Newer treatments for secondary liver cancer

The following treatments are fairly recent developments and may only be available as part of a research trial. They may only be suitable for certain cancers. If your doctor feels that any of these may be helpful in your situation they can refer you to a hospital that carries out the treatments. They are only available in some specialist hospitals so you may have to travel a long way for treatment. These treatments may sometimes be used in combination with treatments such as chemotherapy| or surgery|.

Radiofrequency ablation Back to top

Radiofrequency ablation (RFA)| is becoming more widely used, especially for cancer which started in the bowel (colon). It uses radiowaves to destroy the cancer cells by heating them to high temperatures.

A sedative drug is given to make the person feel drowsy and a local anaesthetic used to numb the skin of their abdomen. Sometimes RFA is given using a general anaesthetic. A fine needle is inserted through the skin over the liver and into the centre of each tumour. RFA is usually given using guidance from a CT scan or ultrasound to make sure the needles go into the right place. Radiowaves are passed through the needle and into the tumours. These heat the cancer cells and destroy them.

This technique takes about 10−15 minutes and can be used to treat tumours of up to 5cm (2 inches) in size. Usually the person is able to go home a few hours after they have had the treatment.

Laser ablation Back to top

This is similar to radiofrequency ablation but uses laser energy to heat the tumours.

Cryotherapy/cryosurgery Back to top

In cryotherapy treatment, a device called a cryoprobe is inserted into the centre of the tumour during an operation. Liquid nitrogen is then passed through the probe. This freezes the surrounding area and destroys the cancer cells. Sometimes the area is thawed for 10−15 minutes and then frozen again.

Cryotherapy is only suitable for liver tumours which are smaller than 4cm (1½ inches) in size. The procedure takes about 30−60 minutes and usually involves a short stay in an intensive care unit followed by a stay of around two days in the specialist liver treatment ward.

This treatment may be painful|. The pain only lasts for a short time after the treatment and you will be given painkillers to help. Some people have a fever afterwards – again this can be relieved with medicines.

Internal radiotherapy treatment Back to top

This treatment involves having millions of very tiny ‘beads’ (microspheres) injected into the liver. Each bead is coated with a radioactive isotope that gives out radiation. The treatment gives a dose of radiotherapy| specifically to the liver over a period of a few days.

Before having the treatment, an angiogram is done – a fine tube is put into a blood vessel in the groin area and passed up into a blood vessel taking blood to the liver. This looks at the blood flow to the liver to make sure that the microspheres do not go anywhere else in the body when the treatment is given.

When the treatment is given, another angiogram is done and the beads are injected through the tube. The treatment involves staying in hospital for between one and four days. It’s important that anyone having this treatment does not come into contact with anyone younger than 15 years old, or anyone who is pregnant.

Side effects include having a high temperature and abdominal pain straight after the injection – these can last for a few days. Other side effects include feeling sick (nausea), being sick (vomiting)| and diarrhoea|.

Microwave ablation Back to top

This treatment destroys cancer using heat. Needle electrodes are placed into the liver tumours, under a local or general anaesthetic. The cancers are then destroyed using microwave energy given through the needles directly into the tumours. This is a very new treatment and it is not yet clear how useful it will be in treating secondary liver cancer. It is only being used as part of cancer research trials.

Alcohol treatment Back to top

Sterile alcohol is used to destroy the cancer cells. The technique is only suitable for tumours less than 4−5 cm (1½–2 inches) in size. A small needle is inserted into the liver tumour under local anaesthetic. The alcohol is then injected directly into the tumour. Alcohol treatment is only effective if there is one small tumour in the liver or a small number of separate tumours. The injection can be painful so you will be given painkillers to take for a while afterwards. Some people have a feeling of being drunk for 10−15 minutes after the injection.

You may be kept in hospital for a few hours after your treatment in case you have any bleeding or pain. This treatment can be repeated some time later if necessary.

All the above treatments need to be done under ultrasound or during an operation. This is to make sure that the treatments are directed at the right area of the liver.

Hepatic artery chemoembolisation Back to top

Whilst using x-ray pictures, a thin plastic tube is placed into a blood vessel in the groin. This is passed upwards until the tip is in position in the artery that takes blood to the liver. A chemotherapy drug mixed with an oily liquid is then injected into the liver and the tube is removed.

The oily liquid creates blood clots in the blood vessels which carry blood to the tumour. This stops oxygen and nutrients getting to the tumour. The chemotherapy stays in the tumour in high concentrations, which can kill some of the cells and shrink the tumour. How long the procedure takes, and the side effects that it causes, will be determined by the type of chemotherapy used. Some people may temporarily experience pain, feel sick or be sick, and have a high temperature. Chemoembolisation is usually carried out under a local anaesthetic.