Considering liver cancer (hepatocellular carcinoma) may not be as well-known or recognized as other types of cancers, it is the fifth most common cancer in the world -- and oftentimes fatal.
Different from metastatic disease, the most common primary liver cancer—also known as hepatocellular carcinoma (HCC) -- actually starts in the liver and is generally caused by factors such as hepatitis B or C, excessive alcohol use, or non-alcohol fatty liver disease -- all which in turn can cause cirrhosis. This irreversible scarring is what puts patients at risk for developing liver cancer.
The second most common type of primary liver cancer, cholangiosarcoma, begins in the bile duct. With approximately 5,000 new cases each year in the US, liver resection is the most common treatment option for these patients, or in some cases a transplant.
HCC cases are on the rise in the US, with approximately 20,000 new patients each year being diagnosed, and about 1 million worldwide.
Liver cancer may not cause symptoms until very advanced stages. As a result, the only way to pick up liver cancer in the early stages is to have a screening test done such as an ultrasound -- especially for those patients with a history of hepatitis or cirrhosis.
For those HCC patients diagnosed in the earlier stages of disease, laparoscopic tumor resection has been successful. But for those patients with larger tumors, a more traditional surgical approach may be best. Liver transplantation and radiofrequency ablation may also be an option for patients.
Patients with advanced tumor disease who are not candidates for surgery and/or radiofrequency ablation may opt for chemoembolization (delivering chemotherapy directly into the liver tumor) or radioembolization (microspheres are placed inside the blood vessels that feed a tumor in order to deliver a high dose of radiation to the tumor, but not to normal tissues). Both procedures are done all in an effort to control tumor growth, but not to cure the cancer. Intravenous chemotherapy may also be administered for patients with metastatic disease.
While less-invasive laparoscopic procedures have improved, researchers continue to look for improvements when it comes to drug development, specifically targeted therapies -- this has been the biggest challenge for researchers when it comes to treating these highly aggressive tumors.
What has been your experience working with patients diagnosed with primary liver cancer?