Liver cancer treatment depends on the stage of the cancer, the patient's age, and the patient's overall condition. Some of the methods commonly used are:
Operation
Surgery is performed if there is only one cancer in the liver, liver function is still good, and the cancer has not spread to other organs. One type of surgery to treat liver cancer is the removal of the cancerous part of the liver.
Another surgical option is liver transplantation, which involves removing the patient's entire liver and replacing it with a donor's liver. Liver transplant is done if the location of the cancer is in a position that is difficult to remove.
Ablation
Ablation is an action to destroy the cancer without having to remove it. This method is used for small cancers, or for patients who cannot undergo surgical removal or liver transplantation.
There are several types of ablation, namely:
Radiofrequency ablation (RFA), which uses high-energy sound waves
Microwave ablation (MWA), using electromagnetic waves
Cryoablation or cryotherapy, using liquid nitrogen
Ethanol ablation or percutaneous ethanol injection (PEI), by injecting ethanol directly into the tumor to destroy cancer cells
Embolization
Embolization is an injection of drugs to block or reduce blood flow to cancer cells in the liver. This procedure is performed on cancers that are more than 5 cm in size with good liver function.
Chemotherapy
Chemotherapy is the administration of drugs to kill cancer cells. This procedure is used for liver cancer that cannot be removed surgically, and for liver cancer that cannot be treated with ablation, embolization, or targeted therapy.
Chemotherapy drugs can be given as a single drug or in combination. Common types of drugs used include:
Capecitabine
Cisplatin
Gemcitabine
Doxorubicin
Chemoembolization
Chemoembolization or trans arterial chemoembolisation (TACE) is a therapy that combines embolization with chemotherapy. TACE is done by injecting drugs into the cancer area and blocking blood flow to cancer cells in the liver.
Chemoembolization is performed in patients who cannot undergo surgical procedures and in patients who are waiting for a liver donor. Chemoembolization may also be performed to shrink the tumor so that it can be removed surgically.
Target therapy
Target therapy is the administration of drugs in tablet form that specifically target proteins in cancer cells so that cancer growth is inhibited. This therapy can be done in advanced liver cancer. However, not all liver cancers can respond well to this therapy.
Drugs commonly used in targeted therapy are protein kinase inhibitors, such as sorafenib and regorafenib; and monoclonal antibodies, such as bevacizumab and ramucirumab.
Immunotherapy
Immunotherapy is the administration of drugs that stimulate the immune system to kill cancer cells. This method is usually used in advanced liver cancer.
Types of drugs used in immunotherapy include:
Atezolizumab
Ipilimumab
Nivolumab
Pembrolizumab
Radiotherapy
Radiotherapy or radiation therapy aims to kill cancer cells using high-energy radiation. One type of radiotherapy to treat liver cancer is external radiotherapy, namely by directing a beam of radiation to the patient's body.
Another method of radiotherapy is stereotactic body radiotherapy. This procedure is performed by shooting radiation beams into tumor cells in a focused manner so that they do not hit the surrounding healthy tissue.
Radioembolization
Radioembolization is done by inserting small balls called microspheres into the blood vessels that supply blood to the liver.
The microsphere containing the radiotherapy substance will then enter into the small blood vessels around and inside the cancer. The radiation released by the microsphere will destroy liver cancer cells.
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