Understanding Liver Cancer and Its Treatment
Liver cancer develops when abnormal cells grow in the liver and form a tumour. Hepatocellular carcinoma (HCC) is the most common primary liver cancer. Chronic liver disease, cirrhosis and certain viral infections can increase the risk of developing this condition.
Treatment depends on the tumour's size, number, location, spread and the condition of the remaining liver tissue. Liver Cancer surgery and liver transplantation are important treatment options for selected patients, but neither is suitable for every diagnosis. A specialist team evaluates each case before recommending a treatment plan.
When Does Liver Cancer Require Surgery?
Surgery may offer a treatment option when doctors can remove the cancer while preserving enough healthy liver tissue. The decision depends on tumour characteristics, liver function and the patient's overall health.
Liver Resection for Localised Tumours
Liver resection involves removing the portion of the liver containing the tumour. Doctors may recommend this procedure when the cancer remains localised, the tumour can be removed safely and the remaining liver can function adequately.
Before surgery, doctors assess liver function, blood tests and imaging results. They also consider cirrhosis, portal hypertension and the amount of healthy liver expected to remain after the operation.
The liver has the ability to regenerate, but this does not mean every patient can safely undergo resection. Significant liver damage or insufficient remaining liver tissue may increase the risk of serious complications.
When Surgery May Not Be Suitable
Surgery may not be appropriate when cancer affects several areas of the liver, involves major blood vessels, has spread beyond the liver or occurs alongside advanced liver dysfunction. Other medical conditions may also increase surgical risks.
In these situations, doctors may consider transplantation, ablation, embolisation, radiation therapy or systemic medication, depending on the diagnosis.
When Is Liver Transplantation Considered?
Liver transplantation replaces the diseased liver with a healthy donor liver. It can treat selected liver cancers while also addressing underlying cirrhosis or severe liver dysfunction.
Transplantation generally suits carefully selected patients whose cancer remains confined to the liver and meets accepted transplant criteria. These criteria consider tumour size, number, absence of certain forms of vascular invasion and whether cancer has spread outside the liver.
A transplant team also evaluates the patient's general health, other medical conditions and ability to undergo transplantation and long-term follow-up. Eligibility varies according to clinical circumstances and applicable transplant protocols.
Surgery Versus Liver Transplantation
Liver resection removes the tumour and affected liver tissue while leaving the remaining liver in place. Transplantation removes the entire diseased liver and replaces it with a donor organ.
Resection may suit patients with localised cancer and adequate liver function. Transplantation may be considered when a patient meets tumour criteria but also has significant underlying liver disease. The treating team weighs the potential benefits, risks and donor-organ availability before making a recommendation.
What If the Cancer Cannot Be Removed?
Not every liver cancer can be treated with surgery or transplantation. Other liver cancer treatment options may help control the disease, manage symptoms or prepare selected patients for another treatment.
Non-Surgical Treatment Options
Thermal ablation uses heat or other techniques to destroy selected tumours. Transarterial chemoembolisation delivers treatment through the blood vessels supplying the tumour, while radioembolisation uses radioactive particles in selected cases. Radiation therapy and systemic medicines may also help manage certain liver cancers.
For some patients, treatment can reduce tumour activity or size and allow the team to reassess eligibility for surgery or transplantation. However, these approaches do not guarantee that surgery or transplantation will become possible.
How Do Doctors Decide the Appropriate Treatment?
The decision requires careful assessment by specialists in liver surgery, hepatology, oncology, radiology and transplantation when appropriate.
Imaging tests, such as multiphase CT or MRI, help determine tumour characteristics and possible spread. Blood tests assess liver function and general health. Doctors may also evaluate portal hypertension and other complications of cirrhosis.
Patients should discuss the expected benefits, risks, alternatives and recovery requirements of each option with their treatment team.
Choosing a Specialist in Mumbai
Patients seeking a best liver transplant doctor in mumbai or an hpb surgeon in mumbai should review relevant qualifications, experience with liver cancer procedures, hospital facilities and access to multidisciplinary care.
Dr Prashant Kadam is a liver transplant and HPB surgeon in Mumbai. Patients can discuss their reports, diagnosis and treatment options during a specialist consultation.
Conclusion
Liver cancer may require surgery when doctors can remove the tumour safely, while transplantation may suit selected patients with eligible tumours and underlying liver disease. Early evaluation, accurate staging and individualised treatment planning help determine the appropriate approach. A specialist team can explain available options and guide patients through the next steps.
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