The treatment depends mainly on the following:

• the number, size, and location of tumors in the liver
• how well the liver is working and whether patient has cirrhosis
• whether the cancer has spread outside the liver

Other factors to consider include age, general health, and concerns about the treatments and their possible side effects.

Several treatment options:

• Surgery
• Ablation
• Embolization
• Targeted Therapy
• Radiation Therapy
• Chemotherapy

Surgery

• An option for people with an early stage of liver cancer. The surgeon may remove the whole liver or only the part that has cancer. If the whole liver is removed, it's replaced with healthy liver tissue from a donor (liver transplant).

Ablation

• Methods of ablation to destroy the cancer in the liver. These are treatments to control liver cancer and extend life. They may be used for people waiting for a liver transplant or they may be used for people who are not suitable for surgery. Surgery to remove the tumor may not be possible because of cirrhosis or other conditions that cause poor liver function, the location of the tumor within the liver or other health problems.

• The methods include;

1. 1. Radiofrequency ablation: The doctor uses a special probe that contains tiny electrodes to kill the cancer cells with heat. Ultrasound, CT or MRI may be used to guide the probe to the tumor.
   2. Percutaneous ethanol injection: The doctor uses ultrasound to guide a thin needle into the liver tumor. Alcohol (ethanol) is injected directly into the tumor and kills cancer cells. The procedure may be performed once or twice a week.

 
Embolization

• For those who cannot have surgery or a liver transplant, embolization or chemoembolization may be an option. The doctor will insert a tiny catheter into an artery in the leg and moves the catheter into the hepatic artery.

1. 1. For embolization, the doctor injects tiny sponges or other particles into the catheter. The particles block the flow of blood through the artery. Depending on the type of particles used, the blockage may be temporary or permanent. Without blood flow from the hepatic artery, the tumor dies. Although the hepatic artery is blocked, healthy liver tissue continues to receive blood from the hepatic portal vein.
   2. For chemoembolization, the doctor injects an anticancer drug (chemotherapy) into the artery before injecting the tiny particles that block blood flow. Without blood flow, the drug stays in the liver longer.
   3. Embolization often causes abdominal pain, nausea, vomiting, and fever.

 
Targeted Therapy

• Sorafenib (Nexavar) were the first targeted therapy approved for liver cancer. Targeted therapy slows the growth of liver tumors and reduces their blood supply. The drug is taken orally.
• Side effects include nausea, vomiting, mouth sores, and loss of appetite. Sometimes, a person may have chest pain, bleeding problems, or blisters on the hands or feet. The drug can also cause high blood pressure.

 
Radiation Therapy

It uses high-energy rays to kill cancer cells. It may be an option for a few people who can't have surgery. Sometimes it is used with other approaches.

Radiation therapy also may be used to help relieve pain from liver cancer that has spread to the bones.

• Doctors use two types of radiation therapy to treat liver cancer:

1. External radiation therapy: The radiation comes from a linear accelerator. This aims beams of radiation at the chest and abdomen.
2. Internal radiation therapy: The radiation comes from tiny radioactive spheres. A doctor uses a catheter to inject the tiny spheres into the hepatic artery. The spheres destroy the blood supply to the liver tumor.

• The side effects from radiation therapy include nausea, vomiting, or diarrhea.

 
Chemotherapy

The use of drugs to kill cancer cells is sometimes used to treat liver cancer. Drugs are usually given intravenously. The drugs enter the bloodstream and travel throughout the body.

• Chemotherapy may be given in an outpatient part of the hospital or at the doctor's office. Rarely, you may need to stay in the hospital.
• The side effects of chemotherapy depend mainly on which drugs are given and how much. Common side effects include nausea and vomiting, loss of appetite, headache, fever and chills, and weakness.
• Some drugs lower the levels of healthy blood cells, and you're more likely to get infections, bruise or bleed easily, and feel very weak and tired. 

Updated:: 15/03/2019 []