Treatment for primary liver cancer depends on various factors, determined based on the diagnosis. The age, health, and treatment preference of the patient are considered by the doctor before treatment options are suggested. Although staging is used to describe the extent of cancer, the doctors use a more practical system to finalize the treatment options. From a treatment point of view, liver cancer can be categorized as transplantable, resectable, and inoperable and advanced.
Those with transplantable liver cancers or resectable liver cancers (Stage 1 and some stage 2 cancers) can go in for surgery or transplant.
Liver surgery for resectable cancer
If the cancer is at an early stage surgery is done to remove the part of the liver that contains cancer. This procedure is also called partial hepatectomy. It can be done only if a part of the liver is affected and blood vessels are not affected by the tumors. The liver should be functioning well before surgery so that it can repair itself post-surgery. Only those without or with early cirrhosis may be considered for partial hepatectomy. Surgery may be an open surgery or laparoscopic surgery. After the surgery, the portion of the liver that remains will start to grow. Even if more than half the liver is removed the remaining portion will regrow to its normal size, within a few months, though sometimes the shape may change slightly.
Liver transplant
If the cancer is at an early stage, but the liver isn’t healthy enough to sustain a surgery and grow again, a liver transplant can be an option. If the tumor is a part of the liver which makes it hard to remove as it may be very big or very close to a blood vessel, then also a transplant is suggested. It may take time to find a suitable liver. Till such time the patient is given other treatments like embolization or ablation, to keep cancer from spreading. Recovery from a liver transplant can take up to 3 to 6 months and it will take a while to regain the lost energy. You will be put on immunosuppressant medication for the rest of your life.
Portal vein embolization (PVE)
Sometimes the surgeon needs to remove a major portion of the liver where the remaining portion may not be able to function normally after the surgery. Transporting the blood from the stomach to the liver is done by the portal vein. This procedure involves blocking the part of the portal vein which carries blood to the part which is being removed. This helps to allow more blood to flow to the other parts of the liver and hence allows faster growth of the liver. The procedure is done by a radiologist under general anesthesia.
Finding a donor
Candidates requiring a transplant are to register with the required organizations for donors if they are unable to get an organ for transplant within the network of family and friends. Once registered in the database allotment will be done mainly based on the urgency of the requirement. A liver can remain outside the body for 12 to 15 hours before it is transplanted.
While matching organs some common factors include
- Blood type – the most crucial factor
- Body weight
- The distance between donor and patient
- The severity of the condition
