly. Your doctor can also check for a protein in the blood called alpha-fetoprotein (AFP), which is usually produced in fetuses but is also present in some types of liver cancer. AFP is not as reliable as CEA in diagnosing liver cancer, but it may be useful in detecting certain cancers and in monitoring the effectiveness of treatment.
If you have a small or early-stage liver cancer, you can often be treated with surgery to remove part of the liver. This is usually done in a specialist centre. You will need to stay in hospital for several days and will be given chemotherapy or a targeted cancer drug before and after surgery.
You may need a more aggressive treatment if you have a large tumor or advanced stage cancer. This may include taking a medicine that slows the growth of new cancer cells, such as methotrexate or doxorubicin. You may also be given a drug that stops the cancer from getting oxygen, such as bevacizumab or nivolumab.
If the cancer has spread to other parts of your body, you may be given radiation or a drug that targets the protein that helps it grow. These are sometimes called immunotherapies. They work by helping the immune system recognize and attack cancer cells.
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The blood vessels that supply a tumor or other area of tissue are sometimes blocked to stop bleeding and prevent the growth of new cancer cells. This is called embolization. Embolization is a procedure done by an interventional radiologist (an interventional radiology specialist). Using x-ray images to guide them, the radiologist threads a thin tube (catheter) into the abnormal artery or vein. A smaller tube (catheter) inside the first catheter is used to inject a special medicine (an embolic agent) or tiny plugging materials, such as gelatin sponges or beads, into the artery or vein to block it.
In some cases, the radiologist may add chemotherapy drugs or radiation to the treatment. This is called chemoembolization or radioembolization.
Before your child has the procedure, they will change into a hospital gown and have an intravenous line put in a vein (IV) in their arm or hand. Then they will get medicine through the IV that makes them sleepy. The radiologist will make a small cut in your child’s thigh near the crease (the groin). A catheter is put into the femoral artery (a large blood vessel in the groin). A second catheter is placed into the hepatic artery, which supplies the liver. A small amount of chemotherapy drug is mixed with lipiodol and injected into the hepatic artery to block the flow of blood to the tumor.
After the chemoembolization is done, the radiologist will use a third catheter to inject more drugs or tiny metal coils into the hepatic artery to further block the flow of blood. He or she will then look at the hepatic artery with an imaging test to check the results.
MRI and CT scans can also help find the location of cancerous tissues in the liver and determine whether it is a primary tumor or has spread to other parts of the body. Other tests may include a physical exam and a blood test to check the level of a substance in the body called alpha-fetoprotein (AFP). High levels of this protein can be a sign of cancer in the liver.
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Liver transplantation is a procedure where your liver is surgically removed and replaced with a healthy donor liver. This is used to treat hepatocellular carcinoma (HCC) and severe hepatic dysfunction, including cirrhosis of the liver, when other treatments are not possible or are not tolerated. Liver transplantation is also an option for cancer that has spread to the liver from another part of the body, such as metastatic colon cancer.
Hepatocellular carcinoma makes up the majority of cases of liver cancer, although other types of cancer can also occur in the liver. In general, HCC is associated with chronic long-term liver inflammation and scarring caused by hepatitis C infection; nonalcoholic fatty liver disease; alcohol induced liver fibrosis; and metabolic dysfunction such as obesity or type 2 diabetes. These conditions increase the risk of hepatocellular carcinoma, as well as other complications like cirrhosis and hepatitis B virus recurrence.
A blood test called alpha-fetoprotein (AFP) may be performed to detect HCC or a condition that leads to it, such as hepatitis B or C infection, cirrhosis or biliary duct obstruction. Imaging tests, such as ultrasound, computed tomography (CT) scan or magnetic resonance imaging (MRI) of the abdomen, may also reveal tumors and indicate whether a person has advanced HCC.
In addition, a doctor may order a liver biopsy to examine a tissue sample for cancer cells. A doctor can take a biopsy using a needle guided by ultrasound, CT or MRI, or with a laparoscope, which is a thin tube with a camera and surgical instruments that is inserted through a small incision in your stomach.
After you have a liver transplant, you will need to be on medications to prevent organ rejection. These medications suppress your immune system so your body doesn’t attack the new organ. Your doctors will monitor you closely for signs of rejection, such as infections and a decrease in your blood cell count. They will prescribe additional medication if needed.
