Liver Cancer: Care and Treatment at NYP
Care and Treatment at NYPPeople with liver cancer, including hepatocellular carcinoma (HCC) and cholangiocarcinoma or bile duct cancer, can benefit from a team of multidisciplinary healthcare professionals at NewYork-Presbyterian. Our providers offer expertise in diagnosing and treating different types of liver cancer through surgery, radiation, chemotherapy or immunotherapy, and also liver transplantation.
At NewYork-Presbyterian, we also offer clinical trials for promising new treatments that aim to increase the survival rate of people with advanced liver cancer and liver metastases. Our goal is to cure your cancer and help you maintain your quality of life.
Types of liver cancer we treat
TypesThe liver is an organ that is integral for multiple bodily processes, including processing nutrients and filtering blood. It breaks down nutrients from the intestines and metabolizes them to be used for energy, produces bile to help digestion, and filters waste from your blood. Liver cancer impairs the function of the liver.
There are several different types of liver cancer:
- Hepatocellular carcinoma (HCC). The most common type of liver cancer affecting adults is hepatocellular carcinoma (HCC), which starts in liver cells known as hepatocytes. HCC is often caused by the presence of some form of liver disease, like cirrhosis, long-term hepatitis B or C infection, non-alcoholic fatty liver disease or alcohol-related disease. About 85 to 90% of all primary liver cancers are HCC.
- Cholangiocarcinoma / bile duct cancer. Also known as bile duct cancer, cholangiocarcinoma is a type of liver cancer that develops in the bile ducts, which carry bile from the liver to the small intestine. Cholangiocarcinoma is a rare and aggressive type of liver cancer, and typically affects adults over the age of 50.
- Other liver tumors. Sometimes, benign (non-cancer) tumors can grow in the liver. While these don’t lead to cancer, they can sometimes cause problems and need to be removed with surgery. The most common types of benign liver tumors include hemangioma, hepatic adenoma, and focal nodular hyperplasia.
Treatment pathways at a glance
Treatment- Surgery/resection. Surgery or resection is one of the most common treatment pathways for liver cancer and offers the best chance for a long-term cure. The process involves removing cancerous or metastatic tumors from the liver. The liver can regenerate after liver surgery, and this gives our surgeons more options for more extensive or aggressive surgical approaches. Our surgeons use minimally invasive laparoscopic and robotic techniques for liver surgery whenever possible.
- Transplant evaluation. If appropriate, your care team might consider you a candidate for a liver transplant. A liver transplant involves removing your liver and replacing it with a healthy one from a donor.
- Y-90/radioembolization. Radioembolization, also known as Y-90 treatment, is a type of minimally invasive therapy that treats liver tumors. The treatment delivers tiny spheres of the cancer-killing radiation Y-90, or yttrium-90, to the tumors in your liver through the main liver artery.
- TACE/chemoembolization. Transarterial chemoembolization (TACE) is another minimally invasive therapy that injects chemotherapy into liver tumors to block its blood supply while saving healthy tissue. While chemotherapy targets the entire body, chemoembolization is more targeted, delivering the drug directly to the tumor.
- Ablation. Another minimally invasive therapy known as ablation destroys liver tumors (ablates) for patients who are not eligible for surgery. Ablation is useful for smaller tumors.
- Radiation (SBRT/IMRT). There are different forms of radiation therapy to treat liver cancer, including intensity-modulated radiation therapy (IMRT), which delivers targeted radiation directly to tumors. Stereotactic body radiotherapy (SBRT) sends pencil-thin beams of radiation to tumors.
- Systemic therapy. Systemic therapy, which can include combinations of immunotherapy and chemotherapy, can be delivered intravenously (by vein), orally in the form of a pill, or by direct infusion into the main liver artery.
High-risk surveillance / early detection
High-risk surveillance / early detectionPeople who are considered at high-risk of developing liver cancer often have an underlying liver disease or condition. That can include cirrhosis, hepatitis B or C infection, or metabolic syndromes like type 2 diabetes.
Cirrhosis, or liver scarring, is a condition in which liver cells are damaged and replaced by permanent scars that impair blood flow and liver function. Persistent inflammation and damage in cirrhosis can lead to the destruction of liver cells and fuel cancer growth.
Cirrhosis can be caused by a variety of different factors, but is most commonly caused by chronic hepatitis B or C infection, non-alcoholic fatty liver disease (NAFLD), or alcohol abuse.
Fatty liver disease, a history of cigarette smoking, and sometimes certain inherited disorders like hemochromatosis, alpha-1 antitrypsin deficiency, or Wilson’s disease can also lead to a higher risk of liver cancer. In some cases, liver cancer can develop from excessive exposure to aflatoxin – a poison from a fungus that can grow on foods like grains and nuts that have not been stored properly. Type 2 diabetes has also been linked to an increased risk of liver cancer.
Liver cancer surveillance involves maintaining regular screenings for people at a high risk of the disease. Surveillance is important because it can help detect cases earlier and improve survival rates. Typically, it involves ultrasounds or alpha-fetoprotein (AFP) blood tests every six months.
NewYork-Presbyterian has a strong surveillance program for people at risk of liver cancer, with the hope of detecting the disease in its early, more curable stages. To schedule an appointment at NewYork-Presbyterian, give us a call at 877-697-9355 and our team can assist you in finding a liver care specialist.
Clinical trials & multidisciplinary care
Clinical trials & multidisciplinary careAt NewYork-Presbyterian, we participate in and lead clinical trials that explore novel treatments to advance the care of people with liver cancer, including those that don’t respond well to standard therapies. If appropriate, you might have the opportunity to participate in a clinical trial for a new treatment.
NewYork-Presbyterian’s liver cancer team is multidisciplinary and includes hepatologists, gastroenterologists, surgeons, medical oncologists, radiation oncologists, radiologists, interventional radiologists, nurses, and other specialists. We gather a personalized team of healthcare professionals to care for you through one medical center, which shares combined clinics and conferences. Your team will meet regularly in multidisciplinary tumor boards to ensure you’re receiving the most effective therapies.
This content has been reviewed by the following medical editors.