https://ejnmmipharmchem.springeropen.com/articles/10.1186/s41181-019-0066-3. Intrahepatic visualisation of Ho-166-microspheres after SIRT. T2-weighted MRI of the liver in a patient with several ocular melanoma liver metastases, outlined by coloured regions of interest (a). After SIRT, the distribution of Ho-166-PLLA-microspheres within the liver was visualized by single-Photon-emission CT (b) and R2-weighted MRI (c). Reprinted from The Lancet Oncology, Vol. 13, Smits et al., Holmium 166 SIRT in patients with unresectable, chemorefractory liver metastases (HEPAR trial): a phase 1, dose-escalation study, 1025–1034, Copyright 2012, with permission from Elsevier.
What is it?
Liver cancer, also called primary liver cancer, starts in the liver itself; not originated from cancer spreading in from elsewhere. The two main adult forms are hepatocellular carcinoma (HCC), which makes up most cases, and intrahepatic bile duct cancer, also known as cholangiocarcinoma.
Less common adult forms include fibrolamellar carcinoma and mixed hepatocellular-cholangiocarcinoma. In children, liver cancers include hepatoblastoma (most common), childhood HCC, fibrolamellar carcinoma, undifferentiated embryonal sarcoma, and others.
Main symptoms:
Liver cancer often shows no early signs. As it grows, people may notice:
- A hard lump or discomfort under the right ribs
- A swollen belly often due to fluid build-up
- Yellowing of the skin or eyes (jaundice)
- Easy bruising, tiredness, nausea, loss of appetite, unexplained weight loss, pale stool or dark urine, or a low-grade fever.
Standard treatment:
Treatment depends on the tumor’s stage and your overall health:
- Localized cancer (non-metastaic):
- Watchful waiting for very small tumors
- Surgery (removing part of the liver) or a liver transplant
- Ablation techniques, like radiofrequency or microwave ablation, to destroy the tumor with heat or cold
- External radiation uses high-energy rays to kill cancer cells; it is used only in certain cases.
- Advanced or spread cancer:
- TACE (transarterial chemoembolization), where chemotherapy is directly delivered to the tumor via the liver's blood vessels
- Targeted drugs uses special drugs that attack specific parts of cancer cells, responsible for the cancer growth or survival; sparing most healthy cells. Immunotherapy helps the immune system fight the cancer.
Radiotheranostics:
Radiotheranostics is a new type of treatment that combines therapy and diagnostics.
For the treatment of some liver cancers and liver metastasis originated from other cancers it is possible to use Selective internal radiation therapy (SIRT), also called radioembolization, this uses tiny radioactive beads injected into the arteries feeding the tumor. These beads block the tumor’s blood supply and deliver radiation directly—helping shrink tumors with minimal effect on healthy liver tissue.
Your doctor can help you understand which treatment is right for you.
To know more about:
Patient associations:
North America: American Liver Foundation (USA), Blue Faery (USA)