Hepatobiliary Cancer Treatment

According to the National Cancer Institute, the projected incidence of primary liver and bile duct cancer in the United States for 2018 are as follows:

• Approximately 42,220 estimated new cases
• About 30,200 estimated deaths

Cancer that originally starts in the cells of the liver is known as hepatocellular carcinoma (HCC) or hepatoma. The liver, located on the right side of the abdomen above the stomach, converts the foods we consume into the proteins and carbohydrates that our bodies use for energy. It also stores vitamins and minerals, breaks down toxins and produces bile. HCC is the fifth most common type of cancer and the third leading cause of cancer-related deaths in the world.

Many of the symptoms of hepatobiliary cancer are vague and hard to pinpoint, particularly in the earliest stages. Not all cancer in the liver is considered liver cancer. For example, if you are diagnosed with cancer in another part of the body, and it spreads to your liver, it’s called metastatic cancer. If you are experiencing worrisome symptoms or signs of hepatobiliary cancer, it’s important to contact your doctor for an appointment. Signs and symptoms of liver cancer can be found to the right.

• Back pain
• Abdominal pain
• Abdominal mass
• Weakness
• loss of appetite
• Weight loss
• Jaundice
• Vomiting

Screening is testing to detect cancer in people with no existing symptoms. For people at higher risk of hepatobiliary cancers, such as those with chronic cirrhosis, doctors may recommend screening every six to 12 months.Two primary methods are typically used for screening hepatobiliary cancers:

• Alpha-fetoprotein (AFP) blood test: AFP blood tests are used to detect high levels of a certain protein in the blood that may indicate liver cancer.
• Ultrasound: Ultrasounds use sound waves and echoes to produce an image of internal organs, which may reveal tumors in the hepatobiliary system.

Hepatobiliary cancers may be difficult to detect in the early stages. Smaller, early-stage tumors are often missed in physical exams because the liver and associated organs are blocked beneath the rib cage. Diagnostic tools for hepatobiliary cancers may include:

• Endoscopic retrograde cholangiopancreatography: ERCP is a procedure used to create images of the digestive tract. During an ERCP procedure, doctors insert a thin, lighted tube into the mouth and down through the stomach to produce an image of the surrounding organs and glands.
• Magnetic resonance cholangiopancreatography: MRCP is similar to an MRI, except that is uses specialized software to target the pancreas and bile ducts and create detailed images.
• X-ray, CT, MR and PET scans are often needed to show the location and extent of the cancer. To confirm a diagnosis, doctors will need to remove a small piece of tissue from a tumor for testing. Often, a biopsy sample can be collected during an ERCP procedure, if one is performed.

Depending on the location of the tumor, where the cancer originated, the stage of the cancer, and the overall health of the patient, several techniques may be used, either independently or together, to attempt to slow tumor growth or relieve pain.

• Partial surgical removal of the liver, if all the tumor can be removed
• Chemotherapy
• Radiotherapy
• Liver transplantation

• Brachytherapy
• Radiotherapy
• Chemotherapy
• Liver transplantation

• Surgical removal of the gallbladder and portions of the liver and lymph nodes
• Radiotherapy
• Chemotherapy

Common side effects of radiation therapy for patients with pancreatic cancer include loss of appetite, nausea, diarrhea, and fatigue. Side effects tend to accumulate over the course of treatment and subside within weeks or months of the final treatment.