Treatment overview for primary liver cancer
The type of treatment you’re offered will depend on the type of liver cancer you have, the stage and grade of the cancer, its size and your general health.
Treatments used to treat primary liver cancer include surgery, chemoembolisation, tumour ablation, chemotherapy and biological therapy. Radiotherapy may occasionally be used.
How treatment is planned
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In most hospitals a team of specialists will talk to you about the treatment they feel is best for your situation.
This multidisciplinary team (MDT) will include:
a hepatologist (liver disease specialist)
a surgeon who specialises in liver cancer
a medical oncologist (chemotherapy specialist)
a clinical oncologist (radiotherapy and chemotherapy specialist)
a nurse specialist.
It may also include other healthcare professionals, such as a dietitian, physiotherapist, occupational therapist, psychologist or counsellor.
If two treatments are equally effective for your type and stage of cancer, your doctors may offer you a choice of treatments. Sometimes people find it hard to make a decision. If you’re asked to make a choice, make sure you have enough information about the different options, what’s involved and the possible side effects, so you can decide on the right treatment for you.
Remember to ask questions about any aspects you don’t understand or feel worried about. It may help to discuss the benefits and disadvantages of each option with your cancer specialist or nurse specialist.
If you have any questions about your treatment, don’t be afraid to ask your doctor or nurse. It often helps to make a list of questions and to take a relative or close friend with you.
The benefits and disadvantages of treatment
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Many people are frightened by the idea of having cancer treatments, particularly because of the side effects that can occur. However, these can usually be controlled with medicines.
Treatment can be given for different reasons, and the potential benefits will vary depending upon your individual situation. In people with early-stage liver cancer, surgery is often done with the aim of curing the cancer. You may also be given additional treatments to reduce the risk of it coming back.
If the cancer is at a more advanced stage, the treatment may only be able to control it, improving symptoms and quality of life. However, for some people in this situation, the treatment will have no effect on the cancer and they’ll get the side effects without any of the benefits.
If you’ve been offered treatment that aims to cure your cancer, deciding whether to accept it may not be difficult. However, if a cure is not possible and the purpose of treatment is to control the cancer for a period of time, it may be more difficult to decide whether to go ahead.
Making decisions about treatment in these circumstances is always difficult, and you may need to discuss in detail with your doctor whether you wish to have treatment. If you choose not to have it, you can still be given supportive (palliative) care with medicines to control any symptoms.
Before you have any treatment, your doctor will explain its aims. They’ll ask you to sign a form saying that you give permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you’re asked to sign the form you should be given full information about:
the type and extent of the treatment
its benefits and disadvantages
any significant risks or side effects
any other treatments that may be available.
If you don’t understand what you’ve been told, let the staff know straight away so they can explain again. Some cancer treatments are complex, so it’s not unusual for people to need repeated explanations.
It’s a good idea to have a relative or friend with you when the treatment is explained to help you remember the discussion. You may also find it useful to write a list of questions before your appointment.
People sometimes feel that hospital staff are too busy to answer their questions, but it’s important for you to know how the treatment is likely to affect you. The staff should be willing to make time for your questions. You can always ask for more time if you feel that you can’t make a decision when your treatment is first explained to you.
You’re also free to choose not to have the treatment. The staff can explain what may happen if you don’t have it. It’s essential to tell a doctor, or the nurse in charge, so they can record your decision in your medical notes. You don’t have to give a reason for not wanting treatment, but it can help to let the staff know your concerns so they can give you the best advice.
Your multidisciplinary team (MDT) uses national treatment guidelines to decide on the most suitable treatment for you.
Even so, you may want another medical opinion. If you feel it will be helpful, you can ask either your specialist or GP to refer you to another specialist for a second opinion. Getting a second opinion may delay the start of your treatment, so you and your doctor need to be confident that it will give you useful information.
If you do go for a second opinion, it may be a good idea to take a relative or friend with you. You could have a list of questions ready, so that you can make sure your concerns are covered during the discussion.