Treatment options for liver cancer vary based on the cancer stage and a person’s overall health and liver function. A person should work with their treatment team to determine the best treatment options for their needs.

Treatments involve invasive and noninvasive procedures to destroy or remove tumors.

This article describes several treatment options for liver cancer.

To discover more evidence-based information and resources for cancer, visit our dedicated hub.

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According to the American Cancer Society (ACS), surgery is the best treatment option for liver cancer. There are two types of surgery:

  • Partial hepatectomy: This involves removing only a part of the liver, including the tumor and some healthy cells surrounding the tumor. It is only an option for someone with healthy liver function and overall good health whose tumor has not grown into their blood vessels.
  • Liver transplant: This may be the best option for people who cannot have part of their liver removed. This procedure involves completely removing the liver and replacing it with a new one. This helps restore liver function and reduces the likelihood that cancer will recur.
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Learn more about liver surgery:

An ablation is a treatment option that involves destroying tumors without removing them.

An ablation is often an option when a person has several small tumors or when a person is not a good candidate for surgery because of health or reduced liver function

However, compared to surgery, ablation is less likely to cure cancer.

Doctors typically use ablation on tumors that are 3 centimeters or smaller. They may also use it on larger tumors in combination with other treatments, such as embolization.

There are several types of ablation, including:

  • Radiofrequency ablation: Doctors commonly use this method for small tumors. They insert a thin needle through the skin and into the tumor and use a high frequency current to destroy cancer cells.
  • Microwave ablation: This procedure involves using electromagnetic waves through a thin probe to destroy cancer cells.
  • Percutaneous ethanol injection: A doctor injects concentrated alcohol into the tumor, damaging cancer cells.
  • Cryoablation: Also called cryotherapy, this procedure freezes the tumor by passing cold gases into it through a probe to destroy the cancer cells.

Embolization involves cutting off blood supply to the tumor in the liver.

The liver has a main vein and artery that supply it with blood. The artery provides the majority of blood to most tumors, which means cutting off blood to the artery can reduce the tumor’s blood supply.

Without a blood supply, the tumor will slowly die and shrink. Since most of the blood enters the liver through the vein, leaving that intact should help keep the rest of the liver functioning as usual.

Embolization may be a good option for people who are not good candidates for surgery. However, people with impaired liver function may not do well with this treatment because they may experience some loss of blood to the healthy parts of the liver.

During radiation therapy, a healthcare professional shoots high energy particles directly at the tumor to kill the cancer cells.

The procedure itself is painless and noninvasive. It is similar to an X-ray but more intense.

Doctors will not likely recommend this therapy for people who have reduced liver function as a result of other health conditions.

A person may qualify for radiation therapy if:

  • the cancer has spread to other areas
  • they are not a good candidate for surgery, embolization, or ablation
  • a tumor thrombus is blocking the portal vein
  • they have pain resulting from large tumors

Targeted drug therapy is a newer form of treatment. This treatment option introduces medication into the bloodstream.

Kinase inhibitors are the most common type of targeted therapy for liver cancer. They work either by interfering with how the cancer cells grow and divide or by affecting the way the cancer cells make blood vessels to feed themselves.

Monoclonal antibodies are another common type of targeted therapy for liver cancer. These mimic the immune system and prevent the tumor from forming new blood vessels. A doctor may refer to them as angiogenesis inhibitors.

Both of these types of targeted therapy can cause side effects ranging from mild to potentially serious, which can include:

A person should discuss the potential side effects with their doctor before treatment and let their doctor know if they experience side effects. A doctor may be able to help alleviate some of the symptoms.

Immunotherapy is a newer treatment method that involves administering medicine through an IV to help the body recognize and attack cancer cells.

Typically, if cells in the immune system, known as T cells, find something that does not belong, they signal an attack to remove it.

However, cancer cells sometimes contain the same proteins as typical, noncancerous cells. This means that the T cells do not recognize the cancer cells as dangerous and do not attack them. The cells can then multiply without a person’s immune system interfering.

Immunotherapy may prevent cancer cells from using these proteins to disguise themselves as healthy cells. Doing so helps the immune system find and destroy cancerous cells.

