Interventional radiology for liver cancer

Interventional radiology uses minimally invasive techniques to manage cancers. There are a wide range of image-guided techniques that help to manage your condition non-surgically.

Liver cancer is a condition that affects your liver and occurs when there is cancer formation in your liver cells. In addition many primary cancers spread to the liver.

Symptoms of liver cancer include loss of appetite,loss of weight, nausea, vomiting, upper abdominal pain, abdominal swelling, general weakness, yellowish discoloration of your skin and white of your eyes, white chalky stools, and fatigue.

Treatment for liver cancer involves a team approach that consists of liver cancer surgeon, hepatologist, gastroenterologist, medical oncologist, and interventional radiologist. The role of interventional radiology in the management of liver caners involves broadly two main methods.

Catheter-based treatments
This includes trans arterial chemoembolization (TACE), that is a procedure designed to cut off the blood supply to the tumors along with delivery of Liver cancer specific chemo­therapy. The chemotherapy is delivered directly to the tumors by inserting a catheter and more often a micro­catheter in a super selective approach under imaging guidance. The blockage of blood flow to the tumorsalso stops it from growing further in majority of the cases. This super selective treatment option helps improve the treatment outcome and also reduces side effects which are often seen in systemic chemotherapy regimens done for other solid organ cancers. The common drugs that are used in liver cancer treatment by TACE is doxorubicin and irinotecan.

The other relatively common catheter-based treatment that is done for advanced liver cancer is trans arterial radioembolization (TARE). Here very tiny microspheres are used and these are infused into the hepatic artery branches that supply the liver cancer. In this procedure, the high dose radiation therapy is directed into the liver cancer using the microspheres and this results in much better tumor control without causing any significant background liver damage to the non-cancerous liver. This is particularly useful in patients who are unable to have chemotherapy or those that do not respond to standard TACE procedure.

Needle-based treatments
A minimally invasive option for managing liver cancer is the Ablation technique. Here we can guide a special probe (in case of Radiofrequency ablation/RFA) or antenna (in case of Microwave ablation/MWA) using ultrasound and CT scan guidance precisely in to the liver cancer. This helps to kill and cure tumor’s that are less than 3 cm in size and particularly useful in those patients that are not suitable for surgery. These procedures can also be done under intravenous sedation even if patients are not suitable for general anesthesia. The technique uses thermal energy to destroy the tumor’s and virtually has no side effect or damage to the surrounding normal liver.Another added advantage is in some cases these procedures can also be done as day care procedure.

Benefits of interventional radiology for liver cancers include:

• Reduction in the complications and possible death due to traditional surgical therapies;
• Reduction in the need for hospitalization;
• Minimal amount of tissue loss and blood loss;
• Better option than surgery in some cases;
• Minimal risk of infection;
• Lesser trauma to adjacent tissues;
• Relief from pain;
• Sessions can be repeated if new tumor’s develop; and
• These techniques can be used along with chemotherapy and in patients post liver transplantation.

To understand whether you are eligible for these interventional radiological techniques, you must speak to your doctor. Consult your doctor to get a fair idea of what will work for you and what will help you manage your cancer better.

Recovery after these radiological procedures is shorter than recovery after traditional surgical procedures. You may need to avoid your routine activity for a few days, but after a follow-up with your doctor, you should be good to go.