Treatments for Liver cancer
Treatments for Liver cancer
The list of treatments mentioned in various sources
for Liver cancer
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
Liver cancer: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Liver cancer may include:
Hidden causes of Liver cancer may be incorrectly diagnosed:
Liver cancer: Marketplace Products, Discounts & Offers
Products, offers and promotion categories available for Liver cancer:
Curable Types of Liver cancer
Possibly curable types of Liver cancer may include:
Liver cancer: Research Doctors & Specialists
Research all specialists including ratings, affiliations, and sanctions.
Unlabeled Drugs and Medications to treat Liver cancer:
Unlabelled alternative drug treatments for Liver cancer include:
- Prednisone - used as part of a combination therapy
- Apo-Prednisone - used as part of a combination therapy
- Aspred-C - used as part of a combination therapy
- Deltasone - used as part of a combination therapy
- Liquid Pred - used as part of a combination therapy
- Meticorten - used as part of a combination therapy
- Metreton - used as part of a combination therapy
- Novoprednisone - used as part of a combination therapy
- Orasone - used as part of a combination therapy
- Panasol-S - used as part of a combination therapy
- Paracort - used as part of a combination therapy
- Prednicen-M - used as part of a combination therapy
- Prednisone Intensol - used as part of a combination therapy
- SK-Prednisone - used as part of a combination therapy
- Sterapred - used as part of a combination therapy
- Sterapred-DS - used as part of a combination therapy
- Winpred - used as part of a combination therapy
- Tamoxifen
- Alpha-Tamoxifen
- Apo-Tamox
- Dom-Tamoxifen
- Nolvadex
- Nolvadex-D
- Novo-Tamoxifen
- PMS-Tamoxifen
- Tamofen
- Tamone
Latest treatments for Liver cancer:
The following are some of the latest treatments for Liver cancer:
- PEG-alfa-interferon
- Surgical resection
- Radiofrequency guided ablation
- Embolization
Hospital statistics for Liver cancer:
These medical statistics relate to hospitals, hospitalization and Liver cancer:
- 0.05% (6,423) of hospital consultant episodes were for malignant neoplasm of liver and intrahepatic bile ducts in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 80% of hospital consultant episodes for required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 62% of hospital consultant episodes for malignant neoplasm of liver and intrahepatic bile ducts were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 38% of hospital consultant episodes for malignant neoplasm of liver and intrahepatic bile ducts were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 35% of hospital consultant episodes for required emergency hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- more hospital information...»
Hospitals & Medical Clinics: Liver cancer
Research quality ratings and patient incidents/safety measures
for hospitals and medical facilities in specialties related to Liver cancer:
Hospital & Clinic quality ratings » »
Choosing the Best Treatment Hospital:
More general information, not necessarily in relation to Liver cancer,
on hospital and medical facility performance and surgical care quality:
Medical news summaries about treatments for Liver cancer:
The following medical news items
are relevant to treatment of Liver cancer:
Discussion of treatments for Liver cancer:
What You Need To Know About Liver Cancer: NCI (Excerpt)
The choice of treatment depends on the condition of the
liver; the number, size, and location of tumors; and whether
the cancer has spread outside the liver. Other factors to
consider include the patient's age, general health, concerns
about the treatments and their possible side
effects , and personal values.
Usually, the most important factor is the stage of the
disease. The stage is based on the size of the tumor, the
condition of the liver, and whether the cancer has spread. The
following are brief descriptions of the stages of liver cancer
and the treatments most often used for each stage. For some
patients, other treatments may be appropriate.
Localized resectable cancer
Localized resectable
liver cancer is cancer that can be removed during surgery.
There is no evidence that the cancer has spread to the nearby
lymph nodes or to other parts of the body. Lab tests show that
the liver is working well.
Surgery to remove part of the liver is called partial hepatectomy .
The extent of the surgery depends on the size, number, and
location of the tumors. It also depends on how well the liver
is working. The doctor may remove a wedge of tissue that
contains the liver tumor, an entire lobe, or an even larger
portion of the liver.
In a partial hepatectomy, the surgeon leaves a margin of
normal liver tissue. This remaining healthy tissue takes over
the functions of the liver.
For a few patients, liver transplantation
may be an option. For this procedure, the transplant surgeon
removes the patient's entire liver (total hepatectomy) and
replaces it with a healthy liver from a donor. A liver
transplant is an option only if the disease has not spread
outside the liver and only if a suitable donated liver can be
found. While the patient waits for a donated liver to become
available, the health care team monitors the patient's health
and provides other treatments, as necessary.
