• Primary liver cancer: Cancer that begins in the liver is primary liver cancer. These cancers include:
  • Bile duct cancer: Bile duct cancer begins in the lining of tubes that carry bile from the liver to the gallbladder (small bile ducts). Bile duct cancer inside the liver is also known as cholangiocarcinoma.
  • Hepatocellular carcinoma: Hepatocellular carcinoma is the most common type of liver cancer. Cancer cells may form a single tumor or may be spread throughout the liver.
  • Gallbladder cancer occurs when cells in the lining of the gallbladder grow in ways they shouldn’t.
• Metastatic liver cancer: Metastatic, or secondary, liver cancer is cancer that began somewhere else in the body and spread to the liver. Many types of cancer can spread to the liver, including colon cancer, pancreatic cancer and stomach cancer.

We typically diagnose liver cancer using imaging tests. The skilled radiologists on our gastrointestinal (GI) cancers team are experts in taking and interpreting abdominal images. We use:

• Computed tomography (CT) scan: Specialists use X-rays to take detailed images of your abdomen. We use these images to locate and assess liver tumors.
• Magnetic resonance imaging (MRI): Our experts use a test that creates images with radio waves and magnets. We interpret these images to determine tumor size, location and type. We also look for blocked blood vessels in or near the liver.
• Ultrasound: Specialists move a probe (transducer) over the skin of the abdomen. This probe uses sound waves to create detailed pictures of the liver and any liver tumors that are present.

Occasionally, our specialists may recommend a liver biopsy. We take a small sample of liver tissue for our pathology experts to examine under a microscope to look for cancer.

The liver cancer experts at Rogel Cancer Center specialize in treating the most complex liver cancers. We get to know you so we can understand your goals before developing a treatment plan. We offer:

Liver cancer surgery

Our expert surgeons develop plans to remove even the most challenging liver tumors. Surgeries we use include:

• Partial hepatectomy: Experts remove the part of the liver containing cancer in healthy people with good liver function.
• Liver transplant: We remove the entire diseased liver and replace it with a healthy liver from a donor. Experts consider tumor size and location, your liver health and overall health in determining if liver transplant is right for you.
• Ablation therapy for liver cancer: When surgery isn’t possible, our experts may use ablation techniques to shrink tumors. We use different types of energy to target and destroy cancerous tissue, including:
  • Irreversible electroporation: Specialists insert multiple thin probes into the liver to destroy cancer cells without excessive heat. This permits ablation of tumors that are close to other critical structures in the liver.
  • Microwave ablation: Experts insert a thin probe into liver tumors to burn cancer cells with electromagnetic waves.
• Interventional oncology for liver cancer: Interventional oncologists use techniques known as trans-arterial therapies to remove and shrink liver tumors. These therapies include:
  • Trans-arterial chemoembolization: Specialists insert a thin flexible tube (catheter) into one of the liver’s main blood vessels (hepatic artery). They inject tiny beads, seeds or pellets that contain chemotherapy drugs to deliver the drug close to the tumor.
  • Trans-arterial embolization: Experts use a catheter to inject tiny particles into the hepatic artery near the tumor. These particles block blood supply to the tumor, causing it to shrink.
• Radiation oncology for liver cancer: Our radiation oncology specialists use advanced radiation techniques to shrink liver tumors. Experts employ these techniques when surgery isn’t possible to provide palliative care and help manage cancer symptoms. We also shrink larger liver tumors so they can be removed surgically or undergo other therapies. We offer:
  • External beam radiation therapy: We use a machine to aim energy beams directly at liver tumors to destroy cancer cells.
  • Stereotactic body radiotherapy (SBRT): Experts deliver strong, precise radiation doses to liver tumors using an image-guided system.
  • Yttrium-90: Experts inject radioactive microspheres into the hepatic artery. The beads stay in the blood vessel and give off radiation near the tumor. Yttrium-90 helps shrink liver tumors by guiding the radiation very precisely into the tumor.
    Learn more about this form of treatment on our Radiation Therapy webpage.
• Systemic therapy for liver cancer: Our experts use certain medications that you take orally (pills) or through a flexible tube placed in a vein (intravenously). We may use:
  • Chemotherapy: Drugs that circulate through your bloodstream and kill cancer cells
  • Immunotherapy: Drugs that tell your immune system to destroy cancer cells
  • Targeted therapy: Drugs that attack specific cancer cells while sparing healthy cells
• Hepatic artery infusion pump (HAIP) therapy for liver cancer: For some cancers that are widespread throughout the liver, our experts may use hepatic artery infusion pump (HAIP) therapy. Specialists implant a small device under the skin of the abdomen and insert a thin flexible tube (catheter) into the hepatic artery. The pump delivers a high dose of floxuridine, a chemotherapy drug, directly to the liver.
  
