Treatments for liver cancer
If you have liver cancer, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. When deciding which treatments to offer for liver cancer, your healthcare team will consider:
- the stage of liver cancer
- how well your liver is working (liver function)
- the amount of scarring in the liver (called cirrhosis)
- whether or not the cancer can be completely removed by surgery
- your overall health
You may be offered one or a combination of the following treatments for liver cancer. Liver cancer is often at an advanced stage when it is diagnosed, so treatment options may be limited.
Depending on the stage of liver cancer, you may have one of the following types of surgery.
Liver resection, or partial hepatectomy, is used to remove the tumour along with a margin of healthy tissue around it. It is used as the main treatment if there is only 1 tumour less than 2 cm in size and the cancer has not spread to lymph nodes or blood vessels of the liver. It is offered only if tests show that the liver is healthy enough to work normally after surgery and there is no increased pressure in the portal vein.
Liver transplant is the main treatment for people who have severe cirrhosis and the rest of the liver would not work normally after surgery to remove a tumour. The cancer cannot have spread outside the liver to other parts of the body.
Transarterial chemoembolization (TACE)
TACE is used to shrink and control liver tumours. It is a treatment that blocks the blood supply to a liver tumour and delivers chemotherapy directly to the tumour.
TACE is offered when the tumour cannot be treated with surgery, but the cancer hasn’t spread to the major blood vessels in the liver, lymph nodes or other parts of the body. It can only be offered to people with good liver function who don’t have any fluid in their abdomen (called ascites) or problems with the main vein of the liver (called the portal vein).
Ablation therapies destroy liver cancer cells, while trying to avoid damaging as much of the surrounding liver tissue as possible. Ablation therapies are offered to people with liver cancer who can’t have surgery.
Radiofrequency ablation (RFA) uses a high-frequency electrical current to create heat to destroy cancer cells. It is the most commonly used ablation therapy for liver cancer. RFA works best for liver tumours that are 2.5 cm or less in size and when there are no more than 3 tumours.
Percutaneous ethanol injection (PEI) is a treatment that injects concentrated ethanol alcohol through a needle into a liver tumour. It works best on tumours that are smaller than 2 cm in size.
Targeted therapy uses drugs to target specific molecules (such as proteins) on the surface of cancer cells. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells while limiting harm to normal cells. It is used to treat advanced liver cancer when the person can’t have surgery or when the cancer no longer responds to other therapies.
External beam radiation therapy may be used to treat liver cancer that has spread to bone. Find out more about bone metastases.
If you don’t want or can’t have treatment
You may want to consider a type of care to make you feel better rather than treat the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.
Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.
Follow-up after treatment is an important part of cancer care. You will need to have regular follow-up visits, especially in the first 2 years after treatment has finished. These visits allow your healthcare team to monitor your progress and recovery from treatment. People who have a liver transplant will be followed by their transplant team.
Some clinical trials in Canada are open to people with liver cancer. Clinical trials look at new and better ways to prevent, find and treat cancer. Find out more about clinical trials.
Questions to ask about treatment
To make the decisions that are right for you, ask your healthcare team questions about treatment.
Establishing a national caregivers strategy
The Canadian Cancer Society is actively lobbying the federal government to establish a national caregivers strategy to ensure there is more financial support for this important group of people.