Treatments

Surgery

Liver Transplant

Most people with primary liver cancer who live in the US have underlying liver disease. Liver transplantation gives people the best chance for a cure.

We use minimally invasive surgical approaches whenever possible. This type of surgery usually results in faster recovery, less pain, and smaller scars.

We are New York’s largest living donor liver transplant program, which means our patients are 10 times more likely to receive a liver transplant than other programs.

For more information about liver transplants at Columbia, visit the Center for Liver Disease and Transplantation.

Resection

If you don’t have significant underlying liver damage, our surgeons can often remove the tumor surgically without a transplant. This is called resection. We use “ex vivo” technology, pioneered by Columbia’s Tomoaki Kato, MD. This technology lets tumors that used to be considered unresectable to be removed, offering a chance for a cure.

Local Therapies

We offer local therapies, which target liver tumors without removing them surgically. Some of these techniques use ablation, or heat, to destroy the tumor. Others use targeted radiation therapy.

Radiofrequency and Microwave Ablation

Radiofrequency and microwave ablation use highly targeted energy waves to destroy the tumor while sparing surrounding tissue. These treatments can sometimes cure patients with very small tumors.

Chemo-Embolization

Chemo-embolization puts small medication beads into an artery that supplies the tumor. The beads block off the blood supply and deliver chemotherapy directly into the tumor.

Radio Arterial Embolization

Radio arterial embolization delivers tiny spheres of a radioactive substance to the tumor using the liver artery system. The substance kills cancer cells at the tumor site.

Stereotactic Body Radiation

Stereotactic body radiation is cutting-edge radiation therapy used to treat locally aggressive tumors. We have seen exciting results in treating hepatocellular carcinomas that have started to invade the portal vein.

Management of Bile Duct Obstruction

Management of bile duct obstruction uses an endoscope—a long flexible tube with a camera, a light, and room to insert surgical tools—to unblock bile ducts and insert a stent. Blocked bile ducts are a potential complication of liver tumors, liver surgery, and bile duct cancer. The stent opens up the duct and allows bile to drain into the intestine to improve your quality of life and relieve symptoms associated with jaundice.

Medication

Chemotherapy

Chemotherapy is the most commonly known cancer treatment. Chemotherapy uses medications (chemicals) to stop cancer growth and spread and to prevent cancer from recurring, by causing rapidly dividing cancer cells to become damaged and die.

Chemotherapy is “systemic” medicine—it interferes with all fast-dividing cells in your body. This is why it causes side effects like hair loss.

Chemotherapy is often given through an IV in our infusion center, but it can sometimes be given through a pill. It’s given in cycles across a few weeks, with each treatment followed by a rest period.

People with primary liver cancer may be offered chemotherapy if you’re not a good candidate for surgery. If you have bile duct cancer, chemotherapy is the primary treatment if the cancer cannot be removed surgically.

Columbia medical oncologists are at the forefront of developing new liver cancer treatments. We have led multiple international clinical trials investigating new and better therapies for liver cancer and we have a wide range of clinical trials available for our patients.

Targeted Therapies

Liver tumors are vascular: They grow lots of blood vessels to supply nutrients. We use a pill-based targeted therapy called sorafenib, which blocks the signaling pathways that cause blood vessels to grow. It’s the most effective targeted treatment option in use today. We participated in the clinical trial leading to the drug’s approval.

Clinical Trials

You may qualify to participate in a clinical trial, which is a research study to learn more about promising new treatments or supportive care therapies. The hope is to improve the quality of life and survivorship of liver and bile duct cancer patients. Columbia Cancer offers dozens of liver cancer clinical trials. You can talk to your care team about whether a clinical trial is an option for you.

Learn More About Clinical Trials

Radiation Therapy

Radiation therapy causes cancer cells to break or die by targeting the DNA with high-energy particles, such as X-rays, gamma rays, electron beams, or protons. Radiation oncology specialists direct these particles to the tumor site from outside of your body to precisely target cancer cells, often sparing nearby tissue. This is sometimes called external beam radiation therapy.

If radiation therapy is recommended to you, your radiation oncologist, who is part of your personal care team, will design a treatment plan just for you to get the best possible results. Your treatment may be daily, weekly, every other day, or a single treatment.

With advanced radiation therapy techniques, doctors can better target tumors while reducing the radiation to nearby healthy tissues. Here at Columbia Cancer, our radiation oncology experts have the ability to provide state-of-the-art treatments for liver cancer.