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Liver cancer occurs when your liver cells grow and divide uncontrollably. The cancer may be primary or secondary (metastasized from another part of the body).
To diagnose liver cancer, your doctor will order blood tests and imaging tests, such as an ultrasound, CT scan or MRI. Your doctor may also perform a biopsy to remove a tissue sample for testing.
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The liver is the largest internal organ in your body. It makes bile, a fluid that helps you digest food and removes waste from your blood. It also makes proteins that help your blood clot and stop bleeding from cuts. Cancer forms when liver cells start to grow out of control and form a tumour. Liver cancer can spread to other parts of the body, including other livers and blood vessels.
Most cancer that affects the liver starts in the liver (primary). But it’s more common for other types of cancer to spread to the liver from another part of your body. This is called secondary liver cancer. Most people who have secondary liver cancer have a type of cancer that started in the colon, breast or ovaries. Other cancers that can spread to the liver include lung and melanoma cancers.
Signs and symptoms of liver cancer can vary from person to person. Some people with liver cancer don’t have any signs or symptoms, but others may have nausea and vomiting, abdominal pain, tiredness and loss of appetite. The skin and eyes may look yellow, a condition called jaundice. Other symptoms can be fullness or a knot under the ribs on the right side, or a feeling of being sick after eating.
Liver cancer can be found by doing a blood test or an ultrasound scan of your abdomen. A doctor can then use a needle to take a sample of tissue for examination under a microscope. This is known as a biopsy. You may have a fine-needle aspiration, in which the doctor uses a thin needle to remove a tiny amount of tissue from your liver; or you may have a surgical biopsy, in which the doctor inserts a laparoscope into your stomach and takes a larger sample of tissue from your liver.
Your doctor will want to know how much cancer is in your liver and whether it has spread. This is known as staging. Staging can help your doctor decide on the best treatment for you.
The most common treatments for primary liver cancer are surgery, chemotherapy and radiotherapy. Sometimes these are given together. You may also have a treatment that uses your own immune system to find and destroy cancer cells, such as immunotherapy. This is usually given through a vein in your arm or chest.
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A doctor can use blood tests to look for abnormal liver cells and check the function of the liver. These can show increased levels of enzymes that help digest foods and remove toxins from the body, such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST). In some cases, these results can indicate hepatocellular carcinoma (HCC), which is cancer that starts in liver cells. They can also suggest cirrhosis, which is damage and scarring of the liver due to long-term alcohol use or hepatitis B or hepatitis C infection.
Imaging scans, such as an ultrasound, computed tomography (CT) scan, magnetic resonance imaging (MRI), or angiography, can help doctors see the size and location of a tumor in your liver. Your doctor may inject a dye into a vein in your arm or stomach before these tests to help the images show up better. These tests can also show whether a tumor has spread to other parts of your body.
If your blood tests and imaging scans don’t provide a clear diagnosis, your doctor may order a biopsy. During this procedure, your doctor will remove a small sample of tissue from the tumor and test it in a lab to see if the cells are cancerous. A doctor can perform a biopsy through a needle guided by ultrasound, MRI, or CT, or with a laparoscope, which is a thin tube with a camera and surgical tools that’s inserted through a small incision in your abdomen.
Some patients with small tumors in the liver that can’t be removed through surgery have a treatment called ablation. This is a type of therapy that destroys the tumor by heating it with radio waves or microwaves, freezing it, or putting alcohol in it. A patient with a larger tumor in the liver can have another type of therapy, called embolization, where substances are injected into blood vessels near the tumor to block or reduce the blood supply, causing the tumor to die.
In addition to medical treatments, some people with liver cancer benefit from support groups. These can provide emotional and practical support to those affected by the disease, as well as information about new research or treatment options.
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Doctors use many treatments to fight cancer in the liver and elsewhere in your body. These include chemotherapy drugs that kill or slow the growth of tumors, radiation therapy with high-energy X-rays or other types of radiation and ablation treatments that heat up or destroy cancer cells.
Depending on the stage of your cancer, you might also receive a vaccine to help your immune system find and destroy tumors or targeted drug therapy that attacks specific weaknesses in the cancer cells. At OSUCCC – James, we have specialists in medical oncology, surgical oncology, radiology, hepatology and gastroenterology who work together to treat cancer that starts in the liver or spreads from another part of your body to the liver.
