Liver Cancer Treatment.

Primary liver cancer may be treated by either surgery or chemotherapy or a combination of the two. If the patient still has good liver function and has no obvious signs of metastases, exploratory surgery may be performed to determine the extent of the cancer and the feasibility of its removal. 

Surgical treatment is most likely to succeed in those instances in which there is a solitary tumor, confined to one lobe, that can be entirely removed. Unfortunately, only a minority of primary liver cancers fall into this category; more often the malignancy has spread through the liver, and the entire cancer cannot be removed. In other patients the liver already may be extensively damaged by cirrhosis or other diseases that hinder the organ's ability to regenerate. Normally the liver has an amazing capacity to regenerate, provided enough healthy tissue remains.

For example, up to 80 percent of the liver can be removed, and with adequate postoperative support of metabolic and other liver functions, the organ will begin to regenerate within a few days and will completely regrow in two to four months. This experience, however, usually occurs in young patients with benign tumors or accident victims, rather than in cancer patients who are more likely to have extensive liver damage that precludes successful surgical removal of the entire cancer.

Chemotherapy, most often with doxorubicin, 5-fluorouracil, or metho-trexate, will sometimes relieve symptoms and prolong survival. Administering the anticancer drugs directly into the liver, via a catheter inserted into the hepatic artery—the vessel that supplies the liver with blood—or threaded nonsurgically from the brachial artery, may decrease the side effects of the chemotherapy. But since the catheters themselves may lead to side effects, the therapeutic advantages of such an approach remain unproved.

Another experimental approach to treatment involves blockage of the arteries