  Your doctor may have you receive HAIP for two weeks and then take two weeks off. You may have HAIP in addition to systemic chemotherapy. This therapy helps improve survival rates in people with liver cancer.
• Histotripsy: Pioneered at the University of Michigan, histotripsy offers a promising alternative to traditional cancer treatments, which often have significant side effects. Histotripsy is a non-invasive treatment performed under general anesthesia. The treatment works by using targeted ultrasound waves to form microbubbles within the tumor. The forces created as those bubbles form and collapse cause the mass to break apart, killing tumor cells and leaving the debris to be cleaned up by the immune system.

Clinical Trials for Liver Cancer

Rogel Cancer Center experts lead and participate in many clinical trials of new therapies to treat GI cancers. For example, our liver cancer specialists are currently leading a study of histotripsy, a way to destroy liver tumors with ultrasound waves. Learn more about our GI cancer clinical trials and ask your care team if you’re eligible to participate.

At Rogel Cancer Center, you can count on personalized treatment for all GI cancer types in a compassionate and caring environment. We get to know you so we can help make the treatment experience as easy as possible with helpful support services. We offer:

Dedicated patient navigators

Our resourceful and friendly patient navigators are your personal resource. We advocate for you and coach those who want to advocate for themselves. Your navigator can help with:

• Coordinating and scheduling appointments with cancer specialists in our multidisciplinary clinics
• Communicating your wishes and priorities to care team members
• Information about resources available to you and your loved ones
• Finding language interpreters when needed
• Lodging, childcare and transportation arrangements
• Questions you may have after seeing a specialist
• Referrals to social work services

Financial services

Cancer care can raise complex financial questions. Rogel Cancer Center provides financial assistance services so you can worry less. Our financial counselors can help you:

• Get information you need about treatment coverage from your health insurance plan.
• Learn how to get any authorizations or referrals your insurance plan requires.
• Plan to manage costs your insurance plan doesn’t cover (out-of-pocket costs).

Mental health support services

A GI cancer diagnosis can create feelings of anxiety. You or your loved one might feel angry, depressed or guilty. Experts at Rogel Cancer Center offer supportive, short-term counseling services and referrals to mental health resources. You also have access to education and group programs within our Patient & Family Support Services.

Complementary therapies

We offer many therapy activities that help relieve stress and manage the mental and physical impacts of cancer treatment. Talk to your patient navigator or cancer specialist about how complementary therapies might benefit you. Our complementary therapies include:

• Art therapy
• Guided imagery
• Music therapy

Supportive care for symptoms and side effects

During GI cancer treatment, you might experience side effects or symptoms that affect your daily activities. We offer supportive (palliative) care to help relieve the symptoms and side effects of cancer treatment. Our specialists provide:

• Cancer nutrition services to help you find foods you enjoy and maintain nutrition.
• Fertility counseling to help preserve your ability to have a baby.
• Information about alternative medicine therapies that can help relieve symptoms and strengthen your mind and body.