Hepatologist Helen Te, MD, and a patient in clinic
Hepatologist Helen Te, MD, is medical director of UChicago Medicine's adult liver transplant program and an expert in the treatment of liver cancer and other liver diseases.

Diagnosis

UChicago Medicine physicians may use one or more of the following procedures to diagnose primary liver cancer:

Imaging scans: Including ultrasound, computerized tomography (CT) scan and magnetic resonance imaging (MRI). CT and MRI scans are used to determine the extent of the liver cancer.

Biopsy: A procedure to sample a small area of liver tissue for testing in a lab. Biopsies can be used to aid in liver cancer diagnosis.

Treatment

With experienced physician specialists in hepatology, diagnostic radiology, oncology, surgery and liver transplantation, we have the skill and experience to provide unparalleled comprehensive care for primary liver cancer. Depending on your specific diagnosis, our team will design the right treatment strategy for you.

We provide the full range of treatment options for primary liver cancer and bile duct cancer, including:

Tumor removal (resection) is one of the main options for curing liver cancer. Our skilled surgeons can safely remove many cancerous liver tumors while preserving liver function.

If the cancer has reached an advanced stage, or if the liver is severely damaged due to cirrhosis, surgery may not be an option.

During TACE, an interventional radiologist inserts tiny chemotherapy-coated particles through a thin catheter into the hepatic artery, the major source of blood supply to the tumor. These particles slow blood flow, starving the tumor of the nutrients it needs to grow. Over time, the cancer cells die. Chemoembolization is sometimes done to help shrink tumors before resection.

Also done by interventional radiologists, TARE allows microscopic radiation beads to be inserted through a catheter into the hepatic artery supplying the tumor. Similar to TACE, this procedure prevents blood flow into the tumor and the tumor cells die over time. It is a two-step procedure; the first step involves an initial angiogram, or mapping, procedure. The second step involves delivering the drug to the tumor.

Radiofrequency or microwave ablation involves the use of special instruments that produce high-frequency waves to burn diseased tissue. Physicians insert a needle-like probe into the tumor to heat and destroy the cancer cells. Depending upon the size and location of the tumors, ablation is an option for some patients who cannot have a resection, or it may be performed during a resection to treat smaller tumors.

Alcohol ablation, also known as ethanol injection, is the injection of concentrated alcohol directly into the tumor to kill cancerous cells. This procedure has slowly fallen out of favor due to the effectiveness of the other procedures described above.

UChicago Medicine is home to one of the most integrated and experienced radiation therapy teams in the country. Our well-respected doctors and physicists design and deliver the most effective treatments available anywhere, using leading-edge technology. Learn more about our radiation oncology services.

Significant recent advances have been made in targeted therapy for primary liver cancer and bile duct cancer with the approval of several new medications. This field is continuously evolving. In addition, a combination of chemotherapy and liver-directed therapy as a bridge to resection or liver transplantation are also being actively studied.

Patients with liver cancer may also benefit from liver transplantation in specific cases. Many UChicago Medicine physicians skilled in caring for liver cancer patients are also members of our world-renowned liver transplant team. We were the first medical center in the United States to perform a living related donor liver transplant. Learn more about our liver transplantation program.

As part of our dedication to providing the best, most advanced care for primary liver cancer, our physicians are actively involved in clinical trials for hepatocellular carcinoma (HCC), the most common type of liver cancer. Through these trials, we can offer our patients targeted treatments that are not widely accessible yet, including new immunotherapies and combination therapies.

We are currently offering phase 1, 2 and 3 clinical trials, and have options for patients who have not received any treatment for liver cancer as well as those who have been previously treated. These treatments are experimental, and are not widely available at other hospitals. Learn more about our clinical trials.

We are conducting long-term outcome studies of liver cancer patients as part of a national liver cancer database. The goal is to better understand the progression of liver cancer and to identify the best treatment protocols.

Some patients with advanced stages of liver cancer will experience pain. We're dedicated to helping patients keep cancer pain under control. Our oncologists and anesthesiologists (pain control physicians) work together to determine the best pain management strategy — from oral medicines to powerful nerve blocks. Learn more about our efforts to help manage cancer pain.

 

 

Patients with conditions that increase the risk for developing liver cancer (e.g. cirrhosis, hepatitis B or C, and hemochromatosis) should be monitored closely by a hepatologist. At the University of Chicago Medicine Center for Liver Diseases, our hepatologists are highly skilled at caring for patients with these conditions, and can offer several types of treatments that slow disease progression.