performed. An MRI is like a CT scan, but uses magnetic forces instead of radiation.
Treatment Options
Treatment of Liver Cancer
Surgery is the treatment of choice for liver cancer. All other methods have not been shown to be as effective as surgery in treating liver cancer. However, because liver cancer is frequently associated with liver damage (cirrhosis) in the other parts of the liver due to alcohol damage or hepatitis, surgery for liver cancer is difficult or impossible for a large proportion of patients.*
As surgery is the only effective method for treating liver cancer, it is crucial that a person with suspected liver cancer has a proper assessment of his condition by a well-trained liver surgeon to decide if the cancer can be removed. A liver surgeon is known as a hepato-pancreato-biliary*(HPB) surgeon.*Liver surgery*is currently safe and effective in treating liver cancer.*
In selected cases, liver transplant is another surgical option for definitive liver cancer treatment.*
When surgery is not possible, there are other options that may help to control the tumour and attempt to prolong survival time but not “cure” the person. The many options available suggest that no single method is particularly effective. It is better to discuss these options with a trained liver cancer specialist who can advise you on the appropriateness of each method. Some of these options that are available at NCCS include*chemotherapy (systemic or local, TACE), alcohol injection, heat-destroying the tumour (radiofrequency ablation, RFA),*or using radionuclear material to deliver local radiation. A newer method that is also available involves delivering*radiation beads directly to the liver tumour (SIRspheres).*
For more advanced liver cancer, when local therapy as mentioned above is not feasible, oral sorafenib, a multi-kinase targeted therapy, has been shown to prolong patients’ survival. Other alternatives include the numerous experimental clinical trials on liver cancer that test new drug combinations conducted at NCCS.
Prognosis of Liver Cancer
Liver cancer is the*third most fatal cancer. If untreated, most patients do not survive beyond 6 months. Surgery is the only method that allows for a reasonable survival beyond 5 years. With curative surgery, the*chance of*survival beyond 5 years*is more than 40%.
New tumour growth is common in liver cancer because of the underlying liver disease (i.e. hepatitis or cirrhosis). There*are currently no effective means of preventing this new growth, and close follow-up after surgery is necessary to detect tumour regrowth at an early stage*as it*can still be treated effectively.
Screening
The risk groups for liver cancer are well defined and screening is targeted at this group. The aim is to try and detect cancer at an early stage when surgery is still possible for a*cure. Based on MOH guidelines, patients with established hepatitis B or C carrier status or have liver cirrhosis would benefit from regular AFP*estimations and ultrasound examinations. These tests are usually done at 6-monthly intervals depending on the severity of liver damage, i.e. cirrhosis.
