Treatment

Our Approach

Because all the blood in the body must pass through the liver, it is unusually accessible to cancer cells traveling in the bloodstream.

Most liver cancers are metastases from some other organ and are treated differently than primary tumors that originate in the liver.

Patients who come to the Siteman Cancer Center for treatment of liver cancer are seen by a team of Washington University Physicians — surgical, medical and radiation oncologists — often during the same visit.  A health psychologist is also available as needed. The treatment team, comprised of surgery, medical oncology, radiation oncology, pathology and interventional radiology meet weekly to review 20-25 liver cancer cases to determine the best personalized care for you.

Experienced nurses then spend time with you, answering your questions and putting you in touch with resources that may help during this stressful time. These nurses offer patient materials on your condition, chemotherapy, radiation therapy, surgery and other related issues. As a unique feature of your care, we also offer the services of a palliative care specialist who can help you fit treatment into your own special circumstances, if needed.

Siteman is one of the top centers in the U.S. for treating liver cancer, because of our highly skilled surgeons. The group has developed techniques that allow for bloodless liver surgery. Transplantation is also performed on a growing number of cancer patients. You benefit from treatment performed in this kind of specialized, high-volume center, which produces better outcomes. The experts at the Siteman Cancer Center treat on average 232 cases a year.

Radiation oncologists have created novel ways to deliver radiation from the outside and the inside of the liver to target single and multiple tumors with less damage to surrounding tissue.

Radiation can attack cancer cells that may be left behind after surgery in hard-to-access areas around blood vessels. For the past few years, radiation oncologists at Siteman have been supplementing chemotherapy after surgery with radiation for patients with liver cancer to deliver radiation more precisely to the tumor, sparing normal tissue. Clinical trials are evaluating new techniques to destroy tumors. One of the outcomes of these trials has been the use of cryosurgery, a technique that destroys abnormal cells by freezing them. Another promising technique is radiofrequency ablation, which uses heat for the same purpose.

Our radiologists provide up-to-the-minute imaging for liver cancer, especially PET scans and ultrasound, both of which have helped more accurately identify patients who can benefit from surgery, sparing those who wouldn’t.

The two types of adult primary liver cancer are:

  • Hepatocellular carcinoma: This is the most common type of primary liver cancer (cancer originating in the liver).
  • Cholangiocarcinoma (bile duct cancer)

Types of treatment used for liver cancer depend on the type of cancer, its malignancy, the stage at which it is diagnosed, whether the cancer originated in the liver or has come from another organ, whether the cancer has spread outside the liver, the patient’s age, and overall health. If the cancer is contained in the liver, you may be eligible for a liver transplant.

Siteman cancer physicians are actively involved in clinical trials that investigate new chemotherapy regimens, and other approaches to cure. Having your cancer treated at Siteman gives you access to new therapies that are as good as – or potentially better than – current standard therapies available elsewhere.