According to statistics, liver cancer ranks fourth among cancer deaths. Liver cancer cases have increased threefold in the last 40 years. In general, the disease is very difficult to detect based on symptoms. Actually, people who are already suffering from severe liver diseases, or who have cirrhosis (usually a disease caused by Hepatitis-B or C virus infection), or those who are suffering from alcoholic liver disease or fatty liver. Those prone to the problem are more likely to get early liver cancer. When cancer spreads to the intestine, lungs, breast and other parts of the body, then the second stage of liver cancer can develop.
Cancer removal through surgery
Removing the affected part from liver cancer through surgery - is considered the best way to treat this disease. Unfortunately, it is not possible for most patients to have surgery due to the tumour size being too large, liver enlargement, or liver disease extending beyond the threshold. Liver transplant facilities are available to a small number of patients, as there is a limited amount of organ supplies required for the transplant. Because of this, patients have to wait for a long time and their tumour increases, resulting in a reduced rate of a liver transplant.
A) Image-guided abstract therapies
Radiofrequency Ablation (RFA):
This method is used to treat tumours of less than 3 cm in size. Interventional radiologists or oncologists place a small, needle-like probe directly into the tumour with the help of live image (CT / USG) guidance to identify the exact location. Then radiofrequency energy is sent through the probe which generates heat and destroys liver tumours. In this process, there is no damage to healthy cells.
Microwave Ablative Therapy:
The process of microwave ablation is known as die-electric hysteresis. With the help of CT / USG guidance, a specially made microwave probe is inserted directly into the tumour and the heat generated around the probe destroys the abnormally enlarged tissue. The microwave ablation process removes the affected organs well, patients experience less pain, as well as less damaging effects on nearby blood vessels.
In the cryoablation process, the use of extreme cold destroys the cancer cells. Ultrasound imaging allows the interventional radiologist to place a liquid nitrogen-containing cryoprobe (metal probe) directly onto the liver tumour. The cryoprobe destroys the tumour by overheating. Cryoablation can be used to treat larger tumours than other methods of removing the affected organs, and this sometimes requires general anesthesia.
Unfortunately, treatment of most patients is not possible through thermal ablation as in most cases the tumour is very close to the main bile duct. However, the use of the direct current in irreversible electroporation (IRE) destroys cancerous cells. It is more useful if the tumour is close to the main bile duct because it is not possible to treat such patients with normal thermal ablation techniques.
B) Trans-arterial liver therapy:
Trans-arterial chemoembolization (TACE):
Traditional trans-arterial chemoembolization (TACE) uses chemotherapeutic agents as well as oil, and it is suggested to use this technique in the second stage of the disease. Chemotherapy uses drugs to destroy cancer cells, which normally prevent cancer cells from growing, dividing, and forming new cells. During this procedure, with the help of live image guidance, Interventional Radiologists transport a small tube (microcatheter) through a small hole in the patient's waist or wrist to the blood vessel that supplies blood to the liver tumor.
Trans-arterial radioembolization (TARE)
Radioembolization with Yttrium-90 seeds is used as an alternative to treatment for patients who have reached the second stage of HCC. In this process, the microcatheter is transported to the blood supply artery to the liver tumor, and then a radioactive material is sent within the tumor. Like chemoembolization, radioembolization is also very effective and safe. Additionally, radioembolization is quite safe and effective for patients with the advanced stage of HCC. Modern methods of radioembolization include radiation segmentectomy, in which high doses of radiation are delivered to the arteries to destroy tumors and protect the normal liver parenchyma from radiation.