Localized unresectable cancer
Localized unresectable
liver cancer cannot be removed by surgery even though it has
not spread to the nearby lymph nodes or to distant parts of
the body. Surgery to remove the tumor is not possible because
of cirrhosis (or other conditions that cause poor liver
function), the location of the tumor within the liver, or
other health problems.
Patients with localized unresectable cancer may receive
other treatments to control the disease and extend life:
-
Radiofrequency
ablation -- The doctor uses a special probe to
kill the cancer cells with heat. The probe contains tiny
electrodes that destroy the cancer cells. Sometimes the
doctor can insert the probe directly through the skin. Only
local
anesthesia is needed. In other cases, the doctor may
insert the probe through a small incision in the abdomen or
may make a wider incision to open the abdomen. These
procedures are done in the hospital with general
anesthesia .
Other therapies that use heat to destroy liver tumors
include laser
or microwave
therapy .
-
Percutaneous
ethanol injection -- The doctor injects alcohol
(ethanol) directly into the liver tumor to kill cancer
cells. The doctor uses ultrasound to guide a small needle.
The procedure may be performed once or twice a week. Usually
local anesthesia is used, but if the patient has many tumors
in the liver, general anesthesia may be needed.
-
Cryosurgery
-- The doctor makes an incision into the abdomen and inserts
a metal probe to freeze and kill cancer cells. The doctor
may use ultrasound to help guide the probe.
-
Hepatic
arterial infusion -- The doctor inserts a tube
(catheter )
into the hepatic artery, the major artery that supplies
blood to the liver. The doctor then injects an anticancer
drug into the catheter. The drug flows into the blood
vessels that go to the tumor. Because only a small amount of
the drug reaches other parts of the body, the drug mainly
affects the cells in the liver.
Hepatic arterial infusion also can be done with a small
pump. The doctor implants the pump into the body during
surgery. The pump continuously sends the drug to the
liver.
-
Chemoembolization
-- The doctor inserts a tiny catheter into an artery in the
leg. Using x-rays as a guide, the doctor moves the catheter
into the hepatic artery. The doctor injects an anticancer
drug into the artery and then uses tiny particles to block
the flow of blood through the artery. Without blood flow,
the drug stays in the liver longer. Depending on the type of
particles used, the blockage may be temporary or permanent.
Although the hepatic artery is blocked, healthy liver tissue
continues to receive blood from the hepatic portal vein,
which carries blood from the stomach and intestine .
Chemoembolization requires a hospital stay.
-
Total hepatectomy with liver transplantation -- If
localized liver cancer is unresectable because of poor liver
function, some patients may be able to have a liver
transplant. While the patient waits for a donated liver to
become available, the health care team monitors the
patient's health and provides other treatments, as
necessary.
Advanced cancer
Advanced cancer is cancer that is found in both lobes of
the liver or that has spread to other parts of the body.
Although advanced liver cancer cannot be cured, some patients
receive anticancer therapy to try to slow the progress of the
disease. Others discuss the possible benefits and side effects
and decide they do not want to have anticancer therapy. In
either case, patients receive palliative care to reduce their
pain and control other symptoms.
Treatment for advanced liver cancer may involve chemotherapy ,
radiation
therapy , or both:
-
Chemotherapy uses drugs to kill cancer cells. The
patient may receive one drug or a combination of drugs. The
doctor may use chemoembolization or hepatic arterial
infusion. Or the doctor may give systemic
therapy , meaning that the drugs are injected into a
vein and flow through the bloodstream to nearly every part
of the body. The doctor may call this intravenous
or IV chemotherapy.
Usually chemotherapy is an outpatient
treatment given at the hospital, clinic, or at the doctor's
office. However, depending on which drugs are given and the
patient's general health, the patient may need to stay in
the hospital.
-
Radiation therapy (also called radiotherapy) uses
high-energy rays to kill cancer cells. Radiation therapy is
local
therapy , meaning that it affects cancer cells only
in the treated area. A large machine outside the body
directs radiation to the tumor area.
