Liver Cancer Treatments

Transarterial Radioembolization (Y90)

An interventional radiologist injects tiny beads containing radioactive material into a blood vessel that leads to the tumor, working right on the tumor with minimal effect on the healthy tissues around it.

Transarterial Chemoembolization (TACE)

Blood supply to the tumor is cut off after chemotherapy is administered. This traps the medication within the tumor.

Ablative Therapy

Ablative therapy is an interventional radiology treatment that uses heat or cold to destroy cancer tumors. It eliminates the need for more invasive surgery. Ablative therapies include cryoablation, microwave ablation and radiofrequency ablation (RFA).

Some patients may benefit from a combination of locoregional and systemic therapies.

If surgery isn’t an option for you, your doctor may recommend systemic therapy. Systemic liver therapy uses drugs that travel through the bloodstream to treat a liver conditions like cancer. The treatment travels throughout the entire body, rather than just in one area.

If your treatment plan involves taking medication in pill form, we have staff to help you. They will assist with prior authorizations and ensure the medicine is delivered to you promptly. You’ll also visit with an oncology pharmacist or nurse practitioner to discuss details about your treatment and side effects.

Radiation applies high-dose energy such as X-rays directly on small areas of the body. It’s used to destroy many forms of cancer cells. In liver cancer, radiation is challenging because it may be more damaging to healthy liver tissue than to cancerous cells.

For this reason, standard radiation is seldom used to treat patients with liver cancer unless it involves one of the newer techniques, such as stereotactic radiation or radiofrequency ablation.

Stereotactic body radiation therapy, or SBRT, is a type of radiation therapy that uses many beams of energy. The beams are carefully targeted to focus on tumors.

The best treatment for primary liver cancer is also the only one that truly cures it: liver resection. It involves cutting and removing the malignant tissues and possibly surrounding lymph nodes.

Unfortunately, for various reasons liver resection isn’t possible for many patients. First, if a patient’s liver is cirrhotic or functions poorly, it might not be safe to perform the operation. Second, the tumors may be so small or widespread that surgery won’t prevent the cancer from returning.

Chemotherapy describes specialized anticancer drugs given by mouth or through an IV. Although highly effective for many types of tumors, chemotherapy doesn’t always work well against primary liver cancer. This is because the liver’s primary job is to filter out all toxic chemicals from the body, including the chemotherapy drugs.

However, a promising new liver cancer treatment is called chemoembolization. It is also called hepatic artery chemoembolization. It injects high doses of chemotherapy directly into the blood vessels that feed the cancer. We also inject special oils and proteins that form a dam, which closes off blood vessels and isolates the tumor.

Chemoembolization attacks liver cancer two ways:

• It destroys the existing tumor.
• Then it chokes off its blood supply, preventing further growth.

These treatments target only the liver tumor, not the entire organ:

Cryoablation

Cryoablation is form of liver-directed therapy. It uses liquid nitrogen to isolate and kill the cancer. Specialists inject super-cold nitrogen right inside the tumor. It freezes and ultimately destroys the cancer cells. An alternative form of this treatment is ethanol ablation. This involves injecting liquid alcohol directly into the tumor.

Thermal Ablation

Thermal ablation is also used to treat liver tumors. Through recent advancements in minimally invasive therapies, we use techniques to heat tumors to the point of cell death. We perform thermal ablation using radio frequency and with magnetic resonance-guided, high-intensity focused ultrasound.

Radiofrequency Ablation (RFA)

Radiofrequency ablation (RFA) uses heat energy in the form of radio waves to kill the liver tumor. Using ultrasound or CT scan equipment as a guide, the physician inserts a metal probe into the tumor. Radio waves emitted at the tip of the probe deliver thermal energy to the center of the tumor. This heat energy destroys the surrounding tissue, killing the tumor.

RFA has emerged as a safe, easy and predictable technology for thermal ablation in the liver and other organs, lymph nodes and soft tissues.

Advanced Stereotactic Radiation

Advanced stereotactic radiationuses special equipment called the Trilogy System. Physicians are able to target the tumor site with high-dose beams of precisely focused external radiation. This gains a much greater degree of accuracy than with traditional radiation techniques. Lahey was one of the first hospitals in New England to offer this advanced technology.

Also called biological response modifier therapy, it “switches on” certain bodily substances. They can restore or mobilize your own natural defenses against cancer.

Lahey physicians have joined other researchers to study MRI-guided, focused ultrasound. This is a bloodless technique that destroys tumors affecting the liver and other organs. The procedure uses an FDA-approved device already in use at Lahey to treat uterine fibroids. We perform it without cutting or puncturing the skin. Physicians use MRI as a visual guide to target the tumor. We aim a highly focused ultrasound beam at the liver tumor under, or between, the ribs.