The treatment of primary and malignant liver tumors depends on the extent of the disease within the liver as well as any tumors that are outside of the liver, the overall health of the liver, and the overall health of the survivor.

Some important questions to ask include:

·         What is my diagnosis? What is the exact type of liver cancer?

·         Do I need treatment right away?

The various options in the treatment of liver tumors are as follows:

 Surgical Resection

The tried and true way to deal with liver cancer is by surgical resection. The hope is to remove the tumors and leave no microscopic cancer cells behind. A margin of normal tissue is included in the resected specimen. Unfortunately, resection is only possible in a small percentage of patients who present with liver tumors. Still, susrgery is the “gold standard” today against which other treatment plans are measured. This is an important part of the treatment plan of the patient who is a candidate. Boh for hepatocellular carcinomas and for some cancers metastatic to the liver, surgical resection is a mainstay.

 Resection with radiofrequency ablation (Resection with RFA)
 
RFA combined with resection has proven worthwhile in many different settings with many different types of cancers. In the case of HCC’s or metastatic cancers to the liver, it now appears that the combination of techniques of liver resection with ablation of other lesions will allow a greater percentage of patients with these cancers to be treated. Resection of a single lobe of the liver can now be accomplished in patients who would have historically been excluded from consideration, since remaining other lesions within the liver can be ablated at the same time as the resection.
 
 Radiofrequency ablation alone (RFA alone)

Radiofrequency ablation, also known as RFA, is a technique of heating up liver cancers with probes inserted into the tumors. 
 
 Liver transplant

A liver transplant is offered for patients with hepatocellular carcinomas of limited extent. These tumors have to be either a solitary lesion of less than five centimeters or up to three lesions of three centimeters or less. Patients with tumors over this size or number have historically been thought to fare poorly with rapid tumor recurrence in most organ recipients.  

 Hepatic artery infusion (port or pump)

HAI is a drug delivery system that is implanted under the skin. A catheter from the pump is connected to the gastroduodenal artery, which joins the hepatic arteries, allowing the pump to infuse only the liver with chemotherapy. .  
 
 Embolization and chemoembolization

Chemoembolization is also known as TACE, standing for transarterial chemoembolization. In this technique an interventional radiologist injects a chemotherapeutic agent directly into the arteries supplying a tumor within the liver.

 Cryoablation

Cryotherapy, also called cryosurgery, cryoablation or targeted cryoablation therapy, uses the application of extreme cold to destroy the tumor.

 Selective Internal Radiation Therapy (SIRT)

SIRT is what YES is all about!!  Selective internal radiation therapy (SIRT) or Yttrium 90 Microspheres is a relatively new treatment suitable for use even in patients with extensive liver involvement.  Radioactive spheres (SIR spheres or Therasphere) are injected into an artery in the liver. The spheres are like very tiny radioactive seeds. After they are injected through the liver artery, they travel into smaller arteries that feed the tumor.  Once the spheres are in the tumor, they give off radiation for about three days. The radioactivity causes damage to cancer cells with little damage to the healthy liver tissue.  It is a highly effective and well-tolerated regional treatment for extensive liver tumors.