The treatment of liver cancer needs to take consideration of liver function tests and location of tumor due to patients usually with chronic hepatitis or liver cirrhosis (may be combined with jaundice, ascites, esophageal varices, hepatic encephalopathy and coagulopathy).
Surgical resection and liver transplantation are both curative therapies. Nonetheless over half of the patients are diagnosed with more than one liver tumor at different lobes and hence few patients could cure only by surgical resection. Some patients will have tumor recurrence after the surgery. Hence patients who could not go over operation and patients with poor liver function must change to choose the other treatment for focal liver tumors.
Local ablation treatment can cure liver cancer under 3cm and located at proper position, including percutaneous ethanol injection (PEI), radiofrequency ablation (RFA) or microwave ablation (MV).
Patients with the bigger tumor size or more tumor numbers, unsuitable for operation might be considered to treat by transarterial chemoembolization(TACE).
Patients with vascular invasion by tumor, distant metastasis or susceptible for tumor recurrence can take oral targeted therapy such as Nexavar, Stivarga or Lenvima, which are effective on advanced hepatocellular carcinoma.
Radiotherapy can alleviate the larger or metastatic tumor. Systematic chemotherapy only works on few patients while patients with high recurrence rate can consider multiple combined modality therapies.
Liver cancer is susceptible to recur. The treatment for liver cancer is one long-term battle. In general, liver cancer with the smaller size than 3 cm will have better prognosis. Hence patients with chronic hepatitis or liver cirrhosis should follow up blood tests regularly and take abdominal ultrasound every 3-6 months.
Prevention
- Chronic hepatitis B and C carriers shall be regularly followed and drawn blood plus taking abdominal ultrasound for early detection of hepatic lesion and then early treatment.
- Avoid the consumption of food susceptible to producing aflatoxin, including peanut, soy bean and corn.
- Avoid drinking.
- Avoid unnecessary injection and blood transfusion.