|LIVER CANCER | DIAGNOSIS | TREATMENT | OUR PRACTICE | NEW PATIENTS | ARTICLES | ANSWERS | CONTACT|
Liver Cancer Information :
|Is liver cancer curable?|
|If I have colon or rectal cancer that has spread to the liver, should I have chemotherapy first?|
|Is ablation of liver cancer as good as resection?|
|If I am not a candidate for liver resection, what should I do?|
|What are the main groups of patients who are candidates for liver resection and/or ablation?|
|What other patients may benefit from these techniques?|
|How do I get more liver cancer information?|
Is liver cancer curable?
Cancer that starts within or spreads to the liver is a very serious problem. However, many patients are potentially curable if they receive aggressive surgical therapies. The patient must be a candidate for either resection or ablation in order to have this chance for cure. If the patient is not a candidate for resection or ablation, other treatment options may provide a healthier, longer life.
If I have colon or rectal cancer that has spread to the liver, should I have chemotherapy first?
In some cases chemotherapy is the best first option of treatment. However, many times surgical treatment provides the best chance for long term survival or even cure. If the cancer spread is limited to the liver in such a way that surgery can be done, surgical therapies should be used first. Chemotherapy then is used as an adjuvant treatment for any possible remaining unseen cancer cells, after the cancerous mass has been cut out or killed by heat or cold. Certainly there are many cases in which surgery is not possible when cancer develops in the liver. However, the decision to use chemotherapy first should only be made, in my opinion, after formal consultation with a surgeon dedicated to the management of the liver cancer patient.
Is ablation of liver cancer as good as resection?
At this time resection is felt to be superior to ablation of liver cancers with either heat or cold. We do not have the long history with the newer techniques of radiofrequency ablation to know how these patients will do over the long term of the next two decades. Also the radiofrequency techniques are still in evolution and there are times when different surgeons have different opinions. Certainly, however, many patients with liver cancer are not resection candidates, yet still may be offered the potential for cure with ablation.
If I am not a candidate for liver resection, what should I do?
There are a number of different technologies and procedures open to the patient who is not a liver resection candidate. The next best things are radiofrequency ablation or cryotherapy, because the patient still has a very significant chance of five year survival and cure with these techniques. Seek out a surgeon who provides these services for his or her opinion. As I have stated elsewhere, I believe all patients with either primary or secondary liver cancer are best served by getting the opinion of a surgeon who deals with liver cancers.
What are the main groups of patients who are candidates for liver resection and/or ablation?
Patients with hepatocellular carcinomas and those with metastatic cancer to the liver from the colon or rectum are the main groups. Also patients with neuroendocrine tumors metastatic to the liver including carcinoids and pancreatic NE tumors are candidates.
What other patients may benefit from these techniques?
In specific cases, resection or RFA may be very useful in the management of a number of other malignancies with spread to the liver. However, in these cases a thorough workup to exclude cancer in other locations must be done prior to considering local therapies. If no cancer is seen elsewhere by clinical evaluation, CT scans, and a PET scan, patients with cancers of the breast, kidney, stomach, sarcomas, and melanomas may be candidates for RFA or resection.
Ken Dixon, M.D.
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