Recurrent cancer
Recurrent cancer means the disease has come back after the
initial treatment. Even when a tumor in the liver seems to
have been completely removed or destroyed, the disease
sometimes returns because undetected cancer cells remained
somewhere in the body after treatment. Most recurrences occur
within the first 2 years of treatment. The patient may have
surgery or a combination of treatments for recurrent liver
cancer. (Source: excerpt from What You Need To Know About Liver Cancer: NCI)
What You Need To Know About Liver Cancer: NCI (Excerpt)
Pain is a common problem for people with liver cancer. The
tumor can cause pain by pressing against nerves and other
organs. Also, therapies for liver cancer may cause
discomfort.
The patient's doctor or a specialist in pain control can
relieve or reduce pain in several ways:
-
Pain medicine -- Medicines often can relieve pain.
(These medicines may make people drowsy and constipated, but
resting and taking laxatives can help.)
-
Radiation -- High-energy rays can help relieve
pain by shrinking the tumor.
-
Nerve block -- The doctor may inject alcohol into
the area around certain nerves in the abdomen to block the
pain.
The health care team may suggest other ways to relieve or
reduce pain. For example, massage, acupuncture ,
or acupressure
may be used along with other approaches. Also, the patient may
learn to relieve pain through relaxation techniques such as
listening to slow music or breathing slowly and
comfortably. (Source: excerpt from What You Need To Know About Liver Cancer: NCI)
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Book Excerpts: Treatment of Liver cancer
Treatments of Liver cancer: Online Medical Books
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for more information about the treatments of Liver cancer.
Hepatomegaly:
Treatment
(In a Page: Signs and Symptoms)
-
Heart failure: Diuretics, inotropes, and afterload reduction
-
Viral hepatitis: Supportive care and antivirals in some chronic cases
-
Alcoholic liver disease: Abstinence from alcohol, steroids in severe cases, and possible transplant
-
Fatty liver: Treat underlying obesity, diabetes, hyperlipidemia
-
Sarcoidosis: Steroids
-
Hemochromatosis: Iron removal by weekly phlebotomy for 2–3 years and/or deferoxamine chelation
-
Wilson's disease: Copper chelation with D-penicillamine or trientine; may require liver transplantation
-
Neoplasms: Resection and chemotherapy
-
Abscess or cyst: Antimicrobials, percutaneous drainage, and/or surgical resection
-
Amyloidosis: Prednisone and alkylating agents
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Jaundice:
Treatment
(In a Page: Signs and Symptoms)
-
Discontinue and avoid potentially hepatotoxic medications
-
Supportive care for viral hepatitis
-
Rehydrate/refeed for Gilbert's syndrome
-
Consider steroids in fulminant alcoholic hepatitis
-
Cholecystectomy or ERCP with stone removal for obstructing gallstones
-
Treat underlying causes of hemolysis or other disorders
-
Antibiotics for cholangitis, sepsis
-
Hydroxyurea and folate for sickle cell disease, prevent crises by adequate hydration, vaccinating against diseases, and try to prevent other infections
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Hepatomegaly:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Geared towards specific disease
-
Cholestasis
–Ursodeoxycholic acid
–Supplemental fat soluble vitamins A, D, E, K
-
Infections
–Consider interferon for hepatitis B
–Consider interferon and ribaviron for hepatitis C
-
Toxins
–Use of NTBC for tyrosinemia
-
Metabolic disease
–Metabolism consultation
–Often requires specific restricted formulas
-
Surgical repair for biliary atresia
–Kasai portoenterostomy has better outcome if done before 60 days of age
-
Mucomyst for acute acetaminophen toxicity
-
Immune suppression for autoimmune hepatitis
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Jaundice in Infants – Direct:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Varies by specific disorder
-
General medication principles of cholestasis include
–Promoting bile flow with ursodeoxycholic acid
–Consider phenobarbital (increases bile excretion)
–Fat-soluble vitamins including K, D, E
–Vitamin A is a relative contraindication given hepatotoxicity at high levels
Consider formula with medium chain triglycerides as fat source (does not require bile acids to be absorbed)
Treat underlying disorder
–Kasai portoenterostomy for biliary atresia
–Surgical repair of choledochal cyst
–Special formulas for tyrosinemia
–Lactose free formula for galactosemia (e.g., soy based)
–Remove toxic exposures
–Treat infections
–Treat hypothyroidism
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Jaundice in Infants – Indirect:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Treatment options vary based on level of bilirubin, age of presentation, and cause
–Goal is prevent levels high enough to cause kernicterus
-
Phototherapy involves the use of photon energy to change the structure of bilirubin and permit excretion without glucuronidation
–Decisions for use are age-based
–Considered when serum level above 14 mg/dL
-
Exchange transfusion should be considered with serum levels above 25 mg/dL
-
IVF or breast-feed more frequently to increase volume
-
-
-
Correct endocrine abnormality
-
Improve perfusion if cardiac problem
-
Correct anatomic abnormality
-
Consider enteral binding agents
–Cholestyramine, charcoal, calcium phosphate
