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Surgical and Non-Surgical Treatment Options for Secondary Liver Cancer

Posted Aug 25 2013 7:12am

Secondary Liver Cancer and Surgical Skill

Consultant Liver Surgeon, Mr Robert Hutchins from Barts & The London Hospitals says, “The key to successful liver surgery is the complete removal of all tumours leaving behind sufficient liver tissueA group of cells with a similar structure and a specialised function. to keep vital functions of the body operational.” However, despite the skills of the surgeon the cancer may have spread to other parts of the body, so the question is – what should be done in these circumstances, and what are the options?

What is Secondary Liver Cancer? And what are the surgical and non-surgical treatment options?

Especially in the two years following the successful treatment of a primary liver cancer unfortunately many patients will go on to develop secondarycancer in other parts of the body such as the bones, lungs and liver. Sometimes the disease will have already spread by the time that the cancer is diagnosed. The development of secondary disease does not reflect any failure on behalf of surgical treatment or subsequent chemotherapyThe use of chemical substances to treat disease, particularly cancer. or radiotherapyThe treatment of disease using radiation. treatments.

Liver treatment is most often surgical but non-surgical treatments are constantly being developed. The survival benefit of these new treatments is not as clear as with surgical removal of the tumour but they are becoming more commonly employed and may be given in conjunction with liver surgery.

Examples of the newer technologies for treating liver secondary cancerA tumour or abnormal swelling that results from the spread of another malignant (uncontrolled) tumour to a distant part of the body. include:

Radiofrequency Ablation - Ablation techniques offer heat or cold treatment to physically destroy tumours once needles to deliver the temperature change have been passed into the tumour

Microwave Ablation - uses heat from microwave energy to destroy cancer cells

HIFUAn abbreviation for high intensity focused ultrasound, a relatively new method for treating cancer using focused ultrasound waves. - very high frequency ultrasoundA diagnostic method in which very high frequency sound waves are passed into the body and the reflective echoes analysed to build a picture of the internal organs – or of the foetus in the uterus. to destroy tumours from outside the body

Cyberknife - very high dose, very accurately localised radiationEnergy in the form of waves or particles, including radio waves, X-rays and gamma rays. therapy

SIRTEX - utilises tiny beads emitting radiation that are passed into the bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. supply of tumours in the liver.

All of these technologies avoid surgery, but small procedures may be needed and in some cases a general anaestheticAny agent that reduces or abolishes sensation, affecting the whole body..

Liver Units in the UK were established to allow surgeons to gain the required specific expertise. Due to the difficult complex procedures required, the surgeon’s skill and experience is the biggest factor affecting a successful outcome. The mortality from liver surgery for bowelA common name for the large and/or small intestines. cancer secondaries should be  less than 3%. In many UK centres it is less than 1%. The morbidity or rate of complications is about 20%. This includes mild liver failure, leak of bileA fluid produced by the liver, which helps the fat ingested in food to combine with the digestive juices in the gut. from the cut surface of the liver (about 5%), infections of the wound, chest and abdominal cavityThe part of the body that contains the stomach, intestines, liver, gallbladder and other organs., bleeding or the general risks of anaesthesia especially on the heart and lungs.

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