Liver Cancer

Your best long-term outcome will be achieved with a comprehensive, coordinated approach that incorporates all available therapies. Your Winship care team draws on Emory’s vast resources in surgical oncology, radiation therapy and medical oncology, to provide the newest, most effective practices and treatments for liver cancer.

Our multidisciplinary care teams include oncology surgeons, radiologists, pathologists, pharmacists and advanced practice nurses with expertise in liver cancer and other gastrointestinal cancers.

The benefits of our multidisciplinary and highly experienced teams include:

• Access to doctors and surgeons who rank among the top cancer experts in the world.
• Weekly review of patient cases by the full team of experts.
• Coordinated scheduling for appointments among various specialties.
• Access to nurse navigator to assist you throughout the treatment process.
• Access to support groups and education classes for you and your caregivers.
• Availability of new treatment options within our clinical trials program.

The primary cancers of the liver are further divided into two types: liver cancer or hepatocellular, and bile duct cancers or cholangiocarcinoma.

A patient with liver cancer symptoms may have one or more of the following procedures to diagnose their disease:

CT scan or MRI: detailed pictures of the liver and surrounding organs can reveal tumors and irregular tissue.

Biopsy: a small tissue sample is examined by a pathologist to determine if cancerous cells are present.

The stage of your disease indicates how much it has spread in the liver and whether it has spread to other organs and lymph nodes. Early stage cancer is a disease limited to the liver. Late stage cancer indicates spread to other organs like the lung or to the bone. Determining the stage of your cancer will affect your treatment plan. Your Winship care team may use one or more tests and procedures to determine the stage of your cancer including a blood test and imaging tests.

Your care team will discuss treatment options with you and it is important to take time and consider all possible choices. One or more of the following types of treatment will be used.

Transplant: is the replacement of a diseased liver with some or all of a healthy liver from another person. This procedure is useful in small tumors that do not involve the blood vessels.

Surgery: a surgeon may remove parts of the liver and nearby affected tissues.

Liver directed therapies: a group of minimally invasive procedures usually performed by interventional radiologists. These procedures include ablation and transcatheter therapies. Ablation means the destruction of the tumors by directly applying heat, cold or energy (microwave). Transcatheter therapies include injecting small particles that carry chemotherapy or radioactive material directly into the blood vessels that supply the tumor. Liver directed therapies may be used to shrink tumors in preparation for surgery or transplant.

Radiation: Liver cancer may be treated using radiation to shrink the tumor. Radiation therapy uses high-energy x-rays to kill cancer cells. For bile duct cancer, radiation may be used in combination with surgery and chemotherapy. It may also be used when surgery is not an option.

Chemotherapy: Chemotherapy is sometimes used to treat bile duct cancer in addition to surgery and radiation. In addition to standard targeted therapies, participating in a clinical trial may be an option in certain cases. Clinical trials provide patients access to new medications that are being developed to treat bile duct cancer.

Targeted therapies: researchers identify unique characteristics of tumors that make them vulnerable to known drugs so therapy can be tailored to an individual’s cancer. In targeted therapies, investigators look for new drugs that more selectively target cancer cells with fewer side effects.

In addition to delivering the highest quality medical care, we recognize the importance of the psychological and emotional aspects of living with a cancer diagnosis and of dealing with treatment. Our supportive oncology team addresses these issues in a timely manner with additional support from counselors, nurse navigators, dietitians and social service professionals.

We understand that this is a very stressful time. We welcome your questions and requests for help. Learn what to expect on your first visit.