-
Crigler-Najjar: Phenobarbital, may need liver transplantation
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Colorectal cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
The most effective treatment of colorectal cancer is surgery to remove the malignant tumor and adjacent tissues and any lymph nodes that may contain cancer cells. The type of surgery depends on the location of the tumor:
❑Cecum and ascending colon — right hemicolectomy (for advanced disease) may include resection of the terminal segment of the ileum, cecum, ascending colon, and right half of the transverse colon with corresponding mesentery
❑ Proximal and middle transverse colon — right colectomy to include transverse colon and mesentery corresponding to midcolic vessels, or segmental resection of transverse colon and associated midcolic vessels
❑ Sigmoid colon — surgery is usually limited to sigmoid colon and mesentery
❑ Upper rectum — anterior or low anterior resection (newer method, using a stapler, allows for resections much lower than were previously possible)
❑ Lower rectum — abdominoperineal resection and permanent sigmoid colostomy.
Chemotherapy is indicated for patients with metastasis, residual disease, or a recurrent inoperable tumor. Drugs used in such treatment commonly include fluorouracil with leucovorin, irinotecan, and oxaliplatin.
Radiation therapy induces tumor regression and may be used before or after surgery or combined with chemotherapy, especially fluorouracil.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Liver cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Because liver cancer is commonly in an advanced stage at diagnosis, few hepatic tumors are resectable. A resectable tumor must be a single tumor in one lobe, without cirrhosis, jaundice, or ascites. Resection is done by lobectomy or partial hepatectomy.
Radiation therapy for unresectable tumors is usually palliative. Because of the liver's low tolerance for radiation, external beam radiation hasn't increased survival. However, radiolabeled antibodies have been used to selectively target cancer tissue; when used concurrently with chemotherapy, patients can convert from nonresectable to resectable.
Another method of treatment is chemotherapy with I.V. fluorouracil, mitomycin, or doxorubicin, or with regional infusion of fluorouracil or floxuridine (catheters are placed directly into the hepatic artery or left brachial artery for continuous infusion for 7 to 21 days, or permanent implantable pumps are used on an outpatient basis for long-term infusion).
Appropriate treatment for liver metastasis may include resection by lobectomy or chemotherapy with mitomycin or fludarabine (results similar to those in hepatoma). Liver transplantation is now an alternative for a small subset of patients.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Malignant spinal neoplasms:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment of spinal cord tumors generally includes decompression or radiation. Laminectomy is indicated for primary tumors that produce spinal cord or cauda equina compression; it isn't usually indicated for metastatic tumors. If the tumor is slowly progressive or if it's treated before the cord degenerates from compression, symptoms are likely to disappear, and complete restoration of function is possible. In a patient with metastatic carcinoma or lymphoma who suddenly experiences complete transverse myelitis with spinal shock, functional improvement is unlikely, even with treatment, and his outlook is ominous. If the patient has incomplete paraplegia of rapid onset, emergency surgical decompression may save cord function. Steroid therapy with dexamethasone minimizes cord edema and temporarily relieves symptoms until surgery can be performed. Partial removal of intramedullary gliomas, followed by radiation, may alleviate symptoms for a short time. Metastatic extradural tumors can be controlled with radiation, analgesics and, in the case of hormone-mediated tumors (breast and prostate), appropriate hormone therapy. Transcutaneous electrical nerve stimulation (TENS) may control radicular pain from spinal cord tumors and is a useful alternative to opioid analgesics. In TENS, an electrical charge is applied to the skin to stimulate large-diameter nerve fibers and thereby inhibit transmission of pain impulses through small-diameter nerve fibers. Chemotherapy generally hasn't proven effective against most spinal tumors, but may be recommended in some cases.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Jaundice [Icterus]:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
Encourage the patient with a hepatic disorder to decrease his protein intake sharply and increase his intake of carbohydrates. If he has obstructive jaundice, encourage a nutritious, balanced diet (avoiding high-fat foods) and frequent small meals.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Colorectal cancer:
Treatment
(Handbook of Diseases)
The most effective treatment for colorectal cancer is surgery to remove the malignant tumor and adjacent tissues as well as any lymph nodes that may contain cancer cells. The type of surgery depends on the location of the tumor:
❑ Cecum and ascending colon: A right hemicolectomy (for advanced disease) is performed. It may include resection of the terminal segment of the ileum, cecum, ascending colon, and the right half of the transverse colon with corresponding mesentery.
