‘New ray of hope to treat liver cancer’

Liver is a common site for cancer — both primary cancer that originates in the liver as well as secondary cancer that originates elsewhere. Until recently, patients with liver cancer were considered to have a dismal prognosis without any useful treatment options. However, a significant proportion of such patients can expect considerable prolongation of life and even complete cure. Dr Sanjay Govil, hepatobiliary surgeon, Healthcare Global (HCG), spoke to DNA about this disease and the treatment.

What are the latest developments in the treatment of liver cancer?
The potential treatments include combinations of surgery, chemotherapy and ablative therapies such as radio frequency ablation, arterial chemoembolisation and cyber-knife radiotherapy.
Surgery of the liver has become safer, with the risk of peri-operative death falling to one to two per cent in patients with normal liver function and 5-10% in those with jaundice or cirrhosis. The average hospital stay is about 10 days.

Can patients with liver cancer get back quality life?
The increasing safety of liver surgery permits more patients to benefit from tumour resection. In some patients with primary liver cancers and cirrhosis, resection may risk post-operative liver failure from a poorly functioning liver remnant. These patients are candidates for liver transplantation, which, though expensive, is now widely available in our country. Far from being a hopeless situation, many patients with liver cancer can look forward to many years of productive life.

Who are at risk of developing liver cancer?
Patients with liver cirrhosis and chronic Hepatitis B or C carriers are at a particularly high risk of developing cancer. These patients should be screened every six months with liver ultrasound and serum alphafetoprotein. While this will not detect all cancers, those that are picked up are usually small with a better chance of cure.

Is a combination of treatments a safe approach?
Other modalities of treatment may be combined with surgery to increase the number of patients who become eligible for operation. These include radio frequency ablation (RFA) and Trans-arterial Chemoembolisation (TACE) in particular.
Moreover, laproscopic surgery reduces the trauma of surgery without compromising safety.