Liver, Gallbladder &
Liver cancer is cancer that occurs in the liver. The liver is the largest glandular organ in the body and performs various critical functions to keep the body free of toxins and harmful substances. The liver is responsible for producing bile, which is a substance that helps you digest fats, vitamins, and other nutrients. When cancer develops in the liver, it destroys liver cells and interferes with the ability of the liver to function normally.
Liver cancer is generally classified as primary or secondary. Primary liver cancer begins in the cells of the liver. Secondary liver cancer develops when cancer cells from another organ spread to the liver. Unlike other cells in the body, cancer cells can break away from the primary site (where the cancer began). The cells travel to other areas of the body through the bloodstream or the lymphatic system. Cancer cells eventually collect in another body organ and begin to grow there- called a metastasis.
What Are the Different Types
of Primary Liver Cancer?
The different types of primary liver cancer originate from the various cells that make up the liver. Primary liver cancer can start as a single lump growing in the liver, or it can start in many places within the liver at the same time. People with severe liver damage are more likely to have multiple cancer growth sites. The main types of primary liver cancer are below.
Hepatocellular carcinoma (HCC), also known as hepatoma, is the most common type of liver cancer, accounting for 75 percent of all liver cancers.
Cholangiocarcinoma, more commonly known as bile duct cancer, develops in the small, tube-like bile ducts in the liver. These ducts carry bile to the gallbladder to help with digestion. It accounts for approximately 10 to 20%.
Liver angiosarcoma is a rare form of liver cancer that begins in the blood vessels of the liver.
Hepatoblastoma is an extremely rare type of liver cancer. It’s nearly always found in children, especially those under age 3. With surgery and chemotherapy, the outlook for people with this type of cancer can be very good.
WHAT is the BEST treatment
for Liver Cancer?
This is a question we get asked frequently. But there is no single best treatment. The best treatment depends on various factors. Each patient is unique, as is their disease. When making a decision on the best treatment for YOU, Our multi-disciplinary team of doctors, guided by knowledge from world class clinical trials and established scientific guidelines, will customise your management plan taking into consideration all the factors related to your disease. Additionally, in case of cancer, we adopt world class treatment protocols and we discuss each case individually at our special tumour board meetings.
When should we
- The tumor is too large to be removed safely
- The tumor is in a part of the liver that makes it hard to remove (e.g. attached to an essential blood vessel)
- There are several tumors or the cancer has spread throughout the liver
Anything else NOT TO DO?
In certain selected cases of liver cancer, a liver transplant might be a good option. But in the presence of extensive disease in the liver, distant metastasis or other issues with the patient like low BP, active sepsis, and other rare conditions, liver transplant is also contraindicated. Primary liver cancers are often resistant to standard systemic chemotherapy, and so do consult an experienced oncologist before starting any such therapy.
If not operable,
what are the other options?
In situations where an operation is contraindicated, we will rely on alternate approaches to reduce the burden of tumour with an aim to increase the quality of life for the patient. Treatment options include either ablation (destroy with physical elements like heat) therapy or tumor embolization (cut off its blood supply) and in some cases a combination of both. These are less likely to cure the cancer than surgery, but they can still be very helpful for some people for whom there are no surgical options.
For ablating a tumor a needle or probe is guided into place with an ultrasound or CT scan and the tumor cells are destroyed. However, this is only suitable in selected cases where the size is quite small. Most cancers are found at a later stage when such ablation techniques are not feasible anymore. To embolize a tumour we inject substances to try to block or reduce the blood flow to cancer cells in the liver. In this way the tumor cells are destroyed. These treatments are also sometimes used in patients waiting for a liver transplant.
Other options may include targeted therapy, immunotherapy, chemotherapy, and/or radiotherapy. In some cases, treatment may shrink the tumor(s) enough so that surgery (partial hepatectomy or transplant) may become possible. If for any reason we are unable to treat the cancer, we can in most cases at least offer supportive care to help control pain or stenting to reduce jaundice, or any other symptom in order to optimise the quality of life.
Is chemo & radiotherapy
The main stay of treatment for liver and biliary cancers is surgery and is mostly the ONLY treatment which can cure. So chemo or radiotherapy alone will not result in long-term survival. However, in select cases we would recommend a special form of modalities like chemotherapy which is through branch of hepatic artery or even special forms of radiotherapy. We have access to all these modalities and once we stage your disease we will, in discussion with you, tailor the most appropriate treatment plan for you.
What do we do different
for patients with Cancer?
At South Asian, focused care, is a core value. We are an institute that focuses on a specific organ system, so we are able to offer the very best when it comes to diseases of the liver, pancreas and gall bladder. Patients benefit from our multidisciplinary team approach which brings together the very best professionals who are skilled in hepato-biliary disease including hepatologists, hepato-biliary surgeons, onco-surgeons, oncologists, radiologists who have specific interest in liver related radiology, pathologists, dieticians etc.