The incidence of liver cancer in the United States is increasing and will continue to increase over the next 10 to 20 years.

Patients with underlying liver disease due to conditions including Hepatitis B, Hepatitis C, alcohol and obesity are at increased risk.

The good news is that liver cancer is now curable in over 90% of patients if it is diagnosed and treated early. It is important to know that there are still many good treatments for even more advanced cancers, though they may not provide a cure.

The only way to diagnose liver cancer early is to screen on a regular basis with blood tests and imaging studies.

The Comprehensive Liver Center at Hartford Hospital specializes in the diagnosis and treatment of liver disease including liver cancer.

All patients with liver disease seen in The Comprehensive Liver Center are assessed for cancer risk and placed in regular screening programs if appropriate.

Once a cancer is diagnosed, patients are scheduled for evaluation in the Multidisciplinary Liver Tumor Clinic which is part of the Comprehensive Liver Center and includes the same group of health care providers. This clinic is a joint venture between the Comprehensive Liver Center and the Helen & Harry Gray Cancer Center.

Our focus is to bring together specialist from all different fields including Oncologists, Liver Surgeons, Interventional Radiologists and Hepatologists (Liver Doctor) to provide state of the art, compassionate care for a patient with liver cancer.

Our goal is to have an initial evaluation including imaging studies, laboratory work and health care visits in the same day leading to a diagnosis and treatment plan that day.

A letter summarizing the Clinic visit and treatment recommendations is sent to both your referring and primary care physicians.

TREATMENT:

Treatment for Liver Cancer depends on the size and number of the liver cancers and if there is involvement of the blood vessels of the liver, lymph nodes or other organs.

There are now many options to treat liver cancer which can be given alone or in combinations. Your Hepatologist will help monitor your treatment course and take care of any problems related to your liver disease.

Treatment options for Liver Cancer may include:

Interventional Radiology Procedures

Thermal ablation: Imaging guided techniques to kill tumors where they live with extremes in temperature.
Cryoablation – targeted freezing of tumors using thin probes and CT scan and ultrasound guidance. This is an outpatient procedure requiring only mild sedation.

Microwave ablation – targeted heating of tumors to lethal temperatures using precisely placed microwave probes. This is also an outpatient procedure.
Transarterial Chemoembolization (TACE) – A thin tube is threaded into the artery feeding the tumor in the liver and tiny beads containing a powerful anticancer drug are injected. They block tumor blood flow and expose the tumor to a high dose of drug.

Radioembolization – The same approach as with chemoembolization, but tiny resin spheres (SirSpheres) containing radioactive yttrium are injected instead of the drug-containing beads. The radiation dose is very high to the tumor with almost nothing getting to surrounding normal liver.

Systemic Chemotherapy
Sorafenib (Nexavar) is a pill used to treat advanced liver cancer when other treatments are not indicated or in combination with other treatments. There are many other new treatments on the way.

Radiation Therapy
External radiation therapy is sometimes used to kill cancer cells and shrink the tumor. Radiation can be used in combination with other treatments and can help prolong survival.

Liver Transplantation
For those who meet liver transplant criteria, this is an excellent option. It treats the cancer, decreases any risk of cancer recurrence by removing the liver and also treats underlying liver disease. A candidate for transplantation can be evaluated and transplanted at Hartford Hospital through the Comprehensive Liver Center.

Surgery
The tumor and nearby tissue (and possibly lymph nodes) are removed.

Clinical Trials
New types of treatments are being investigated in clinical trials. We can help you access both national and local clinical research trial opportunities.

SUPPORTIVE CARE AND NAVIGATION SERVICES:

The Palliative Care Team is available for consultations and supportive care to help improve quality of life. All patients are also provided with the services of an Oncology Certified Nurse Navigator (OCNN). The OCNN will help to coordinate care, provide emotional support and education and make referrals to supportive services as needed. Services may include social work, nutritional consultations, financial counseling, home care services and integrative therapies. The OCNN may be reached at 860-545-4184.

SUMMARY:

The Comprehensive Liver Center at Hartford Hospital utilizes a coordinated, multidisciplinary approach to liver cancer offering cutting edge treatment. This individualized, streamlined approach to care results in reduced waiting and increased patient satisfaction. By bringing the combined knowledge of our specialists to you over the course of one day we place the patient at the center of care and demonstrate our commitment to diagnose, evaluate and provide treatment in the timeliest manner to ensure best possible health outcomes.

We are confident you will find a team of dedicated professionals at The Comprehensive Liver Center at Hartford Hospital who look forward to the opportunity to provide expert care to meet your health needs.