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Liver Cancer Diagnosis and Treatment

Reaching a Diagnosis for Liver Cancer

Neehar Parikh, MD at a Tumor Board Meeting
Neehar Parikh, M.D. discusses treatment options for a patient with the Liver Cancer Tumor Board

The diagnosis of liver cancer begins with a good quality CT scan or MRI. Not all CT/MRI scans are the same-our radiology experts use the latest technology and techniques to obtain better images, and specialize in looking at images of the liver. This allows us to make the diagnosis without biopsy 80% of the time.

In cases where biopsy is required, we use a special technique to avoid spreading the tumor.

Advanced, Personalized Treatment for Liver Cancer

There are many treatment options for liver cancer, and the list of choices can be confusing for patients and many physicians. At the University of Michigan's multidisciplinary Liver Tumor Program we have a dedicated Liver Tumor Board that meets weekly and includes a team of experts in hepatology, surgery, medical oncology, radiation oncology, and diagnostic and interventional radiology. This group then prepares a personalized treatment plan for each patient. Yearly, more than 400 patients with liver tumors or masses are evaluated in the Liver Tumor Clinic and more than two-thirds of these patients have a diagnosis of liver cancer.

Treatments offered at the University of Michigan for primary and secondary liver cancers include:

    Surgical resection:
    Surgery to remove the cancerous portion of the liver, which in some cases can be done laparoscopically, leaving only small scars. In 2014, more than 83 liver resections were performed for liver cancer or other suspicious liver masses at the University of Michigan. Approximately two-thirds of these were performed using laparoscopic techniques.

    Liver transplantation:
    We are one of a handful of centers nationwide to offer liver transplantation for cholangiocarcinoma in addition to hepatocellular carcinoma. More than one-third of our liver transplants are performed for liver cancer - as many as 18-24 patients per year.

    Transarterial chemoembolization (TACE):
    A minimally invasive procedure where chemotherapy beads are injected directly into the tumor.

    Injection of radioactive beads directly into the tumor.

    Radiofrequency ablation:
    A needle placed into the tumor uses radiofrequency waves to destroy tumor tissue, often without requiring surgery.

    Stereotactic body radiotherapy (SBRT):
    Also called radiosurgery, this technique uses a computer to concentrate radiation beams in precise locations.

    We offer standard chemotherapy as well as access to many clinical trials unavailable elsewhere. Clinical trials offer hope to patients who have failed other treatments.

Expertise in Liver Surgery and Postoperative Care

We utilize the latest technologies for both open and laparoscopic liver resection. More than 90% of patients do not require stays in the intensive care unit. Our hepatobiliary surgeons (doctors who specialize in surgery relating to the liver and bile, bile ducts, and gallbladder) also have expertise in liver transplantation along with vascular reconstruction techniques for more complicated liver resections. When future liver function is a higher concern, our surgeons work with our interventional radiologists to perform liver volumetric analysis and preoperative portal vein embolization to increase the size of the future liver remnant before surgery. Patients with existing liver disease in addition to liver or bile duct cancer are often able to safely undergo surgical resection of their cancer. In some cases of secondary (metastatic) liver cancers, liver surgery often follows initial chemotherapy to "down-stage" the disease prior to resection. Patients can expect to be in the hospital for five-seven days following open surgery and approximately three-four days using laparoscopic techniques.

Global Pioneers in Imaging and Radiation Therapy for Primary Liver Tumors

We have seen thousands of patients with liver tumors and actually developed the radiological (imaging) criteria to more accurately diagnose primary liver tumors (where the tumor originated). In fact, we have the largest funded research program in primary liver tumors in the United States and are worldwide pioneers in radiation therapy for primary liver tumors.

Make an appointment/referral, or have your questions answered

The Cancer AnswerLine™ is staffed by oncology nurses and is just a phone call away to answer your questions or to assist you in making an appointment. Please call 800-865-1125 to make an appointment or for the answers to any questions you have.

NOTE: Children and young adults receive treatment in the Solid Tumor Oncology Program, part of C.S. Mott Children's Hospital.

If you would like to refer a patient, please contact our M-Line service: 800-962-3555. For more information, visit our Make an Appointment web page.

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