Liver Cancer Care

Expert Liver Cancer Care in Boston

Liver cancer, also known as malignant liver tumor, requires timely, specialized care for the best possible outcomes. At Beth Israel Deaconess Medical Center (BIDMC), our Liver Tumor Program is dedicated to treating liver cancer using the most advanced therapies available. We combine leading-edge treatment options with highly personalized care to support every patient’s unique medical and emotional needs.

Treatment for liver cancer may include liver surgery, CyberKnife or other targeted radiation therapies, systemic treatments such as chemotherapy or immunotherapy, as well as minimally invasive procedures like radioembolization, chemoembolization or ablation.

Types of Liver Cancer

The hepatobiliary system includes the liver, gallbladder and bile ducts. Our multidisciplinary team of physicians care for all types of cancer and non-cancerous diseases affecting the hepatobiliary system, including:

• Cholangiocarcinoma is cancer of the bile duct system (the biliary tree). These can start in the liver from the bile duct cells (intrahepatic) or in the major duct draining bile from the liver to the intestines, called the common bile duct (extrahepatic).
• Gallbladder carcinoma is a cancer that can begin anywhere in the gallbladder and can invade the adjacent liver parenchyma.
• Hepatocellular carcinoma (HCC) accounts for the overwhelming majority of primary liver cancer. Hepatitis B (HBV) is the leading cause of HCC around the world. Hepatitis C (HCV) is also a common cause of HCC in the United States, but all people with cirrhosis of the liver are at increased risk for developing HCC.

Cancer Metastases in the Liver

These are cancer cells that have spread from an original (primary) site to one or more locations or organs elsewhere in the body. The liver is a prime site for metastatic cancer for many reasons. These are other cancers that can commonly metastasize, or spread, to the liver:

Screening & Diagnostic Tools

Our liver specialists use the latest screening and diagnostic tools to quickly and accurately diagnose liver cancer. Depending on your symptoms and health situation, you may need some combination of the following imaging and laboratory tests.

Endoscopic Procedures

Endoscopic procedures are one way of determining whether you have a liver tumor. A gastroenterologist (doctor who specializes in the digestive system) uses a device called an endoscope for the examination. There are different types of endoscopies depending upon the nature of your condition:

• Endoscopic retrograde cholangiopancreatography (ERCP) uses X-rays and an endoscope to treat problems of the bile and pancreatic ducts. A nurse injects dye into the areas in question so they show clearly on X-ray.
• Endoscopic ultrasound (EUS) is a minimally invasive procedure that combines endoscopy and ultrasound to get images and information about your digestive tract and the surrounding tissue and organs.
• Intraductal cholangioscopy uses an endoscope to visualize key areas during ERCP.
• Confocal microscopy is an enhanced imaging technique for inspection of your tissue at the cellular level.

Advanced Imaging Studies

BIDMC is known nationwide for our state-of-the-art imaging. Improved imaging helps our radiologists detect and treat cancer in its earliest stages. These are a few techniques we use:

• Rapid multidetector CT angiography and MR (magnetic resonance) angiography for taking a closer look at the vessels supplying blood to your liver. Our doctors may use 3D reconstructions of your CT scans to plan surgeries or procedures.
• MRI.
• Magnetic resonance cholangiopancreatography (MRCP), a non-invasive method for screening your bile ducts and pancreas.

Liver Cancer Treatments

We offer the latest, most effective innovations in liver cancer treatment options.

Liver Cancer Surgery

Experienced BIDMC surgeons use advanced techniques to treat hepatobiliary conditions and disorders. We offer minimally invasive (laparoscopic/robotic) and open surgery, along with these and other specialized procedures:

• Surgery for malignant (cancerous) or benign (non-cancerous) diseases of the liver
• Surgery on the gallbladder and bile duct for benign and malignant diseases, including laparoscopic bile duct injuries and narrowing, and bile duct stones that cannot be removed with a flexible endoscope (lighted tube through the mouth)
• Liver transplant surgery

Non-Surgical Liver Cancer Treatment

Your care plan may involve some combination of these non-surgical treatments for liver cancer:

• Chemoembolization: During this treatment, the doctor injects small particles containing a chemotherapy drug into the hepatic artery. This blocks blood supply to the tumor and shrinks or destroys the cancerous tissue.
• Chemotherapy: Our medical oncologists choose the most appropriate systemic chemotherapy drug or drugs to treat each patients' cancer.
• CyberKnife: During CyberKnife Stereotactic Radiosurgery, your doctor precisely targets radiation therapy at the site of the tumor. A major benefit to CyberKnife is that surrounding healthy tissues have minimal exposure to radiation. Your care team may recommend CyberKnife if you have hard-to-reach or complex tumors in the liver or pancreas.
• Immunotherapy: This innovative treatment works with your body’s immune system to fight cancer. 
• Radiation therapy: Radiation therapy targets the tumor with X-rays or radioactive agents. 
• Ablation: The doctor places a probe into the tumor which generates electromagnetic energy to heat and destroy the tumor cells.