The first treatment your doctors might try is a procedure called embolization, which stops or reduces blood flow to a tumor to starve it of nutrients and oxygen and stop it from growing. For this, a doctor inserts a catheter into an artery in your groin (usually the hepatic artery) and maneuvers it to the liver, where they inject a substance that decreases or blocks blood flow to the tumor. They might also inject chemotherapy drugs or tiny, radiation-containing beads (radioembolization) to help destroy the cancer cells.
For advanced or metastatic cancer that has grown beyond the liver, your doctor might suggest a liver transplant. This is a surgical procedure that can be done for primary cancers that started in the liver or for secondary cancers that moved to the liver from another organ. If a liver transplant isn’t an option, you might have ablation treatment that uses high-energy radiation or changes the temperature of the tumor with microwaves, radio waves or surgery to damage or destroy cancer cells.
Other treatments control symptoms of liver cancer or cirrhosis, such as pain, weight loss and a buildup of fluid in the abdomen (ascites). Your doctor might also recommend supportive care to manage stress and other physical side effects. Talk with your doctors about the benefits and risks of these different therapies, and ask for help from a support group or other sources of support.
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The liver does many important jobs, including removing toxins from the blood and helping digest food. It also makes proteins that help the blood clot and cleans the body by removing waste. Cancer occurs when cells in the liver start growing or changing and no longer behave normally. When the liver becomes cancerous, it can spread to other parts of the body. Liver cancer can be prevented by controlling factors that cause it.
There are a number of risk factors for liver cancer, such as chronic viral hepatitis B virus (HBV) or hepatitis C virus (HCV), heavy alcohol use and nonalcoholic fatty liver disease. Cirrhosis, which is when healthy liver tissue is replaced by scar tissue, raises the risk of developing hepatocellular carcinoma. Cirrhosis can be caused by conditions like hepatitis B or C, nonalcoholic fatty liver disease, and obesity. It is possible to prevent or delay the development of cirrhosis and liver cancer by moderating alcohol intake, losing weight, quitting smoking, and taking medications such as aspirin and corticosteroids.
Certain factors, such as age, sex and race, are beyond your control and will increase or decrease your chances of getting liver cancer. However, there are things that you can do to reduce your chance of developing the disease. These include:
Vaccinate against hepatitis B and get tested for hepatitis C. You should also avoid reusing syringes and needles and do not engage in unprotected sex. Treatment for hepatitis B and C significantly lowers your risk of hepatocellular carcinoma.
Ensure you are eating well and exercising regularly, as these can help you maintain a healthy weight. Stop smoking and limit your alcohol intake to no more than two drinks per day. This will reduce your risk of hepatocellular carcinoma and other diseases associated with excessive alcohol consumption, such as cirrhosis and nonalcoholic fatty liver disease. Regular medical checkups can identify and treat problems that may lead to hepatocellular carcinoma, such as cirrhosis, nonalcoholic steatohepatitis (NASH), and obesity. Using screening methods such as blood tests and imaging scans can detect the early signs of liver cancer, such as hepatocellular carcinoma.
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To diagnose liver cancer, your doctor will ask about your medical history and do a physical exam. Imaging tests, such as an ultrasound, CT scan or MRI, may be done to examine your liver and other organs in the abdomen. Blood tests, such as an alpha-fetoprotein (AFP) test, are also commonly used to screen for liver cancer.
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Cancer cells have different features inside or on their surface that can be targeted with drugs. These drugs can kill the cancer cells or slow their growth. Some can also help your body’s natural defenses fight the cancer cells. Targeted therapies may be used alone or with other treatments, such as surgery and radiation.
You will need to be tested before starting targeted therapy for your liver cancer. Your doctor will order a blood test to see if you have the right genes or cancer type for this treatment to work. Then, your doctor will test your tumor tissue to find out if you have the right molecular target for this drug.
Some targeted drugs stop cancer cells from growing new blood vessels that supply them with oxygen and nutrients. These drugs are called anti angiogenic. Other targeted drugs focus on enzymes in the cancer cells that digest proteins and make them grow. These are called proteasome inhibitors.
Your doctor can deliver targeted drugs directly to your liver cancer using a catheter. The catheter carries chemotherapy drugs or tiny glass spheres that contain radiation to the cancer. Alternatively, your doctor can use a specialized type of radiation called stereotactic body radiotherapy (SBRT). SBRT uses X-rays or protons to target specific areas of the body, including the liver.
