Liver Cancer Treatment in AU and NZ
Around 1,700 Australians and 300 New Zealanders get primary liver cancer each year.
Liver cancer that starts in the liver is called primary liver cancer. Liver cancer that starts somewhere else, for example the bowel or breast, is called secondary liver cancer.
Primary and secondary liver cancers are very different. In Australia and New Zealand, secondary liver cancers are much more common.
Radiation Therapy and Liver Cancer
The best person to talk to about radiation therapy for head and neck cancer is a radiation oncologist. A radiation oncologist is a specialist doctor who is part of the team that takes care of people having radiation therapy.
You can ask your doctor for a referral to a radiation oncologist to learn if radiation therapy is an option for you.
The Treatment Team
There are many treatments for people with primary and secondary liver cancer.
Doctors make a treatment plan for each person based on the:
- type of cancer
- where the cancer is
- what other treatments have been tried
- the person’s health.
The type of treatment a person gets is worked out by a team of doctors and health professionals often called a Multidisciplinary Team.
A highly trained radiation oncology team takes care of people having radiation therapy. This includes radiation oncologists, radiation therapists, medical physicists and radiation oncology nurses.
Treatments for Liver Cancer
Options can include:
Surveillance: This is when doctors keep an eye on tumours with regular screening.
Surgery: This is when doctors remove the part of the liver with cancer. It is a good option for people with healthy livers.
Liver transplant: This is when doctors replace the entire liver with a donated liver. It is common for people to have other treatments while waiting for a liver transplant.
Ablation therapy: This treatment uses heat to kill liver cancer cells.
Embolisation therapy: This treatment blocks the cancer’s blood supply, which can kill cancer cells.
Stereotactic Ablative Body Radiotherapy (SABR): This is when doctors deliver a very high dose of radiation to tumours in a short time frame.
Targeted systemic therapy: This is when doctors use medicine, such as chemotherapy, to treat the cancer.
Treatments for secondary liver cancer: Treatments for secondary liver cancer depend on things, such as where the cancer started and how much it has spread. The main options are:
- Surveillance
- Surgery
- Systemic therapy with anti-cancer drugs
- Radiation therapy
Types of Radiation Therapy Used for Liver Cancer
Radiation therapy uses high-energy x-rays to destroy cancer cells in the liver. There are a few types used to treat liver cancer.
External Beam Radiation Therapy (EBRT) is when radiation oncologists deliver highly targeted radiation beams to the cancer from outside the body. It is a painless, non-invasive treatment that is highly effective. People usually get EBRT daily over several weeks.
Stereotactic Ablative Body Radiotherapy (SABR) is a type of EBRT. This is when radiation oncologists deliver a very high dose of radiation to tumours in a short time frame. A course of SBRT is usually 5 treatments over 2 weeks.
Before SABR treatment, people have a special planning CT scan and an MRI to ensure the radiation is targeted accurately.
Sometimes, the treatment team inserts small markers into the liver near the cancer to localise the cancer during treatment. This feels like a biopsy.
The radiation oncology team combines all the scans to create an individual treatment plan. The preparation time before treatment is usually about 2 weeks.
SABR treatment takes 40-60 minutes. During the treatment, patients lie on a special body-length bean bag moulded to the body’s shape to help them stay still. While it’s very important for people to stay very still when they get SABR, radiation oncology teams allow for small movements, such as breathing, when they do the treatment.
Usually, people feel well during and after treatment and medicine can help common side effects.
General Information About Side Effects of Radiation Therapy
Radiation therapy is more effective with fewer side effects than ever before.
Recent advances mean radiation oncologists can effectively treat the cancer while getting less radiation on healthy body parts. This means much fewer side effects.
Side effects from radiation therapy vary between people, even for those having the same treatment.
While some people feel no side effects, some feel mild side effects, such as tiredness or skin redness during and/or just after treatment. These usually get better within a few weeks.
The treatment team will offer advice and medicine to help with side effects.
Serious side effects that start later (months to years after the radiation therapy) are rare.
Before starting treatment, your radiation oncologist will talk to you about side effects and answer your questions.
The side effects of radiation treatment can be split into 2 groups:
- Early side effects which occur during and shortly after radiation treatment.
- Late side effects which can occur months to years after radiation treatment.
For more information, go to the Potential Side Effects page.
Early Side Effects of Radiation Therapy for Liver Cancer
Early side effects often start during the first few treatments and end a few weeks after treatment.
Early side effects may include:
Fatigue: This is very common for people getting radiation therapy. Most people get better a few weeks after treatment ends.
Skin changes: People may notice skin redness in the second week of treatment. This usually gets better 4-6 weeks after treatment.
Nausea: The small bowel is sensitive to radiation therapy and even a small dose can trigger nausea in some people.
Swelling: Some people have swelling of the stomach from a fluid build-up.
What can help early side effects?
Resting can help with tiredness. Medicine can help with most of the other side effects.
Late Side Effects of Radiation Therapy for Liver Cancer
Late side effects can develop a few months or years after treatment, but they are rare.
Late side effects may include:
Chest pain: Liver SABR can weaken the ribs and cause chest pain. It can also cause rib fractures. This is very rare.
Ulcers and bleeding: Although it is very rare, radiation therapy can cause stomach ulcers and bleeding.
Radiation-induced liver disease (RILD): 3 months after SABR a small number of people may get RILD, which causes the liver and stomach to swell. Blood tests may also show a drop in liver function.
Narrow bile ducts: For cancers in the centre of the liver, there is a very small chance of getting narrow bile ducts.
What can help late side effects?
After treatment with liver SABR people see their doctor quite often. At each appointment, the doctor will do a blood test to check the health of the liver.
It is also common for people to have regular scans to check how well the treatment worked.
Radiation Oncologist
The best person to talk to is a radiation oncologist. You can ask your doctor for a referral to find out if radiation treatment is right for you.
GPs and Health Professionals
Information for any health professional involved in a patient's cancer care with a particular focus on primary care providers.
Talking to Your Doctor
Your GP or other doctors in the cancer team can organise a referral to a radiation oncologist.
Treatment Centres
Search and find your closest Radiation Oncology Treatment Centre.