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Usually, treatment is aimed at controlling the cancer for as long as possible and reducing any symptoms. Chemotherapy or surgery can lengthen life for many people with liver cancer and can help people to stay as well as possible, for as long as possible.
The choice of treatment for secondary cancer in the liver depends on:
Chemotherapy| is the main treatment for secondary cancer in the liver. If chemotherapy worked well for the primary cancer, then it will usually work well for secondary cancer in the liver.
Surgery| is used for a small number of people. It is usually only possible for people where the cancer has spread into the liver from a cancer in the bowel. It is most commonly used if the cancer cells affect only one area of the liver and there is no cancer anywhere else in the body. In this situation it is sometimes possible to cure the cancer.
If the secondary cancer is affecting more than one area of the liver it is not usually possible to remove all of the cancer cells with surgery.
Sometimes surgery can be used with other treatments such as chemotherapy or the newer treatments|. Although this is unlikely to cure the cancer, it can help to control it.
Radiotherapy| is not usually used to treat secondary cancer in the liver. However, it may be used to relieve symptoms| of pain and discomfort and also sickness.
Hormonal therapies| are sometimes used, usually for a cancer that started in the breast.
In most hospitals a team of specialists will discuss with you the treatment that they feel is best for your situation. This multidisciplinary team (MDT) may include a surgeon experienced in liver surgery, a medical oncologist (chemotherapy specialist), and a clinical oncologist (radiotherapy specialist). It may also include a number of other healthcare professionals such as a:
Together the doctors will be able to advise you on the best course of action and plan of treatment taking into account a number of factors. These include your age and general health, as well as the type and size of your cancer.
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 very hard to make a decision. If you are asked to make a choice, make sure that you have enough information about the different treatment options, what is involved and the side effects you might have, so that you can decide what is the right treatment for you.
Before you have a treatment, your doctor will explain the aims of the treatment to you. They will usually ask you to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form, you should have been given full information about:
If you don’t understand what you have been told, let the staff know so that they can explain again. Some cancer treatments are complex, so it’s not unusual for people to need repeated explanations.
Patients often feel that the hospital staff are too busy to answer their questions, but it is important for you to be aware of how the treatment is likely to affect you. The staff should be willing to make time for you to ask questions.
You can always ask for more time to decide about the treatment if you feel that you can’t make a decision when it is first explained to you.
You are also free to choose not to have the treatment or to stop having a treatment. If you are considering this, it is essential to discuss things fully with your cancer specialist so that they can give you the best advice and record your decision in your medical notes.
Many people are frightened at the idea of having cancer treatments, particularly because of the side effects that may occur.
Although many of the treatments can cause side effects, these can usually be controlled with medicines.
Treatment can be given for different reasons and the potential benefits will vary depending upon the individual situation.
For many people with secondary cancer in the liver, the treatment will only be able to control it, leading to an improvement in symptoms and a better quality of life. However, for some people in this situation the treatment will have no effect upon the cancer and they will get the side effects with little benefit. For a few people with secondary cancer in the liver, the treatment will be aimed at curing the cancer. It is important to discuss with your doctors what the aims of the treatment are.
If you have been offered treatment that aims to cure your cancer, deciding whether to accept the treatment may not be difficult. However, if a cure is not possible and the treatment is to control the cancer for a period of time, it may be more difficult to decide whether to go ahead with treatment.
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, you can still be given supportive (palliative) care, with medicines to control any symptoms.
Even though your treatment is planned by a multidisciplinary team, you may want to have another medical opinion. Most doctors will be willing to refer you to another specialist for a second opinion if you feel it will be helpful. This may take some time to organise and can cause a delay in the start of your treatment, so you and your doctor need to be confident that it will provide useful information.
If you go for a second opinion, it may help to take a friend or relative with you, and to have a list of questions ready so that you can make sure your concerns are covered during the consultation.
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