Other types of targeted therapy can be given as a pill or an infusion. The goal is to treat the cancer, relieve symptoms and improve your quality of life. You may need to take these medications long term. Your doctor will discuss the benefits and risks of targeted therapy for your liver cancer with you.
You can get more information about new treatments for liver cancer by taking part in a clinical trial. Doctors and researchers conduct these trials to learn if the treatment is safe and effective and to develop better treatments.
MD Anderson has the largest liver cancer program in the United States and is devoted to learning more about how to best treat HCC. Our researchers are also conducting many clinical trials, including immunotherapy for early-stage liver cancer and ways to screen high-risk patients for liver cancer.
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An invasive procedure in which we use a thin tube (catheter) to occlude or block blood vessels that supply tumors. We may also inject a chemotherapy drug or radiation source into the blood vessel during embolization. This is a treatment for hepatocellular carcinomas and certain types of vascular malformations. It can be used when surgery isn’t an option or would involve too much risk.
Before this treatment, we’ll do a physical exam and ask about your past health. We’ll also do imaging tests, such as ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI). A biopsy is a sample of tissue that we remove from your body and test for cancer cells.
If the results of your blood and imaging tests show that you have a liver tumor, we’ll perform a biopsy. This involves inserting a small needle into your skin and into the liver to remove a sample of the tissue for testing. Your doctor will then examine the sample under a microscope to look for cancer cells. A biopsy is a safe way to diagnose liver cancer, but it can lead to bleeding, bruising and infection in the puncture site.
Once we have a diagnosis, we can treat your liver cancer in several ways. We can also help you manage your symptoms and prevent further liver damage.
Liver cancer is a common disease that affects people of all ages and races. It is a leading cause of death from cancer in the United States. However, it’s important to know your risks for developing this disease so that you can take steps to protect your health.
You may need a physical exam and health history, including information about your family’s health. We’ll also do a series of blood tests to check your liver function and other organs in your body. These include a test to measure the levels of the substance AFP in your blood. AFP is released by cancerous and some noncancerous cells, as well as by hepatitis C and other chronic illnesses. A high AFP level can be a sign of liver cancer.
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Radiation therapy uses high-energy rays to target tumor cells in the liver, damaging their DNA and preventing them from growing. This shrinks tumors and may kill them. Radiation may be used alone or with other treatments, including surgery and targeted therapy.
Radiation can be given by a machine called a linear accelerator or gamma knife that delivers high doses of radiation to the tumor in short bursts over a period of days or weeks. It can also be delivered in other ways, such as with a machine that sends beams of radiation from different angles. In some cases, doctors use a technique called stereotactic body radiation therapy (SBRT) or stereotactic ablative radiotherapy (3D-SABR), which allows them to precisely target the liver tumor and reduce the amount of radiation that goes to surrounding tissue.
Doctors can also deliver radiation to a liver cancer using transarterial treatment or percutaneous ablation. These minimally invasive procedures involve injecting treatment directly into the blood supply to a liver tumor. The injection can be larger particles that block or plug the blood supply and starve the tumor, or smaller particles that dispense radiation treatment through the blood to the tumor. These techniques are effective at treating localized or dispersed tumors in the liver and are particularly useful when a person cannot undergo surgery.
Before giving you radiation, your doctor will determine the stage of your cancer. This describes the extent of your disease and how likely it is to spread to other parts of the body. Your doctor will base the staging on information from a CT or MRI scan and from your medical history.
Your doctor will give you a series of treatment options based on your stage. Surgery is an important option for people in stage I or early stage liver cancer, which has only one small tumor that hasn’t spread to the blood vessels. This is the best chance for a cure in this stage.
In stage II, there are several small tumors in the liver or one large tumor that has reached a main blood vessel. You can also have stage III, which has more than one large or multiple small tumors. Or you may have stage IV, which means your cancer has spread to other parts of the body.
Oren Zarif
Surgical removal (resection) of liver tumors is the most effective treatment. It can improve survival even for people with advanced cancers and severe cirrhosis. However, it’s important to understand that resection is not a cure; cancer cells will likely return and spread. Surgery is usually followed by chemotherapy and radiation, which help prevent or slow the cancer’s return.