❑ Proximal and middle transverse colon: A right colectomy is performed that includes the transverse colon and mesentery corresponding to midcolic vessels or segmental resection of the transverse colon and associated midcolic vessels.
❑ Sigmoid colon: Surgery is typically limited to the sigmoid colon and mesentery.
❑ Upper rectum: Anterior or low anterior resection is performed. A newer method, using a stapler, allows for resections much lower than were previously possible.
❑ Lower rectum: Abdominoperineal resection and permanent sigmoid colostomy is performed.
Chemotherapy is indicated for patients with metastasis, residual disease, or a recurrent inoperable tumor. Drugs used in such treatment commonly include fluorouracil with levamisole, leucovorin, methotrexate, or streptozocin. Patients whose tumor has extended to regional lymph nodes may receive fluorouracil and levamisole for 1 year postoperatively.
Radiation therapy induces tumor regression and may be used before or after surgery or combined with chemotherapy, especially fluorouracil.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Liver cancer:
Treatment
(Handbook of Diseases)
Because liver cancer is usually in an advanced stage at diagnosis, few hepatic tumors are resectable. A resectable tumor must be a single tumor in one lobe, without cirrhosis, jaundice, or ascites. Resection is done by lobectomy or partial hepatectomy.
Radiation therapy for unresectable tumors is usually palliative. However, because of the liver’s low tolerance for radiation, this therapy hasn’t increased survival.
Another treatment method is chemotherapy either I.V. or with regional infusion of a chemotherapeutic drug. (A catheter is placed directly into the hepatic artery or left brachial artery for continuous infusion for 7 to 21 days, or permanent implantable pumps are used on an outpatient basis for long-term infusion.)
Appropriate treatment for liver metastasis may include resection by lobectomy or chemotherapy. (The results are similar to those in hepatoma.) Liver transplantation is an alternative for some patients.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Hepatomegaly:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Instruct the patient to avoid alcohol. Explain the importance of following the treatment plan to correct or control the underlying disorder as needed. Tell the patient to avoid exposure to people with infections and to maintain good personal hygiene. Explain the importance of pacing activities and having frequent rest periods.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Jaundice:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Encourage the patient with a hepatic disorder to decrease his protein intake sharply and increase his intake of carbohydrates. If he has obstructive jaundice, encourage a nutritious, balanced diet (avoiding high-fat foods) and frequent small meals. Teach the patient ways to reduce pruritus.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Hepatomegaly:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for liver enzyme, alkaline phosphatase, bilirubin, albumin, and globulin studies to evaluate liver function and for X-rays, a liver scan, celiac arteriography, a computed tomography scan, and ultrasonography to confirm hepatomegaly.
▪ Provide bed rest, relief from stress, and adequate nutrition to help protect liver cells from further damage and to allow the liver to regenerate functioning cells.
▪ Monitor and restrict dietary protein as needed.
▪ Give hepatotoxic drugs or drugs metabolized by the liver in very small doses, if at all.
Patient teaching
▪ Explain the underlying disorder and its treatments.
▪ Stress the importance of avoiding alcohol and people with infections.
▪ Discuss the importance of pacing activities and rest periods.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Jaundice [Icterus]:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ To decrease pruritus, frequently bathe the patient; apply an antipruritic lotion, such as calamine; and administer diphenhydramine or hydroxyzine.
▪ Prepare the patient for diagnostic tests to evaluate biliary and hepatic function, including laboratory studies (such as urine and fecal urobilinogen, serum bilirubin, liver enzyme, and cholesterol levels; prothrombin time; and a complete blood count), computed tomography, ultrasonography, cholangiography, liver biopsy, and exploratory laparotomy.
Patient teaching
▪ Teach the patient appropriate dietary changes.
▪ Discuss ways to reduce pruritis.
▪ Review with the patient prescribed medications and their possible adverse effects.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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