Liver Cancer

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The liver

Primary liver cancer (hepatoma, hepatocellular carcinoma or HCC) is the fifth most common cancer and the third most common cause of cancer deaths in the world.

At Fox Chase, Baruch S. Blumberg, MD, PhD, received the 1976 Nobel Prize in medicine for identifying the hepatitis B virus as one of major causes of liver cancer. His Fox Chase laboratory group also created the first highly effective vaccine capable of preventing a human cancer, namely, hepatitis B vaccine, which Merck introduced in 1982. The American Academy of Pediatrics currently recommends the use of this vaccine in all children.

In addition to viral hepatitis B, there are other causes that can lead to cirrhosis (significant liver scarrings) and liver cancer including viral hepatitis C, fatty liver disease (alcohol and non-alcohol), chronic biliary obstruction (primary biliary cirrhosis), autoimmune disorders and hereditary conditions such as iron (hemochromatosis), copper overload (Wilson's disease) or alpha-1-antitrypsin deficiency.

Treatment Options for
Primary Liver Cancer

Treatment Team
Your Liver Cancer treatment is a group effort lead by specialists such as:

Gastroenterologists
Minhhuyen T. Nguyen, MD

Medical Oncology
Steven J. Cohen, MD
Crystal S. Denlinger, MD

Radiation Oncology
Joshua Meyer, MD

Interventional Radiology
David S. Ball, DO
Richard John Daniels, MD
Stephen A. Leschak, MD
Samuel G. Putnam III, MD

Surgical Oncology
Yun Shin Chun, MD
John Michael Daly, MD, FACS
Nestor F. Esnaola, MD, MPH, MBA, FACS
Jeffrey M. Farma, MD, FACS
John P. Hoffman, MD, FACS
Andreas Karachristos, MD
Elin R. Sigurdson, MD, PhD, FACS
James C. Watson, MD, FACS

Nutrition Support
Eileen Trombetta, RD, CSP, LDN

Palliative Care Team
Michael H. Levy, MD, PhD
Marcin Chwistek, MD

Treatment might include

Chemotherapy
Liver-Directed Therapy
Surgery (resection or transplantation)
Palliation and Support Care

Since treatment of liver cancer often involves both the tumor biology and the underlying liver disease, it requires a concerted effort from various specialties including Surgical Oncology, Medical Oncology, Hepatology, Radiation Oncology, Interventional Radiology and Nutrition Support. We offer a comprehensive treatment platform including medications for the underlying liver disease, resection for small localized tumors, ablative therapies, chemoembolization, selective internal radiation therapy (SIRT) and systemic chemotherapy. For patients who are good candidates for liver transplantation, we refer them to reputable transplant centers in the Philadelphia and surrounding areas.

Treatment Options for
Liver Metastases

Liver tumors coming from another source (e.g., colon, stomach, lung) are called metastases. Our multidisciplinary team also works together to increase survival rates among these patients (see Liver-Directed Therapy).

Relief of cancer pain and patient nutrition support are an integral part of comprehensive cancer care.

These programs are an integral part of our cancer care program. Cancer pain can be relieved safely and effectively in over 95 percent of patients, using an integrated program of systemic, pharmacologic and anticancer therapy. The remaining patients can be helped by the appropriate use of invasive procedures. In addition, palliative-care consultants help identify and treat symptoms of physical and psycho-social problems, aid in communication between multiple caregivers, arrange case management and offer support for the patient's goals.

Liver Cancer Prevention and Early Detection

Since many primary liver cancers can be prevented by treating the causes before the liver developing cirrhosis, Fox Chase has established the Liver Cancer Prevention Center to address this problem. First created by W Thomas London, MD in the early 1980s as a model intervention program for populations at risk of hepatitis B-related liver cancer, the program has now been expanded to treat other causes. Minhhuyen Nguyen, MD, the current director, has continued screening for carriers of the hepatitis viruses and other high-risk conditions, immunizing their family members, treating patients with active liver diseases, and monitoring all patients to detect liver tumors early enough for potentially curative surgery or transplantation.

Liver Cancer Research

Or see National Cancer Institute information on Liver Cancer

Fox Chase is also conducting a major interdisciplinary program on the molecular epidemiology of primary liver cancer, designed to investigate the specific environmental, viral and genetic factors responsible. Our researchers in the Cancer Genome Institute are using leading edge technology to expand the understanding of cancer genetics, develop clinical trials of new treatments, and match emerging drug treatments to the unique genetics of individual patient tumors.