If you’ve received the news that you have hepatocellular carcinoma (HCC), there’s no doubt that you have many questions about treatment. Your doctor can explain why certain treatments may be better for you than others.

Continue reading to learn about the different types of treatment for liver cancer and how they work.

Treatment overview

Among adults, HCC is the most common type of liver cancer. Risk factors for liver cancer include alcohol abuse, cirrhosis, and hepatitis B or C.

There are quite a few methods of treating HCC. Surgical resection and liver transplant are associated with the best survival.

As with most types of cancer, your treatment plan will likely involve a combination of several treatments. Your doctor will make recommendations based on:

  • your age and general health
  • the cancer stage at diagnosis
  • the size, location, and number of tumors
  • how well your liver is functioning
  • whether or not this is a recurrence of previous liver cancer

Targeted drug therapy

Targeted drugs are used to focus on the cells that are involved in the growth and development of cancer.

One targeted treatment for liver cancer is sorafenib (Nexavar). This drug has two functions. It blocks tumors from forming new blood vessels, which tumors need to grow. It also targets certain proteins on cancer cells that fuel growth. Sorafenib is a pill you can take twice a day.

Regorafenib (Stivarga) works in a similar way. It’s usually the next step when sorafenib has stopped working. It’s a pill you take once a day.

In 2017, the U.S. Food and Drug Administration granted accelerated approval to nivolumab (Opdivo) for the treatment of hepatocellular carcinoma. It’s intended for people who have already tried sorafenib. Nivolumab is an immunotherapy drug designed to activate the immune system to find and kill the tumor cells. It’s given intravenously. Some early studies of this drug have shown promising results in the treatment of advanced liver cancer.

Surgical resection

This surgery involves removing the part of the liver that contains the tumor. This is a good option if:

  • the rest of your liver is functioning well
  • cancer hasn’t grown into blood vessels
  • cancer hasn’t spread outside the liver
  • you’re healthy enough to withstand surgery

It may not be a good option if:

  • your liver doesn’t function well, usually due to cirrhosis
  • the cancer has metastasized
  • you’re not healthy enough for surgery

Risks of surgery include infection, bleeding, and blood clots.

Liver transplant

If you have early stage liver cancer but can’t have surgical resection, you may qualify for a liver transplant. This procedure significantly lowers the risk of a second liver cancer. However, donor livers are in short supply, and waiting lists are long.

If you do have a liver transplant, you’ll need antirejection medications for the rest of your life.

Transplant surgery risks include bleeding, blood clots, and infection.

Radiation therapy

Using high-powered X-ray energy, radiation therapy is used to kill cancer cells and shrink tumors. External beam radiation is usually given five days a week for several weeks. It can take some time to get you set up in exactly the right position before each treatment. But the actual treatment only takes a few minutes, during which you’ll have to remain perfectly still.

Temporary side effects of radiation therapy include skin irritation and fatigue.

Another type of radiation therapy is called radioembolization. In this procedure, the doctor injects small radioactive beads into the hepatic artery. There they give off radiation for several days. The radiation is confined to the tumor in the liver, sparing surrounding tissue.

Ablative techniques

Radiofrequency ablation is a procedure in which the surgeon uses an ultrasound or CT scan to guide a needle through the abdomen into the tumor. An electric current is used to heat and destroy cancer cells.

Cryoablation uses extreme cold to kill cancer cells. In this procedure, the doctor uses ultrasound to guide an instrument containing liquid nitrogen, which is injected directly into the tumor.

Pure alcohol can also be used to destroy cancer cells. Your doctor can inject it into the tumor through your abdomen or during surgery.

Chemotherapy

Systemic chemotherapy isn’t standard treatment for liver cancer because it’s generally not effective in the long run. But powerful chemotherapy drugs can be injected directly into the liver. Side effects of chemotherapy include fatigue, nausea, and low white blood counts.

Supportive and complementary care

While you’re treating the cancer itself, you can also seek help from a palliative care specialist. These specialists are trained to manage pain and other symptoms to improve quality of life. They will coordinate care with your oncologist and other doctors.

In addition, complementary treatments may help control pain, nausea, and anxiety. Some of these are:

  • massage
  • music therapy
  • breathing exercises
  • acupuncture
  • acupressure

Consult with your doctor before starting new therapies. And always make sure you’re dealing with qualified practitioners.

You might also be interested in trying dietary or herbal supplements. But some can interfere with your medications, so always check with your doctor first. It may also help to meet with a nutritionist or dietician to go over your nutritional needs.

Clinical trials

Clinical trials help researchers test the safety and effectiveness of experimental treatments in humans. Through a trial, you might gain access to state-of-the-art therapies. There’s also a lot to consider. These trials often have strict criteria and involve a time commitment. Talk to your oncologist about clinical trials for people with liver cancer.

For more information, visit the American Cancer Society’s Clinical Trials Matching Service.