Liver Cancer Surgery Recovery
- Liver cancer surgery can lead to excellent results in early stage disease, sometimes even leading to a cure.
- Recovery times from surgery vary, generally spanning 3-6 weeks, influenced by the surgery type and individual health.
- In general, recovery is easier after minimally invasive procedures that involve making smaller cuts.
- Enhanced Recovery After Surgery (ERAS) guidelines help manage post-surgery recovery with the goal of lessening stress and improving results.
- Surgery results and the need for further treatment depend on the cancer stage, overall health, and surgical approach.
“A surgical resection while it sounds terrifying, actually has wonderful success rates as we were talking about, and not all the liver is removed, and you can continue a normal life…” Dr. Winner says.
Read MoreWill the type of surgery I have affect my recovery?
Elliot Newman, MD, the chief of surgical oncology at Lenox Hill Hospital, explains that when deciding on what type of surgery to have, there are two major considerations. “Assessing the safety of removal in terms of where it’s located relative to blood vessels and making sure that after we remove a piece of the liver, we’ll still have enough liver left for good function,” he says.There are two types of surgery your care team will consider for treating liver cancer: open and minimally invasive.
Traditional open surgery, including traditional liver resection and liver transplantation, involves making a large incision (cut into the body) so your doctor can directly access and treat the affected area. It’s usually reserved for more complex cases.
In liver resection, the surgeon removes the part of the liver where the tumor is located. In liver transplant, the diseased liver is replaced by a new liver from a healthy donor.
“If I think that a patient’s best option is a surgical resection, it’s usually because the tumor is small, because their liver function is preserved, and I think that they can undergo the stress of a surgery,” Dr. Winner explains.
Open surgery offers clear visibility and space for the surgeon to operate.
In minimally invasive surgery, your surgeon makes a small incision and uses specialized instruments to remove cancerous tissue. If your tumor is small and contained and your overall health is good, your surgeon will opt for this type of treatment.
There are many different types of minimally invasive surgery ranging from resection, where the part of the liver that contains the cancer tissue is removed through a small incision, to ablation, where electricity or temperature isolate and kill cancer cells.
Your recovery time will depend on the type of surgery you have.
Open surgery recovery
With open surgery, the recovery typically lasts around three to six weeks from the time you leave the hospital.
You may experience an array of symptoms after surgery, including:
- Tiredness
- Reduced appetite
- Decreased focus
The larger incisions can mean more postoperative pain and greater chances of complications.
Minimally invasive surgery recovery
When minimally invasive surgery can be used, recovery tends to be quicker than open surgery. Smaller incisions (cuts) mean less pain and faster wound healing.
Full recovery can still take from three to six weeks, but patients tend to feel better much faster.
Related: Understanding the Link Between Liver Cancer and Alcohol
How can I manage my recovery?
Doctors typically manage the recovery period after liver surgery by following the Enhanced Recovery After Surgery (ERAS) guidelines.
The goal is to reduce surgical stress and improve outcomes.
ERAS includes:
- Preoperative measures like avoiding smoking and alcohol
- Nutritional support
- Prehabilitation (getting in shape before surgery) for high-risk patients.
- Pain management
- Monitoring for complications
- Gradual physical rehabilitation
Your care team will tailor your recovery plan to your specific needs, taking into account the type of surgery and overall health.
Watch: Liver Cancer and Post-Surgery Monitoring – What Comes Next
What results can I expect?
“If we’re talking about a small tumor that is surgically removable with normal liver function or as near to normal liver function as we can measure, you can have excellent survival approaching anywhere between 60 and 80% at the five-year mark…” Dr. Winner says.
Winner adds that individual outcomes can vary based on factors such as the stage of cancer, overall health, and specific treatment approaches.
Generally, minimally invasive surgery for liver cancer is associated with positive outcomes like shorter hospital stays, less postoperative pain, quicker recovery, and results about the same as traditional open surgery.
Surgery can sometimes be a potential cure for liver cancer, especially when the cancer is detected early and is localized within the liver.
Success rate can vary widely depending on:
- Type and stage of liver cancer
- Specific technique used
- Patient’s overall health
- Expertise of the surgical team
Research looking at survival rates show:
- One study found that patients who underwent liver resection surgery had good long-term survival rates, with 89% surviving to one year and more than half still alive at five years.
- For patients with early-stage liver cancer, surgery can be a potential cure.
- The five-year survival rate for localized liver cancer (when the tumor is confined to the liver and hasn’t spread extensively) is approximately 33%
“In a case of a very advanced tumor that was removed, even though chemotherapy right away may not be beneficial enough to recommend it, the risk of that tumor coming up in lymph nodes outside of what was removed by surgery, at the edge of what was cut by surgery, or spread within the liver, which is a common pattern of spread, may be high enough to warrant CT scans or MRIs sometimes on an every three month basis,”Dr. Winner advises.
Will I need additional treatment?
“For hepatocellular carcinoma that is surgically removed, there is no evidence that the addition of therapy on top of that, assuming it all came out with surgery, has any beneficial effect,” Dr. Winner says. “So following a surgery for hepatocellular carcinoma that has removed all of the disease, there is no need to proceed to chemotherapy or to radiation.”
However, she says in some instances, if a case is more advanced or the cancer is found elsewhere, she may recommend patient additional treatment either before or after surgery.
Common additional treatments include:
- Chemotherapy to prevent recurrence.
- Radiation therapy to eliminate remaining cancer cells.
- Targeted drugs that specifically kill cancer without hurting surrounding healthy tissue
- 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. Winner, the need for added treatment depends on a detailed assessment by your care team. You will have to be carefully evaluated by your medical team post-surgery.
“We know that underlying liver disease is a risk factor for the appearance of an hepatocellular carcinoma and therefore the rest of the liver is at risk for development of additional disease. And so there is going to be surveillance with a team that not only includes the surgical oncologist but also a medical oncologist to follow the remnant liver or the remaining liver to make sure that no other disease crops up,” Dr. Winner says.
Questions to ask your doctor
- How long will my recovery take?
- How long before I can return to regular activities?
- What problems can I expect during the recovery period and how will we manage them?
- Will I need any additional treatment?
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