Diagnosis and Treatment of Liver Cancer

Liver cancer is most commonly diagnosed when tumors from other parts of the body have metastasized to the liver (metastatic liver cancer), but can also more rarely arise directly in the liver (primary liver cancer).

Causes of Liver Cancer

Primary liver cancer is about four times more common in Southeast Asia than in North America or Western Europe because the disease is strongly associated with chronic infections of hepatitis B and hepatitis C viruses, which are more common in Asia. As the incidence of hepatitis infections in North American and Western Europe are rising, so is the incidence of liver cancer.

Hepatitis B is a virus and when people who are chronically infected develop liver cancer DNA from the virus is often found in the cancer cells. Researches think that the virus DNA disrupts a cell’s normal DNA driving it into a cancerous state.

Chronic hepatitis C infection is clearly linked with the development of liver cancer, yet the way it causes cancer is less clear. It may be that the virus causes liver cirrhosis, which in general increases the risk of liver cancer, or it may be a protein from the virus inhibits  genes that normally keep cells from becoming cancerous.

Liver Toxins
Because cirrhosis is known to increase the risk of primary liver cancer, substances that are toxic to the liver increase the risk of liver cancer. Two common toxins include alcohol, and aflatoxin B1 (a fungus that can grow on certain foods when they are stored improperly).

Stanford Expertise

The Stanford Cancer Center brings together physicians with exceptional expertise in treating liver cancer. Patients with primary or metastatic liver cancer are evaluated and treated by the multidisciplinary physicians of the Liver Tumor Clinic and the Liver Tumor Board.

In addition, physicians at the Stanford Asian Liver Center are internationally recognized for their groundbreaking work on liver cancer in the Asian population.

Diagnosis & Treatment
The Asian Liver Cancer Center has detailed information about liver cancer treatment and diagnosis that is available in English, Chinese (traditional and simplified), Korean, and Vietnamese.

In addition to laboratory tests, Cancer Center physicians have the best technology administered by highly skilled technicians to make the most accurate diagnosis, including:

• Ultrasound imaging 
• PET/CT imaging 
• Magnetic resonance imaging (MRI) 
• Biphasic spiral CT imaging

Treatments that your physicians will consider include surgery, chemotherapy, radiation, and in some instances liver transplantation. Innovative therapies available at the Cancer Center include:

• Radiofrequency ablation, an advanced, minimally invasive procedure that uses a heat-generating, electrode-tipped catheter to destroy tumor cells. 
  
  
• Radioimmunotherapy -- a specialized treatment in which radioactive sources are targeted to and carried directly to specific cancer cells.
  
  
• Intrahepatic arterial chemoembolization or chemoinfusion (TACE or TAC), a method for delivering chemotherapy directly to the liver.

Clinical Trials
As recognized leaders in treating liver cancer, Cancer Center physicians are active in developing and testing new therapies to treat the disease. Some of the innovative therapies that Cancer Center physician are offering to their patients through clinical trials include:

• Stereotactic radiosurgery, a method for delivering precise doses of radiation with millimeter accuracy
  
  
• Dendritic cell immunotherapy
  
  
• Targeted biological agents (e.g., Iressa)
  
  
• Botanical drugs to reduce the side effects of chemotherapy

When appropriate, patients are invited to participate in studies to investigate the newest treatments as well as large-scale clinical trials for more established treatments.