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Traditional treatment for liver cancer typically involves surgery, chemotherapy and external beam radiation. However, not all patients are candidates for surgery and some may not respond to traditional chemotherapy and radiation.
Today, there are several innovative approaches — such as radioembolization, chemoebolization and microwave ablation — that are making treatment more precise and more accessible to a broader number of patients.
With radioembolization, radiologists insert a catheter into the hepatic artery — the blood supply to the tumor — and insert tiny beads that lodge in the artery and give off small amounts of radiation, selectively targeting the tumor.
The procedure, which is performed through a small incision in the groin or the wrist and guided by X-ray images, kills the cancer cells and shrinks the tumor while sparing the surrounding healthy liver tissue.
Radioembolization is a generally a treatment option for cancer that is largely confined to the liver and for patients who meet certain baseline standards for liver function.
Similar to radioembolization, chemoembolization uses a catheter in the hepatic artery to delivery tiny beads of chemotherapy to the tumor. It is most beneficial in patients whose cancer is predominately limited to the liver.
Both radioembolization and chemoembolization block or reduce blood flow to the tumor, helping to kill off the cancer cells. Because the main blood supply to the liver is through the portal vein, healthy liver cells are relatively unharmed.
Another procedure, microwave ablation uses heat to destroy tumors. With microwave ablation, doctors — guided by an ultrasound or CT scan — insert a needle-like probe into the tumor. The probe emits heat from microwave energy that reaches temperatures greater than 100 degrees and kills the cancer cells.
Microwave ablation is typically used to treat smaller tumors, generally no more than 2 inches across.
All three procedures are generally well tolerated by patients. Side effects are typically mild and may include low-grade fever, abdominal pain and nausea. Usually, the procedures are performed on an outpatient basis.
In addition, because the procedures are precisely targeted there is normally little damage to healthy liver cells.