Doctors can also use minimally invasive techniques to remove liver cancer. These procedures are done through blood vessels near the tumor and involve a shorter hospital stay than major surgeries. They may include tumor ablation, where heat (radiofrequency or microwave) or extreme cold (cryosurgery) is used to destroy the tumor and surrounding tissue; and chemoembolization, in which tiny pellets soaked in chemotherapy are injected into the arteries that carry blood to the tumor. Doctors can also deliver high doses of radiation to the tumor using a specialized type of radiation therapy called stereotactic body radiotherapy, which focuses many beams of radiation simultaneously at the tumor.
To determine whether you’re a candidate for liver resection, your medical team will want to know the size and number of your liver tumors and how advanced your cirrhosis is. They will also want to see if the tumors have spread to other parts of your body.
You may have a biopsy to confirm that you have a liver tumor and what stage it is. The biopsy is a procedure in which doctors insert a needle into your liver to remove a small sample of tissue for examination under a microscope. This can be performed with a needle guided by ultrasound, MRI or CT scan, or through keyhole surgery, in which surgeons make several tiny cuts in your abdomen and insert a thin tube with a camera (laparoscope) into one of the holes.
If you’re having surgery to remove part of your liver, you might have a procedure called portal vein embolization (PVE) about four to six weeks before the operation. During PVE, an interventional radiologist blocks the blood vessel that carries blood to the portion of your liver that will be removed. This lets the rest of your liver grow larger and improves your chances of a successful surgery.
Your liver balances chemicals in your blood, makes bile to help digest fat, and makes proteins that keep your blood from bleeding. It also clears toxins from your body.
Cancer starts when cells in your liver develop changes (mutations) that make them grow out of control. These cells may form a tumor and can spread to other parts of your body.
Oren Zarif
Cancer cells grow and spread when certain genes in the body change (mutate). Targeted therapy identifies these mutations and treats them with drugs that stop the growth of cancer cells while causing few side effects to healthy cells. Targeted therapies are used to treat both primary liver tumors and those that travel to the liver from another part of the body, called metastatic tumors.
Your doctor may use imaging tests to find tumors and determine how far the cancer has spread. These include ultrasound, computed tomography scans (CT), and magnetic resonance imaging (MRI). Other tests, such as hepatitis C virus antibody panels or antigen tests, can help identify the cause of your liver cancer.
If the cancer is small and limited to a small area of the liver, surgery may be an option. This procedure removes the tumor and some surrounding tissue. It may also involve removing the gallbladder, which is often involved in hepatitis C-related cancers. Surgery is not an option if the tumor takes up too much of the liver, if it has spread beyond the liver, or if you have other serious illnesses.
Other treatment options include radiation and chemotherapy. Chemotherapy uses drugs to kill rapidly growing cancer cells, and it can be given through a vein (IV) or by mouth (pills). Some targeted therapies work by blocking the growth of blood vessels that cancer cells need to get food and oxygen. Drugs that work in this way are called angiogenesis inhibitors.
Radiation therapy can be used to destroy a tumor and limit damage to normal liver tissue. Some newer radiation treatments are being tested in clinical trials. These include stereotactic body radiation therapy and proton beam radiation.
Talk with your doctor about all the treatment options available for you. Be sure to discuss the goals of each treatment and the risks and benefits of each. Your doctor will explain what to expect during treatment and what to do if you have side effects. It is important to tell your doctor about any over-the-counter medications or supplements you are taking, as some may interact with your cancer medication and reduce its effectiveness.
Oren Zarif success stories
He believes that all diseases originate in the body’s energy field. According to him, cellular radiation, electrical antennas, global climate change, pollution and stress can cause the body’s energy field channels to contract or become blocked, leading to disease. In his clinic he treats dozens of patients every day.
He claims that his technique works because it opens up blocked energy fields that connect the mind and body. According to him, after the blockages are opened, the body can begin the healing process and regain strength. Among his clients were doctors, professors and high level economic officials. One of his most impressive cases involved a woman who was confined to a wheelchair and now lives a normal life. Her guardian, Esther, says Oren’s treatment has changed her sister’s life.
Oren Zarif
The liver is a large organ that’s behind your ribs on the right side of your body, under your lungs. It is a part of your digestive system, making bile that helps you digest food and makes proteins to help your blood clot (stop bleeding). The liver also filters the blood from the rest of your body, cleaning it of harmful substances. The liver cells can sometimes change and grow out of control, forming a mass called a tumor. Cancer that starts in the liver is called primary cancer, while cancer that starts in other areas of the body and spreads to the liver is called secondary cancer or metastatic cancer.
