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Treatment for secondary liver cancer

There are different types of treatment for cancer that has spread to the liver (secondary liver cancer). You might have one of these treatments if you can’t have surgery to remove the secondary cancer.

Treatments include specialised ways of giving chemotherapy and radiotherapy directly into the secondary cancer. Listed below are different types of treatments available to treat secondaries in the liver if surgery is not an option.

How your doctor decides about treatment

Your doctor will consider different factors when deciding if they are suitable for you. Some factors are:

  • your general health 
  • how quickly your cancer came back after other treatments 
  • whether you have secondary cancer anywhere else that cannot be removed 

Your doctor will talk to you about the possible benefits and risks of these treatments in your situation. If your bowel cancer has spread anywhere else in your body, your doctor is not very likely to suggest these treatments. They will probably suggest chemotherapy instead because it circulates throughout the body and so treats all areas of the cancer.

Hepatic artery chemoembolisation

What is it

Doctors put an oily liquid into the main artery taking blood to the liver. The liquid helps to block the blood vessels taking blood to areas of the liver containing the cancer. This cuts off the supply of oxygen and nutrients to the cancer and damages the cells. The oily liquid also contains chemotherapy. High levels of chemotherapy stay in the area of the cancer for a few hours. This kills the cancer cells and shrinks the cancer. 

How you have it

You might have medicine to make you drowsy (sedation). The surgeon injects a local anaesthetic into the skin over a blood vessel at the top of your leg. Using x-ray pictures, they slide a thin plastic tube into the blood vessel. They push the tube gently upwards until the tip is in the artery taking blood to the liver.

When the tube is in the position the surgeon injects the chemotherapy drug mixed with the oily liquid. The surgeon then removes the tube. This treatment takes from 30 minutes to a couple of hours.

Afterwards

You might have some pain, feel or be sick, and have a high temperature. Your nurse will give you medicine to help with this. 

Selective internal radiation therapy

What is it

Selective internal radiation therapy (SIRT) is also called radioembolisation. It is a newer type of treatment for cancer in the liver. The doctor (radiologist) puts tiny radioactive beads called microspheres into the main artery taking blood to the liver. These beads give off high doses of radiation to the tumour but cause little damage to the surrounding healthy tissue. 

About 1 or 2 weeks before you have the treatment, you have an angiogram. This test looks at the flow of blood to the liver, which is different in different people. The radiologist blocks off small blood vessels that go to other organs of the body. This is so that when the radioactive beads are put in, they won't go anywhere else in the body and damage healthy tissue. 

How you have it

The treatment itself takes about an hour, and you need to stay lying down for about 4 hours afterwards to prevent bleeding. You might stay in hospital overnight. Side effects include tiredness, loss of appetite, a high temperature, pain in your abdomen and feeling or being sick.

Afterwards

Due to the radiation, you need to avoid long periods of close contact with young children and pregnant women for about 10 days after treatment. Your doctor will advise you about this before you go home. Most of the radiation has gone after 2 weeks, and has gone completely after a month. The beads stay in the liver permanently but are harmless. 

Radiofrequency ablation

What is it

Radiofrequency ablation uses radio waves to destroy cancer cells in the liver by heating them to high temperatures.

How you have it

You usually have a sedative to make you drowsy but some people have a general anaesthetic. If you have the sedative, your doctor injects a local anaesthetic into the skin of your tummy (abdomen) to numb it. They then push a thin needle through the skin and into the centre of each tumour. They use a CT scan or ultrasound scan to make sure the needles are in the right place. Then they pass radio waves through the needle to heat the tumours and destroy them.

RFA can treat tumours up to 5cm (2 inches) in size. It takes about 10 to 15 minutes. Usually, you can go home a few hours afterwards.

Afterwards

You might need to have the treatment repeated. The main side effects are pain and a high temperature for a few days. Your doctor or nurse will give you painkillers to take at home. They will also give you instructions on what to do if you get a high temperature.

Cryotherapy

What is it

Cryotherapy is also called cryosurgery. It destroys the cancer by freezing it. It is only suitable for small tumours, usually up to 4 cm. It takes about 30 to 60 minutes. You might have it as part of open surgery under general anaesthetic or using keyhole techniques under local or general anaesthetic.

How you have it

The surgeon puts one or more cryotherapy probes (called cryoprobes) through a small cut in the skin and into the cancer. The surgeon uses a CT scan or ultrasound scan to make sure each probe is in the right place. The tip of the cryoprobe is then cooled to below freezing.

The probe creates an ice ball within the surrounding tissue that aims to destroy the cancer cells. Sometimes the area is thawed for 10 to 15 minutes and then frozen again.

Afterwards

You will have some pain afterwards and possibly a high temperature, but you will have painkillers to help. You usually have a short stay in an intensive care unit followed by around 2 days in the specialist liver treatment ward.

Microwave ablation

What is it

Microwave ablation uses microwave energy to produce heat and kill cancer cells. It is a newer type of treatment. You can have this treatment for more than one secondary liver tumour. You might have a local anaesthetic or general anaesthetic.

How you have it

Your doctor puts a thin needle into each tumour. They use a CT scan or ultrasound scan to make sure the needles are in the right place. Then they connect the needles to a microwave generator. The microwaves are released through the needles to destroy the cancer cells.

Afterwards

The most common side effects include pain and a high temperature.

Laser therapy

What is it

Laser therapy is also called laser ablation. The surgeon uses a very high powered beam of light to destroy cancer cells in the liver, by heating them to high temperatures. You usually have a sedative to make you drowsy but you might have a general anaesthetic.

If you have the sedative, your doctor injects a local anaesthetic into the skin of your abdomen to numb it. They then push a flexible tube that carries the laser light through the skin over the liver and into the centre of each tumour.

How you have it

The doctor uses a CT scan or ultrasound scan to make sure the tip of the tube is in the right place. Then the laser heats the tumours and destroys them.

Laser therapy can treat tumours up to 5cm (2 inches) in size.  It takes about 10 to 15 minutes.

Afterwards

Usually, you can go home a few hours afterwards. You might need to have the treatment repeated. The main side effects are pain and a high temperature for a few days afterwards.

Alcohol treatment

What is it

This treatment uses sterile alcohol to destroy cancer cells. It involves injecting alcohol (ethanol) through the skin, directly into the cancer in the liver. Ethanol destroys the cancer cells by killing the proteins in the tumour and dehydrating it.  

It is only suitable for liver tumours smaller than 4 to 5cm.

How you have it 

You might have medicine to make you drowsy. The surgeon then injects local anaesthetic into the skin over the liver. They push a thin needle through the skin and into the tumours. A CT scan or ultrasound scan makes sure the needle is in the right place. Then they inject the alcohol directly into the tumour. 

You can have this treatment for more than one tumour in the liver.

Afterwards

It can be painful, so you take painkillers for a while afterwards. Some people feel drunk for about 10 to 15 minutes after the injection.

You usually stay in hospital for a few hours after your treatment, in case you have any bleeding or pain. You can have the treatment again some time later if the tumours grow back.

Information and help

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