Liver Cancer Treatment Approaches

At City of Hope, our goal is to ensure that treatments are effective and comprehensive, and provided in a setting of care and compassion. Our surgeons, medical oncologists, radiation oncologists and interventional radiologists work together as a team to provide combined treatments with maximum benefits.
Patients with liver tumors often require some form of surgery to remove the affected tissue. When appropriate, minimally invasive surgical techniques may be possible. These require only small incisions to accommodate thin, flexible laparoscopic instruments, similar to performing a biopsy. Laparoscopic surgery offers results comparable to open surgery, but with less pain, reduced loss of blood, faster recovery, shorter hospital stays and a lower risk of post-operative complications.
City of Hope surgeons are also highly skilled in robotic-assisted surgery, using the most advanced da Vinci S Surgical System. This system provides excellent results in complex and delicate operations. A surgeon directs and controls the movements of a specially designed robot, equipped with a camera and miniature surgical tools. A sophisticated computerized imaging system provides real-time, three-dimensional views of the surgical area, with better visualization than can be achieved with the surgeon’s eye alone.
Types of surgery used to treat liver cancer include:
  • Partial hepatectomy Removing the area of the liver where a tumor exists, along with a margin of the healthy tissue around it. The remaining liver tissue can regenerate, restoring liver function.
  • Total hepatectomy and liver transplant In certain cases, the entire liver may be removed, and then replaced with a healthy donated liver.
Radiation Therapy
Radiation therapy uses high-energy X-rays and other types of radiation to kill cancer cells. City of Hope was the first in the western U.S. to provide treatment for liver cancer using helical TomoTherapy. This advanced radiation therapy system combines two technologies, precision spiral CT scanning and intensity modulated radiation therapy, which allows doctors to match the highest dose of radiation to fit the exact shape of the tumor. The system not only provides more effective and potentially curative treatment, it reduces the unwanted exposure of normal tissues and reduces potential complications.
In cases where liver cancer cannot be removed by surgery, patients may receive localized internal radiation treatment using radioactive Yttrium-90 labeled microspheres. These are infused into the affected area, destroying the tumor but leaving most of the healthy tissue relatively unaffected.
Chemotherapy drugs destroy cancer cells by interfering with their growth and multiplication. There are several methods by which these cancer-fighting medicines are delivered. Some involve an infusion of drugs into a vein or central line. Others utilize interventional radiology, in which substances are injected directly into the liver through a thin tube (catheter) or needle, guided into the correct area by the use of X-ray imaging.
This type of local chemotherapy is used to treat tumors that have spread to the liver. An anticancer drug mixed with a substance that embolizes (blocks) blood vessels is injected into the hepatic artery. As the artery is blocked off, the drug is trapped near the tumor, for maximum effect.