Surgical removal of liver tumors offers the best chance of cure. Unfortunately, liver tumors are often too large or affect large blood vessels, as well as other vital structures. This makes operations too risky or impractical. Surgical removal is not possible in more than 30-40% of primary patients and in 90% of patients with secondary liver cancer.
Historically, drugs have been ineffective in treating liver cancer. Therefore, there are a number of techniques to combat this disease.
Kinds
Primary liver cancer : The most common form of primary cancer is hepatocellular carcinoma (HCC). This is a tumor that begins in the main cells of the liver. Primary liver cancer is twice as likely to occur in men than in women. HCC often occurs in those who have cirrhosis of the liver.
Metastatic liver cancer: Cancer can be transmitted from any part of the body to the liver. There, cancer cells can grow for several months or years before they are discovered. often with tumors of the colon and rectum. Patients with other types of cancer are also at risk of developing liver cancer.
The liver acts as a starting station for cancer cells circulating in the bloodstream. These cells can grow and form a tumor. It is believed that 70% of all patients with uncontrolled cancer end up with a secondary liver tumor or metastases (tumors formed by primary cancer cells that have spread from other cancer sites).
Diagnostics
There are a number of tests that can help diagnose cancer, including blood tests, a physical examination, and various imaging methods, including x-ray, computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound.
Usually, a definitive diagnosis cannot be made until a biopsy is done. After examining a biopsy sample, experts can determine which cancer is present and how quickly it can spread. This information is important when deciding on the type of treatment.
Treatment
Tumors need blood supply so that it actively generates, feeds itself and grows. Radiologists, together with specialists in the field of vascular surgery, deliver targeted drugs introduced into the blood vessels through a catheter throughout the body.
In the treatment of cancer patients, radiologists can attack the tumor by influencing it through embolization and radio waves. Embolization is a well-developed method of interventional radiology, which is used to treat injured with massive bleeding, control bleeding after childbirth, reduce blood loss before surgery, and to treat tumors.
In the treatment of cancer patients, embolization is used to reduce the blood supply to the tumor, to deliver radiation (radio embolization), or combine this method with chemotherapy to deliver the cure for cancer directly to the tumor (chemoembolization).
In addition, cancer cells are killed by thermal methods (radiofrequency ablation) or the tumor is frozen (cryoablation).
Chemoembolization
Chemoembolization is a minimally invasive treatment for liver cancer, which can be used either alone or in combination with other procedures. Chemoembolization provides the introduction of a high dose of chemoembolizate directly into the body, depriving the tumor of its blood supply by blocking or embolizing the arteries that feed the tumor. Using the testimony of the scanner as a guide, the interventional radiologist inserts a tiny catheter into the femoral artery. A large dose of the drug is used, since the procedure acts selectively and, accordingly, less of the drug circulates in healthy cells of the body. Chemoembolization usually involves a hospital stay of two to four days. Patients, as a rule, return to a normal lifestyle within a month.
Chemoembolization is extremely effective in the treatment of malignant neoplasms of the liver, especially in combination with other methods of treatment. Chemoembolization has shown promising results in the treatment of metastatic tumors. It is this type of treatment approved by the FDA for the treatment of metastases.
Embolization
Radioembolization is very similar to chemoembolization, but using radioactive microspheres. This therapy is used to treat both primary and metastatic liver tumors. Embolic spheres of the yttrium-90 radioisotope are used to deliver radiation directly to the tumor. Each sphere is five red blood cells wide. These granules are inserted through a catheter into the groin and cause cell death. The technique provides a higher, local dose of radiation, without risk to healthy tissues.
This is a relatively new therapy that has been effective in treating primary and metastatic liver cancers. It has fewer side effects compared to standard cancer treatments.
Radiofrequency ablation
For inoperable liver tumors, radiofrequency ablation offers a non-surgical localized treatment that kills tumor cells with heat, sparing healthy liver tissue. Thus, this treatment is much easier for the patient than systemic therapy. The FDA has approved RFA for the treatment of liver tumors.
In a small number of cases, RFA can extend the life of patients. Depending on the size of the tumor, RFA can shrink or kill the tumor, increasing the patient's survival time and significantly improving their quality of life. Because this is a local treatment and does not harm healthy tissue, treatment can be repeated as often as necessary to keep patients in a comfortable area. This is a very safe procedure, with a complication rate of about two to three percent, and has been available since the late 1990s.
New Cancer Treatments
Interventional radiology plays an important role in developing new methods that can improve cancer treatment in the future, including using magnetic particles and delivering genetic material called gene therapy to fight or prevent cancer. These methods are still being researched and they offer new hope in the war against cancer.
Magnetic Chemotherapy
Interventional radiologists are currently exploring a new technique that uses magnets to draw a chemotherapeutic drug into a tumor. Microscopic magnetic particles are attached to the drug and delivered through a catheter to a blood vessel that feeds the tumor. A rare earth magnet is placed above the patient’s body directly above the location of the tumor. A magnet attracts particles so that they enter the tumor. Although the technique is still experimental, it is very promising. Doctors hope that she will support the effects of chemotherapy, avoiding some of her side effects, such as hair loss and nausea.
Gene therapy
In recent years, scientists have gained a new understanding of genes - the basic biological units of heredity and the role they play in the formation of diseases. This knowledge laid the foundation for medical science - gene therapy. Although science is still at the beginning of the experimental stage, researchers hope that in the future it can be used to:
- treating cancer and other genetic diseases;
- changes in the cells of the patient’s immune system with cancer and returning them to the body, where they could attack the disease or act as a vaccine;
- replace the faulty gene responsible for cancer growth with a “good" gene.
One of the problems with gene therapy is finding safe and effective methods for delivering genes or genetically modified cells to the tumor.
Doctors have high hopes for new developments and their early application in medical practice.