For Some Patients With Liver Cancer, Surgery Is A Good Option And May Even Offer A Cure

“Primarily we would like to remove the liver tumor if possible,” Dr. Newman says. “That is by far the best way to give us the best chance of achieving a cure.”

Related: Understand The Basics Of Liver Cancer

What types of surgery are there for liver cancer?

There are two types of surgery your care team will consider for treating liver cancer: open and minimally invasive.

Open Surgery:

This is the traditional surgical method that involves making a larger incision so your doctor can directly access and treat the affected area. Open surgery offers clear visibility and space for the surgeon to operate, especially for complex or large-scale procedures. However, it is riskier and means a longer, potentially more painful recovery period.

There are two methods of open surgery:

• Traditional Liver Resection: Involves a larger incision to remove part of the liver containing the tumor. This is often used for larger or more complex tumors.
• Liver Transplantation: In cases where the liver is extensively damaged by cancer and other treatments are not viable, a liver transplant might be considered. This involves replacing the diseased liver with a healthy one from a donor.

Minimally invasive surgery:

This approach typically results in less pain, a shorter hospital stay, and a faster recovery compared to traditional surgery where a doctor cuts open the patient.

On the downside, it may not remove all of the cancer. It may not be an option if your case is more complex or advanced.

“We certainly see benefits in minimally invasive surgery when it’s possible because patients have smaller incisions and can recover more quickly and get out of the hospital more quickly and get back to full functionality more quickly,” explains Dr. Newman.

Types of minimally invasive surgery and procedures:

• Laparoscopic Liver Resection (LLR): Removal of liver tumors through small incisions using special tools.
• Robotic Liver Resection (RLR): Similar to LLR but uses a robotic system for enhanced precision.
• NanoKnife Ablation: Utilizes electrical currents to target and destroy small tumors.
• Cryoablation: Employs extreme cold to freeze and kill cancer cells.
• Microwave Ablation: Uses microwave energy to heat and destroy cancer cells.
• Irreversible Electroporation (IRE): Destroys cancer cells with electrical pulses, sparing surrounding tissue.

Considerations for either open and minimally invasive surgeries Include:

• Tumor’s size
• Tumor location
• Number of tumors
• Patient’s overall health and liver function.

Related: The Difference Between Bile Duct Cancer and Liver Cancer

Who is a good candidate for surgery?

Not everyone diagnosed with liver cancer will be able to have surgery.

“When it comes to assessing patients for suitability for surgery with respect to liver cancer, we look at a number of different things,” Dr. Newman explains.

“Assuming that the patient is a surgical candidate, then we have to look specifically at the nature of the liver tumor that we’re dealing with and whether it can be safely removed,” he says.

Your doctor will consider a surgical approach if:

• Disease is early stage
• Tumor is small, typically less than 5 cm
• There are a few, isolated tumors
• Tumors are located in places that are easily reachable
• You are in good general health with adequate liver function
• You don’t have significant cirrhosis or other liver diseases

What are the risks and benefits of surgery?

Every medical procedure comes with some risks. Surgery is no different, though it does offer substantial benefits to certain patients.

Pros:

• Potential for cure, especially for early-stage liver cancer
• Immediate removal of the tumor, providing quick relief from symptoms.
• Advanced Techniques such as minimally invasive options reduce pain and recovery time

Cons:

• Risks of surgery include bleeding, infection, and complications related to anesthesia.
• Even with minimally invasive techniques, some recovery period is necessary,
• Need for additional therapy if surgery does not get all of the cancer
• Not suitable for all patients

Related: Oregon Man Given ‘Terminal’ Liver Cancer Diagnosis Is Thriving Today 

Will I need additional treatment before or after surgery?

Some patients need additional treatments even after having surgery – and sometimes beforehand to help get their cancer under control. This depends on the stage of cancer, whether or not any cancer remains, and the patient’s overall health.

Common additional treatments include:

• Chemotherapy to prevent recurrence
• Radiation Therapy to eliminate remaining cancer cells
• Drugs that specifically target cancer cell mechanisms without affecting normal cells, used in cases where the tumor has specific genetic markers
• Immunotherapy to boost the body’s immune system
• Ablation Therapies  with techniques like radiofrequency ablation or microwave ablation to address small tumors that remain or recur

According to Dr. Newman, the need for added treatment depends on the results from a detailed assessment by your care team.

“.. it’s very important to realize that we have made a lot of progress in the last couple of decades both in the terms of the surgical approaches that we can do now more minimally invasively which allows you to recover faster,” he says.

“And in terms of the medications and drugs that we can use to treat afterwards in the form of chemotherapy or very newer drugs that are called targeted agents…” he adds.

Questions for your doctor

• What type of surgery do you recommend for my liver cancer and why?
• How does the size and location of my tumor affect the surgical approach you take?
• What are the potential risks and recovery time associated with the surgery?
• What, if any, additional treatments I might need before or after surgery?
• What will insurance cover and how much can I expect to pay out of pocket?

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