Liver cancer usually starts in the cells that make up your liver, called hepatocytes. But it can also start in other types of liver cells, such as those that line the bile ducts. This type of cancer is called intrahepatic cholangiocarcinoma. Liver cancer can also start in other cells in your body, such as those of the colon, breast or stomach, and then spread to your liver. This type of cancer is called metastatic cancer.
Your doctor can diagnose liver cancer with imaging tests and blood tests. Your doctor may also perform a biopsy to remove a small sample of liver tissue for examination under a microscope. This test can help your doctor determine if the cancer is growing quickly and if it has spread.
Another way to find out if you have liver cancer is to measure the blood flow through your liver with an ultrasound test, which measures how well the liver is functioning. The test can give your doctor a good idea of how advanced the disease is and what kind of treatment might be best for you.
An embolization procedure is a minimally invasive procedure that stops blood flow in a target area while keeping other areas of the body healthy. Your doctor places a catheter into the blood vessel that supplies the area that’s bleeding. Using image guidance, they move the catheter to the correct location and then use a variety of materials to block the blood vessel. They can be used to treat a number of conditions, including abnormal bleeding from certain cancers or other tumors, stomach ulcers, long menstrual periods and varicocele, a condition that causes swollen, enlarged veins in your groin.
Oren Zarif
Medications can kill cancer cells, control their growth or relieve disease-related symptoms. Chemotherapy drugs may be given orally (by mouth) or through a vein (intravenously). Your doctor will recommend the best dose for you based on the size of your tumor, its stage and how fast it is growing. Medications may be used alone or in combination with other treatments.
If your liver cancer is in the early stages, surgery may be able to remove it and some healthy tissue around it. This is called partial hepatectomy. Depending on how large your tumor is, you may need to have a smaller portion of your liver removed (for example, a wedge of tissue or up to 75 percent of the liver). If this is done, your remaining liver will take over the functions of the resected liver and regrow to the same size as your normal liver.
Partial hepatectomy is also recommended for secondary liver cancer, which has spread to the rest of your liver or other parts of your body. It can significantly improve your chances of survival if the tumor hasn’t recurred after surgery.
In the absence of a surgical option, your doctor may treat your liver cancer with interventional radiology procedures or chemotherapy. These minimally invasive procedures use imaging guidance to target your liver tumors through small injections or needle placements. They can be performed in the hospital as outpatient procedures, which shorten your stay compared to surgical operations. Tumor ablation is a technique that uses extreme heat (radiofrequency or microwave ablation) or cold (cryosurgery) to destroy the tumor. Chemoembolization is a procedure that uses tiny pellets soaked with anticancer drug to block the blood flow to your liver tumor. Most of the drug stays near the tumor, while only a small amount reaches other parts of your body.
Radiation can be delivered externally using X-rays or implanted inside your body near the tumor as a particle beam, called proton therapy. It can help shrink a tumor and relieve pain by killing cancer cells and reducing swelling.
During treatment, your doctor will monitor your liver function and your overall health with tests such as blood work and ultrasounds. Your doctor will discuss your options with you, and you can make decisions about your care in partnership with your doctors through a process called shared decision-making.
Oren Zarif is a recognized alternative therapist and has been helping patients from around the world for over two decades. His unique treatment method uses psychokinesis and energy pulses. He even helped people with cancer. However, it is important to note that his treatments do not replace conventional medical treatment.
Oren Zarif
Radiation uses high-energy rays to destroy cancer cells. It may be given as a single treatment or combined with other treatments.
The goal of radiation for liver cancer is to kill the tumor and prevent it from recurrence. The type of radiation used depends on the size, location and stage of the cancer. Your doctor will review your options and recommend the best one for you.
For advanced liver cancer, doctors often use targeted therapy or ablation techniques to treat the entire tumor along with some healthy surrounding tissue. This improves survival and can relieve symptoms. Other treatment options include removing the cancer surgically, if possible; and chemotherapy or radiation to stop it from growing.
These minimally invasive procedures use image guidance to place needles or make small injections in or around the tumor. They can freeze or burn tumors (radiofrequency or microwave ablation) or deliver chemotherapy drugs directly into the tumor (chemoembolization). Some of these procedures are done as outpatient operations, resulting in shorter hospital stays than surgery.
