Liver cancer is on the rise in the United States, but less-invasive laparoscopic surgery is easing treatment for some patients.
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Cancer of the liver is becoming more common due to such factors as hepatitis C, as well as another condition called non-alcohol fatty liver disease.
Hepatocellular carcinoma is the most common type of liver cancer. It is the fifth-most common type of cancer overall and the third-most common cause of cancer deaths. U.S. doctors diagnose about 20,000 new cases of this type of cancer each year. About 1 million new cases occur worldwide each year.
About a third of hepatocellular carcinoma patients are candidates for treatments that may cure the disease, says liver transplant surgeon Federico Aucejo, MD. These treatments include liver resection, which is the surgical removal of the diseased part of the organ. Other options include liver transplant and radiofrequency ablation, which kills smaller tumors.
Cholangiocarcinoma is the second-most common type of liver cancer. It occurs in the bile duct. Doctors diagnose about 5,000 new cases per year in the United States. Liver resection is the most likely surgical option for this type of cancer, Dr. Aucejo says. However, in some cases doctors perform a transplant.
Even as the number of patients with liver cancer grows, minimally-invasive laparoscopic techniques are evolving, Dr. Aucejo says.
For those who are candidates for surgery, which means their tumor hasn’t become too advanced, there have been advances in minimally-invasive surgery. Over the last two decades, laparoscopic resection has evolved and made these procedures less physically burdensome for the patient, Dr. Aucejo says. These procedures can be used for treatment of both types of liver cancer, he says.
While doctors are treating “more and more” liver cancers through laparoscopic means, traditional surgery is still the best course for some larger tumors, Dr. Aucejo says.
The patient outcomes are very similar for traditional surgery and minimally-invasive laparoscopic surgery, he says. However, minimally invasive techniques have some advantages.
“These patients have less pain, they’re in the hospital for shorter periods of time because the recovery is faster, and they get to go back to work earlier, compared to open surgery,” Dr. Aucejo says.
Patients whose tumors are too advanced for surgery or radio ablation are candidates for local and regional treatments that will not cure the cancer, but will help to control the tumor’s growth, Dr. Aucejo says. These treatments include chemoembolization and radioembolization. These treatments release localized chemotherapy and radiotherapy through a catheter into the blood supply.
Researchers also continue to look for improvements and innovation in medication, he says. Many medications are in the process of clinical study.
“There are always new medications appearing,” Dr. Aucejo says.
