Liver Cancer

Please follow the links below for information on liver cancer and how it is treated by the Belfast Trust:


Types

There are several main types of liver cancer:

  • Hepatocellular carcinoma (HCC) is the main type of primary liver cancer. Approximately 85 out of every 100 (85%) primary liver cancers are this type.
  • Metastatic Carcinoma is a cancer that has spread to the liver from a primary tumour of the rectum or bowel.
  • Benign liver tumours are non-cancerous tumours that do not spread to other parts of the body. They are usually small and have no accompanying symptoms.

Rarer types inlcude angiosarcomas and hepatoblastomas.

Please follow the link for more information on liver cancer.  

Investigations and Diagnosis

Patients will be seen by a specialist Consultant when they are referred to the hospital. The doctor will ask the patient about their symptoms and general health before doing a physical examination. A blood test may be required to assess a patient's general health.

Patients may then be sent for tests to find out the cause of their symptoms. Investigations include:

 

Treatment

If a patient has confirmed liver cancer the type of treatment they have will be based on individual circumstances. The patient's doctor will discuss the various treatment options available and give advice on the treatment decision. Before patients can have any treatment they must give their consent

Please follow one of the links below for general information on the the types of treatment:

Chemotherapy/ Chemoemobilisation

Chemoemobilisation treatment aims to get rid of the cancer by giving chemotherapy directly into the affected part of the liver and by cutting off the blood supply to the tumour. Chemotherapy drugs are injected directly into the tumour in the liver. The chemotherapy drugs will be mixed with a substance called lipiodol that helps the chemotherapy stay in the liver for longer. This makes the treatment more effective.

Chemoemobilisation is carried out in the x-ray department in the Royal Victoria Hospital by Consultant Radiologists who are specially trained for the procedure. Patients undergoing chemoembolisation will usually need to stay in hospital overnight and possibly longer. The treatment can be repeated several times.

Depending on their circumstances, patients may also undergo chemotherapy in the Northern Ireland Cancer Centre.

Radiotherapy

Patients who require radiotherapy as part of their treatment will do so under the care of an oncologist in the Radiotherapy Department of the Cancer Centre.

Ablation

Ablation is a process used to destroy primary liver tumours. Primary liver tumours can be ablated, using either alcohol (also known as a  percutaneous ethanol injection) or heat (also known as radiofrequency ablation or RFA).  

Surgery

Surgery aims to completely remove the cancer completely with an operation.

Very small cancers can often be treated with a simple surgical operation under local or general anaesthetic, or with laser surgery. There is often no need for patients being treated in this way to stay in hospital overnight.

If the cancer is larger, surgery will often involve a hospital stay and an operation under general anaesthetic.

If only certain areas of the liver are affected by cancer and the rest of the liver is healthy, it may be possible to remove the affected part. This is called a liver resection.

If the operation involves the removal of a whole lobe of the liver, it is called a hemi-hepatectomy.

The liver has an amazing ability to repair itself. Even if up to 80% of the liver is removed it will start to re-grow very quickly, and may be back to normal within a few weeks.

Patients will most likely have their surgery as an inpatient in the Mater Hospital.

Liver transplant

It may be possible to remove the whole liver and replace it with a liver from another person – a donor. In the treatment of Hepatocellular carcinoma (HCC) a liver transplant can only be done if  patient has:

  • a single tumour that is between 3–5cm
  • a single tumour that is between 5–7cm that hasn’t changed in size for six months
  • a maximum of five tumours, all smaller than 3cm in size.

Patients may also have a liver transplant if they have cirrhosis of the liver. However, patients with severe cirrhosis may not be well enough to go through this major operation.

Patients from Northern Ireland, under the care of the Belfast Trust, who require a liver transplant will travel to England to have their operation. This will be arranged by the Belfast Trust and patients will discuss this with their Consultant.