Liver cancer

Diagnosis

Diagnosing liver cancer 

These are the tests done to diagnose liver cancer 

• Blood tests. Liver function test to detect any abnormalities.
• Imaging tests. Ultrasound, Computed Tomography (CT) Scan and Magnetic Resonance Imaging (MRI).
• Biopsy. A sample of liver tissue is taken for examination under a microscope to check for cancer.

Determining the extent of the liver cancer

The doctor will do the staging of cancer after liver cancer diagnosis. Cancer is staged in order to know the location and size of cancer. Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and bone scans are done to stage cancer.

There are different types of liver cancer staging. One is using Roman numerals such as from I to IV and the other is using letters such as from A to D. Staging will figure out which treatment is best done and determine the prognosis of the disease.

Treatment

Primary liver cancer is treated based on its stage, the patient’s age, general health and treatment choice.

Surgery

• Surgery to remove the tumor. In some cases where the liver function test is normal and the tumor is still small, surgery is done to remove part of the liver where the cancer is located, as well as some healthy tissues around it.
• Liver transplant surgery. The liver with cancer is removed and replaced with a new liver from a donor mostly done for those who are at an early stage. 

Localized treatments

Treatment that targets only the cancer cells and its surrounding area is called a localized treatment. The following choices are available:

• Heating cancer cells (Radiofrequency ablation). Electric current is utilized to heat up and kill the cancer cells by radiofrequency ablation.
  Ultrasound is used to guide the doctor and see the image where a thin needle will be inserted in the abdomen to reach for the tumor. The needle then applies heat into the tumor by electric current to destroy the cancer. 
• Freezing cancer cells (Cryoablation). The doctor uses a cryoprobe which is an instrument that contains liquid nitrogen with the assistance of an ultrasound imaging to apply extremely cold temperature into the liver cancer to destroy it.
• Injecting alcohol into the tumor.  Pure alcohol is injected into the tumor to kill cancer cells by injecting it through the skin or directly into the liver during surgery.
• Chemoembolization. A chemotherapy drug to counteract cancer is applied directly into the liver with cancer to destroy cancer cells.
• Placing beads filled with radiation in the liver. Radiation may also be applied directly into the liver to kill cancer cells using small beads containing radiation.

Radiation therapy

Cancer cells are targeted using X-rays and protons with strong energy beams to shrink the tumor. This treatment may be applied if other treatments are not effective or for advanced stage liver cancer to relieve symptoms. During this procedure, the patient will lie down on the table and a machine will target directly the part of the body that needs treatment. Another way of applying direct radiation into the cancer cells is by stereotactic radiotherapy which utilizes tiny radiation beams on a specific body part.

Targeted drug therapy 

Targeted therapy blocks the specific abnormalities or genetic mutation of the cancer cells which will be tested for specific receptor within laboratory.  

Immunotherapy 

Immunotherapy uses the body’s own immune system to destroy cancer cells. Cancer cells produce proteins to disguise themselves so that the body’s own immunity wouldn’t attack them. Immunotherapy counteracts this disguise process of the tumor so that the body can fight the cancer cells. This therapy may be applied on advanced stage liver cancer.

Chemotherapy 

Chemotherapy uses chemical medications to destroy cancer cells administered orally by the use of pills or intravenously. It may also be used sometimes for advanced-stage liver cancer.