Liver Cancer Treatment & Ongoing Care

Alcohol Injection

Percutaneous Alcohol Injection Therapy (PEI or PEIT) is currently a wild card in the management of hepatocellular carcinoma in the United States. It has been embraced as a potential low tech solution to HCC’s in Europe—especially Italy—as well as in the Far East in Japan, Taiwan, and Hong Kong. Although long term cures are rare, response rates and getting to the “NED state” are frequent. PEI is an innovative, low morbidity technique with real benefit. It can be given in the OR as a relatively large volume treatment or, more commonly, as an outpatient procedure under sonographic guidance in the office or radiology department setting.

Alcohol Injection as a Useful Tool

Although PEI has really not caught on yet in most centers in the United States, I think it is a worthwhile addition to the arrows in the surgeon’s quiver. I do offer this in some circumstances in the HCC patient. It does not appear that PEI will be as effective in the patient with metastatic cancer to the liver, since most metastases are relatively hard and avascular in a normally soft liver. This allows spillage of the alcohol into the surrounding liver substance, hurting the liver next to the tumor while not killing the tumor because the alcohol doesn’t stay in place long enough to have the desired effect. On the other hand, in the hard, cirrhotic liver with a highly vascular and soft HCC, PEI is worth consideration as a method of liver cancer treatment.

Contact my office to find out more about other methods of liver cancer treatment.