Immunotherapy can cause several side effects, such as:

Sometimes, a person may develop a reaction at the injection site.

In more severe cases, a person may develop an autoimmune reaction in which their immune system attacks healthy cells in their body.

Chemotherapy involves taking medication to kill cancer cells. For liver cancer, a doctor administers the medication into the blood vessels to stop the cancer from growing. This is called chemoembolization.

However, this is not a very effective treatment option for liver cancer. It is successful in shrinking only some tumors.

A doctor may recommend chemoembolization if:

  • surgery is not an option
  • the cancer has not responded to local therapies
  • targeted therapies are no longer a good option

A doctor may recommend a single chemo medication, but a combination of medications is often better for liver cancer.

There are several medications a doctor may choose from that work systemically, regionally, or within the liver itself.

Some common side effects include:

Often, a doctor will discuss the best treatments for a person based on the cancer stage.

This section looks at which treatment methods are most likely to be effective for each stage.

Potentially resectable or transplantable liver cancer (stage 1 or 2)

The best candidates for resection or liver transplant tend to be people with stage 1 or 2 liver cancer in which the tumor has not grown too large or spread.

Resectioning may work well if the person’s liver is otherwise functioning as expected and the person is healthy overall.

A transplant may work best for people whose liver is no longer fully functioning.

Because waiting times for a new liver are potentially long, a doctor may recommend other therapies, such as ablation or embolization, to help manage the cancer.

Unresectable liver cancer (stage 2 or 3)

Unresectable liver cancers can occur in several stages of liver cancer before it has spread to lymph nodes or more distant areas.

However, resectioning and transplant are not good options if:

  • the person is not healthy enough for surgery
  • the person has multiple tumors
  • the tumor is too large
  • the tumor is near a blood vessel or other area that makes it hard to remove

In these cases, a person’s doctor may recommend other treatments, such as chemotherapy, ablation, or radiation therapy.

In some cases, treatment may help shrink the tumor enough to allow for surgical intervention.

Metastatic cancer or advanced liver cancer (stage 4)

Metastatic cancer, also called advanced or stage 4, has spread to the lymph nodes or other areas. Doctors can no longer treat it with surgical intervention.

A doctor will likely recommend the following medications as a primary treatment option:

If these medications do not work, a doctor may recommend using different targeted or immunotherapy medications.

They may also recommend participating in a clinical trial of new, possibly more effective treatment methods.

Finally, a doctor may recommend additional treatments to help relieve symptoms, as well as radiation therapy to further shrink the tumor.

Recurrent

Recurrent liver cancer occurs when the cancerous cells return after successful treatment.

The recurrence can happen in the liver itself or may spread to other areas of the body.

Treatment for recurrent treatment can vary based on several factors, including:

  • what the initial treatment was
  • where the cancer recurs
  • overall liver function

For cancer that returns to the liver, a doctor may recommend therapies such as surgery, ablation, or embolization.

If the cancer has spread, they may recommend therapies such as targeted therapy, chemotherapy, or immunotherapy.

Survival rates typically measure how many people with a certain stage of liver cancer are still alive 5 years after treatment.

Though they are a useful tool to help a person understand their outlook, they do not provide a full picture. Several factors, such as age and overall health, can also impact a person’s chances of survival.

According to the ACS, the likelihood of surviving for 5 years based on the stage of liver cancer is as follows:

  • Localized: 35%
  • Regional, or has spread to local tissue or lymph nodes: 12%
  • Distant, or has spread to other areas of the body: 3%
  • Combined stages: 20%

If one treatment does not work, a doctor may recommend trying another treatment option.

Often, a doctor will not stop trying new treatment options until the cancer goes into remission or the person chooses to no longer try to treat the cancer.

People who need financial help to pay for treatments have options beyond insurance.

Several government, nonprofit, and other organizations can provide help to different groups.

Some organizations may limit who they help based on age, type of cancer, or income level.

For more information, a person can visit CancerCare.org for a list of organizations that may be able to provide some financial assistance.

A person has several treatment options to choose from for liver cancer.

However, not all treatments work well in every situation.

A person should work with their doctor or healthcare team to determine their best options and to get a better idea of their overall outlook.