Liver Cancer Treatment: Is surgery the only good solution?

As of today, liver cancer is considered to be one of the fourth biggest causes of deaths. Where it has also seen a three-fold increase in its current and new cases in the last 40 years. It is usually difficult to treat due to late diagnosis. Primary liver cancer usually affects individuals who already have liver disease or cirrhosis (hepatitis B and C virus infection), alcoholic liver disease, or fatty liver disease. The secondary liver can be caused by cancers in the cancers, bowel, lung or breast.

What is surgical resection?

Surgical resection of that part of the liver, where cancer is found, is considered a better solution. But at the same time some patients are not able to take advantage of this surgical procedure due to enlargement of tumor, tumor spread outside the liver or other liver disease etc. Liver transplantation is available to very few people, because organ supplies are limited. At the same time, due to the increasing waiting period, an increase in the tumor is seen, due to which the patient ignores this remedy. While systemic chemotherapy and radiotherapy are not effective except for the convenience of chemotherapy or the growth of antibodies, long-term survival of liver cancer is extremely rare. Therefore, many alternative treatments for liver cancer are now available.

Interventional radiology is a blend of medicine and technology that is making a mark as a minimally invasive anti-cancer treatment. These therapeutic strategies are divided into two categories. The first of these categories is Guided Ablative Therapies, which includes Radiofrequency Ablation (RFA), Microwave Ablative Therapy, Cryoablation, Irreversible Electroporation Therapies. The second category consists of trans arterial hepatic therapies, mainly using trans arterial chemo embolization (TACE) and trans arterial radio embolization (TARE). Let us now understand in detail about these therapies.

Guided ablative therapy

Radiofrequency Ablation (RFA)
This treatment is done to cure small tumors whose size is less than 3 cm. Interventional radiologists insert a small, needle-like probe live image (CT / USG) into the tumor. After this, radiofrequency energy reaches the tumor through the probes and produces heat, so that liver tumors can be destroyed. This procedure does not harm the normal and healthy cells.

Microwave ablative therapy
Microwave ablation works through dielectric hysteresis. With the help of CT / USG, the probes are inserted into the tumor and these tumors are destroyed by heat. Microwave ablative therapy increases the distention zone of the cancellous cells and reduces pain in the patient. Also, it reduces the damage to healthy blood vessels.

In cryoablation, the cancerous tumor is destroyed using extreme cold. Interventional radiologists employ ultrasound imaging using cryo-probes, which are filled with liquid nitrogen. This probe is inserted into the tumor, which helps it to freeze. Cryoablation is used to treat large tumors, which sometimes require the patient to be given general anesthesia.

Irreversible electroporation
Unfortunately, many patients cannot be given thermal ablation as the tumor reaches the main biliary tract. Irreversible Electroporation (IRE), which is used to kill tumors with the help of current, can be used in this situation. Irreversible electroporation is used where thermal ablation is considered to be technicized. Tumors are eliminated by using pulsed direct current without damaging the bile duct.

Now we talk about other types of categories, which can be used in the treatment of liver tumors

Trans arterial hepatic therapies

Trans Arterial Chemo Embolization (TACE)
Trans arterial chemo embolization (TACE) is used as first line therapy, which is used in intermediate stage. It is used by mixing chemotherapeutic agent in oil. Such drugs are used in chemotherapy which kills cancer cells. . In this procedure a radiologist uses a small tube, called a micro catheter. In this procedure, through a hole in the patient’s groin or wrist, it is transported to a blood vessel that supplies blood to the liver tumor. The chemotherapeutic agent is then injected from this catheter and the blood vessel is blocked. This causes these agents to remain present in the blood vessel for some time and destroys liver tumors.

It has been found from the study that through this technique, the present survival rate has been seen to be increasing. Drug alluring seeds are also used in place of oil, which causes less harm to the liver. For people who are waiting for a liver transplant, this therapy may also work, which reduces the growth rate of the tumor.

Trans Arterial Radio Embolization (TARE)
This treatment is used for intermediate stage patients. In this procedure, the catheter is inserted into the artery, which supplies blood to the tumor. The treatment and safety of this treatment is the same as chemo embolization. Radio embolization is a new concept, surviving normal liver radiation.

These non-surgical treatments are given separately or in combination for better results. Their benefits are that they are less invasive and their side effects are also less compared to chemotherapy. Ablative therapy targets the tumor itself, causing no harm to healthy organisms. In these procedures, the patient can feel better and there is no need for anesthesia.

When liver cancer is identified in the early stage, the results of these treatments appear to be good. Therefore, patients who have chronic hepatitis, cirrhosis problems or who have a risk of developing liver cancer, need regular monitoring.

Original Article

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