Reviewed By: Pramod Kerkar, MD, FFARCSI

What Is The Best Treatment For Liver Metastases?

Chemotherapy for liver metastases is very helpful in a slow progression of cancer. Systemic chemotherapy, hepatic arterial infusion, and chemoembolization are used to stop or slow the growth of liver metastasis. Systemic means circulation of drugs throughout the body which can be given either orally or intravenously. Hepatic arterial infusion is the process of delivering the drugs through an artery of the liver. Chemotherapy is directly to liver tumors where surgery is not applicable. Floxuridine is the most common drug used for hepatic arterial infusion. Chemoembolization is an interventional radiology procedure designed to reduce blood supply to a tumor and deliver chemotherapy drugs directly to a tumor while reducing exposure to healthy tissues.

Targeted Chemotherapy

Targeted chemotherapy is more effective and completely different from standard chemotherapy. Here, drug requires specific receptor for attachment. It is helpful in clearing cancerous cells that are in a distant organ. Like chemotherapy, these drugs subjected to the bloodstream. Best example is sorafenib (nexavar), regorafenib (stivarga) bevacizumab (avastin) or cetuximab (erbitux), and erlotinib (tarceva). Some of the drugs often used along with standard chemotherapy.

Pain Management

People with liver cancer or metastases frequently experience pain, especially in their upper right abdomen. Corticosteroids such as dexamethasone (decadron, dexasone) and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (motrin, advil, nuprin) are some of the most common drugs used for managing pain in liver metastases condition. Narcotic pain relievers such as codeine, morphine (Kadian, MS Contin, Oromorph), and oxycodone (OxyContin) require a prescription.

Hormonal Therapy

Hormonal therapy is used to slow the growth of tumors in the liver and relieve symptoms. It is given for some types of cancer that have spread to the liver, especially breast cancer. Liver metastasis is a frequent occurrence in patients with breast cancer. Common side effects of many types of hormonal therapy are hot flashesweight gain and less interest in sex.

Radiation Therapy

Radiation therapy uses high-energy rays to kill cancer cells. In rare cases, external beam radiation is given to the whole liver to relieve symptoms (called palliative treatment). However, high risk of liver damage associated with this radiation therapy. Similarly, Stereotactic body radiation therapy (SBRT), a short-time therapy given in high doses of radiation for 5 days a week or several weeks. Beams are aimed at the tumor from many different angles. Radioembolization or selective internal radiation therapy is a procedure that delivers radiation directly to liver tumors which uses tiny radioactive beads called microspheres. A catheter transmits the radioactive beads through the hepatic artery to the liver. Its site of action is specific i.e. focusing on tumor and not on healthy liver cells.

Ablation Therapy For Liver Metastases

Ablation techniques are used in patients who have tumors where surgery is not an option. It involves treatment that destroys liver tumors without removing them. It is done by radiofrequency ablation (RFA) which uses electrical currents to create heat that destroys cancer cells. Cryotherapy is another form of ablation therapy which uses extreme cold to freeze and destroy abnormal and cancerous cells or tissue. It is also called cryosurgery or cryoablation. The third method is known as percutaneous ethanol injection which involves the injection of ethyl alcohol directly into a liver tumor. Ethyl alcohol can kill cancer cells and shrinks the tumor.

Liver Metastases Surgery

Surgery may be used to treat liver metastasis when only one area or a few areas of cancer are found. This is called as partial hepatectomy i.e. surgery to remove part of the liver. It is also referred to as liver resection. It has a possible risk and only skilled surgeons are recommended to do liver resection without affecting other part of the body. Bleeding after surgery is a major concern associated with liver resection.

Liver Transplant

Liver transplant is the best option for some people who tumors that cannot be removed with surgery. Because of the location of the tumors or the liver is too diseased. Like partial hepatectomy, a liver transplant also a major operation with serious risks like bleeding, infection, blood clots, and complications from anesthesia.

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Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: June 28, 2018

This article does not provide medical advice. See disclaimer

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