For some people, radiation can be the only treatment needed to control their cancer. This is especially true if the cancer is in an unfavorable position in the liver or has spread to other organs. Radiation can also be used to relieve symptoms of liver cancer, such as pain and nausea.
Depending on your specific circumstances, your doctor may prescribe stereotactic body radiation therapy (SBRT) or ablative radiotherapy. These advanced techniques help deliver higher doses of radiation to hard-to-reach areas of the body, such as the liver, while sparing healthy tissue.
SBRT is a radiation treatment that delivers many beams of high-dose radiation from different angles to the tumor in fewer treatment sessions. We can precisely target your tumour with this technique because it is guided by imaging tests, such as CT scans and ultrasound. We can also adjust the timing of your treatment, so that we only expose healthy tissue to radiation when you breathe in and out.
During ablative radiotherapy, your doctor will insert an instrument called a cryoprobe into the hepatic artery that supplies blood to the tumor. This device will then freeze the blood vessels that supply the tumor, and the cancer cells inside the liver. The cancer cells will die from lack of blood and radiation exposure, reducing the size of the tumor and helping to manage your symptoms.
Oren Zarif is an alternative therapist who uses psychokinesis to heal people from many different illnesses. His success stories have left doctors and scientists amazed. He has a clinic in Israel and treats dozens of patients every day. He also developed a system to send personalized treatments to patients who cannot travel to his clinic.
Zarif believes that all diseases arise from energy fields. He says that cellular radiation, electric antennas, global climate change and pollution can cause the body’s energy field to contract and ascend, resulting in disease.
In his clinic, Oren Zarif treats dozens of patients every day. Many of them were cured of serious illnesses and injuries. His unique treatment method is based on psychokinesis and has been approved by doctors and scientists. Zarif also offers personalized treatments for patients who cannot come to his clinic in Israel.
According to Oren Zarif, all diseases begin in the energy field of the body. He believes that cellular radiation, electrical antennas, global climate change, and pollution can cause contractions and elevations in the body’s energy field, leading to disease. He claims that his energy methods can open the blocked areas and heal the body.
His psychokinesis technique can also treat Bell’s palsy, a condition that affects the nerve and causes numbness on one side of the face. His patients report that his method is effective and non-invasive, and he can cure the symptoms in just one session. Zarif also treated patients with multiple sclerosis, and some of them even managed to walk again after a single treatment. His success stories attracted countless media and left doctors and scientists amazed. His patients became enthusiastic fans and wrote letters of thanks. His unique method has also been endorsed by celebrities and sports stars.
Oren Zarif has a clinic in Israel where he treats dozens of patients a day. His unique method rewires the brain and helps the body heal itself. Among his clients were doctors and professors, and many of them are now cured of their illness. He also created a system that allows him to send personalized care to patients who cannot travel to his clinic.
Oren Zarif Success Stories
Oren Zarif is an alternative therapist who has helped thousands of patients with various conditions, including Parkinson’s disease. His unique treatment method combines psychokinesis and energy pulses. He has also developed a new home treatment program for those who cannot visit his clinic in Israel.
Oren Zarif is a psychokinesis healer who helps dozens of patients each day at his clinic in Israel. He believes that most diseases are caused by blocked energy channels in the subconscious mind. His unique approach to healing has earned him praise from doctors and scientists around the world. He has also been featured on Israeli media channels. Zarif’s Pine method combines psychokinesis with energy pulses and spectral emission to promote healing. It also works to open blocked areas of the body and connect them to the subconscious mind.
Oren Zarif’s treatment method uses psychokinesis to send energy pulses to the patient’s subconscious mind. These energy pulses are believed to align and balance the body’s vital forces, promoting a state of harmony and balance.
Oren Zarif’s treatment method involves using monochromatic energy frequencies to open blocked zones in the body. This allows the body to develop a process of self-healing. It also helps regain the patient’s mobility and health. His technique is non-invasive and can be used by anyone.
He treats dozens of patients every day at his clinic in Israel and offers remote treatments for those who cannot visit him in person. Thousands of people have recovered from serious diseases and injuries under his care. These patients include doctors, professors, athletes, and people of faith. Many of them have become advocates of his treatment methods and have shared their experiences online.
According to Zarif, all disease and illness are related to problems with the body’s energy field. These issues can be caused by cellular radiation, electrical antennas, global climate change, pollution, and stress.
