Liver cancer rates on the rise But new advances show great promise in fighting the disease

A diagnosis of liver cancer used to mean minimal chance of survival. However, with new advances in diagnosis and treatment, the outlook for patients with liver cancer is improving.

HCC, a primary malignant tumor, is a disease in which malignant cancer cells first begin to grow in the tissues of the liver. HCC accounts for about 84 percent of liver cancers and differs from secondary liver tumors -- malignant cells originating in places other than the liver, that have spread to the liver through the blood stream.

One of the newest treatments for HCC is a minimally invasive therapy called radiofrequency thermal ablation. An electrical current is delivered into the tumor through a needle, which heats and destroys the cancerous cells.

"This treatment is generally for patients for whom surgery is not an option because of the size of the tumor or the patient's medical condition. Tumors can successfully be destroyed in more than 90 percent of the cases," said Adrian M. Di Bisceglie, M.D., professor of internal medicine and chief of hepatology at the School of Medicine.

Di Bisceglie says that though surgery is still the main course of action for patients who are candidates, radiofrequency thermal ablation and ethanol ablation -- when alcohol is injected into the liver through the skin by a radiologist using ultrasound or computed tomography guidance to destroy the tumor -- might one day replace surgery. "Though the rates of liver are cancer are increasing, these new treatment options have shown great promise in helping to combat this disease," Di Bisceglie said.

Why are more people being diagnosed with liver cancer? "The rise in incidence of hepatitis C is a major factor for the recent increase," Di Bisceglie said. Hepatitis C, a viral infection of the liver, results in HCC through cirrhosis, which is the formation of scar tissue in the liver. As part of the liver injury, inflammation and regeneration occurs. Approximately 20 percent of people with hepatitis C develop cirrhosis, and 50 to 80 percent of patients diagnosed with HCC have cirrhosis.

In Western countries, HCC most often occurs in people who are in their 50s and 60s. HCC is found four times more often in men than in women. People who have hepatitis B (another viral infection of the liver, but one for which there is a vaccine) also are more likely to develop HCC.

The most common symptoms of HCC are right upper abdominal pain, weight loss and a noticeable liver mass. "Often HCC may be defeated by screening patients known to have hepatitis or cirrhosis. Diagnosing small tumors at an early stage offers the best hope for a cure," Di Bisceglie said. If a patient is in need of a liver transplant because of hepatitis C or cirrhosis, and a cancerous tumor is found, the tumor needs to be destroyed or kept in check while the patient is waiting for a transplant. "A wait for a new liver can take a year or more. But if we can shrink the tumor before it spreads, via radiofrequency thermal ablation or ethanol ablation, the patient still has a chance for transplantation," Di Bisceglie said.

Di Bisceglie is director of the Liver Cancer Treatment Group, a team of physicians and medical staff committed to a multi-disciplinary approach to treating liver cancer, including specialists in the fields of hepatology, oncology, radiology, abdominal surgery, surgical oncology, pathology and radiation oncology.

Top