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Liver Tumors
There are two kinds of liver tumors. Primary liver tumors are caused by malignant cells stemming from the liver. The second type are liver metastases which are formed when cancer cells migrate to the liver. Due to the liver's significant position in the blood stream, metastatic disease is far more common than primary liver disease.
Options for treatment of liver tumors, whether primary or metastatic, are limited. The gold standard for treatment remains surgical resection, as a potential cure of the disease. Numerous conditions however, like extent of disease in both liver lobes or presence of disease beyond the liver make a surgical cure impossible. Therefore few patients qualify for surgical resection.
Other therapeutic options are available, including:
These methods are used as an alternative to liver resection. But
there is no doubt that patients with unresectable liver lesions will
benefit from these alternative treatments.
The concepts of cancer therapy
To understand the different treatment options for liver cancer, it may be helpful to know two principal concepts of cancer treatment - local and systemic treatment. Cancer stems mostly from a single primary site like colon, breast, lung, thyroid gland, and thereafter can spread to distant parts of the body. Today's medical imaging methods cannot detect spreading cancer cells which might develop into a distant metastatic site.
Local treatment tries to eliminate cancer at a specific location (in this case the liver), which has been diagnosed with various imaging methods. There is the possibility, however, that some cancer cells at other distant sites remain undetected and untreated.
In contrast, systemic treatment modalities like
chemotherapy can treat cancer cells not seen with today's medical
imaging methods. Systemic treatment affects cells irrespective of
their location. So, shouldn't all cancer be treated systemically?
Cancer which can be seen on CT scans or ultrasound poses the
biggest threat for the patient and determines the prognosis. Local
treatment methods control visible tumors better than systemic
treatments because more aggressive treatment can be applied.
On the other hand, systemic therapy like chemotherapy and radiation
therapy are less aggressive to tumor cells and have in general more
unwanted side-effects.
Therefore, the goal of chemotherapy and radiation therapy is
primarily tumor reduction whereas local therapy methods attempt to
completely kill the tumor.
The reason why systemic therapy methods sometimes fail is the way
they are applied: Chemotherapy drugs are transferred to the tumor
cell via the bloodstream and not every cell will get a high enough
dosage. Radiation beams are diminished by distance - the deeper the
beam has to go into the body, the lower the effective dosage. Because
of side-effects, there is always an upper dosage limit.
In conclusion, the different treatment modalities can accomplish
different goals in cancer treatment, to get the maximum success,
physicians frequently combine different cancer treatments.
In addition, when there is no definite cure for a patient, treatment
decisions focus heavily on possible side-effects such as toxicity,
difficulty of application, pain, length of hospitalization and so
forth.
With the development of the Radiofrequency Ablation treatment approach, we have a new local treatment for liver tumors. It has few side effects and a relatively small impact on your quality of life after the procedure.
The next section gives a short history of this ablation technique.
