Liver Cancer

We provide rapid liver cancer diagnosis and expert treatment. We understand that this can be a troubling time for you. Therefore, throughout your appointments with us, you’ll be assigned a specialist nurse who will be with you throughout your treatment journey, from your first clinic appointment to aftercare. The nurse will help you with any problems or questions you may have.

Specialists from different medical areas meet weekly. This is called a multi-disciplinary team meeting (MDT) and is central to the way we work. The MDT advise, support and create treatment plans that are personalised for every patient.

We provide:

• Access to the latest treatments - The clinical trials programme makes new treatments available to patients – often giving them a better outcome. We aim to have a trial option open to patients at each step of the treatment path.
• Specialist techniques - We are one of the three centres in the UK for training health professionals to use endocopes to look inside the body. We have a large, experienced team including 16 consultants and eight specialist nurses. This speeds up diagnosis for our patients.
• Research-driven care - As a university hospital, we lead research into liver cancer diagnosis, treatment and prevention. We regularly publish research papers that help in the fight against cancer.
• Screening for liver cancer - Screening means testing for early stages of a disease – before there are any symptoms. It's vital in the fight against liver cancer. We run a regular screening and monitoring programme for high-risk patients.

Types of liver cancer

• Cancer that begins in the liver is known as primary liver cancer. The leading cause of primary liver cancer is hepatocellular carcinoma (HCC).
• Another type of primary liver cancer is cholangiocarcinoma (cancer of the bile duct).
• Most cases of liver cancer are known as secondary. This means that the cancer started somewhere else in the body before spreading (metastasising) to your liver.

Your doctor will refer you to the hospital for further investigation if liver cancer is suspected. We will see you within two weeks of the doctor’s referral. You’ll meet a range of liver cancer experts at the clinic including:

• doctors who specialise in diseases of the digestive system (consultant gastroenterologists)
• nurses with specialist training and experience of liver cancer (clinical nurse specialists).

Symptoms for liver cancer usually become obvious when it has reached an advanced stage. Early liver cancer is more difficult to detect. It is often discovered by chance through blood tests or during a routine scan of the body.

Other tests that may be performed are:

Interview and examination: you’ll be asked about your medical history and any current symptoms. Your blood may be taken again for examination. The specialist then examines you by feeling your tummy (abdomen).

Liver ultrasound scan: this uses sound waves to make a picture of your liver. A small probe that looks like a microphone is passed over your abdomen. Anything solid is bounced back to make a picture – revealing any abnormal growths.

CT scan for liver and pancreas: CT means computerised tomography. The scan uses special X-ray equipment to demonstrate your body tissues. It creates pictures from different angles around your body and also shows slices (cross-sections) of your tissue and organs.

MRI scan of liver: MRI means magnetic resonance imaging. This special scan uses a strong magnetic field and radio waves to produce images of the liver and other organs.

Biopsy: A biopsy means removing a sample of tissue and looking at it under a microscope. It shows whether the cancer in your liver is a primary liver cancer, or whether it is a secondary cancer that has spread to your liver from somewhere else in your body.

The specialist may use an endoscope (a thin, flexible tube with a camera and small scanner at the tip) to look at the liver and bile ducts. This allows them to assess the stage of the cancer. We are one of the UK’s centres for teaching and performing this procedure.

Before you have a biopsy, we will check the condition of your liver to make sure it is safe for you to have it.

If these tests suggest liver cancer, you will receive a follow-up appointment at the rapid access liver clinic. Here we use tests to find out much the cancer has grown (the cancer ‘stage’).

Treatment starts as soon as possible after the cancer is discovered. It may take up to two weeks for your test results to come through. This depends on the types of tests you have at the hospital.

Planning your treatment

Your test results are discussed by the multi-disciplinary team (MDT). This is a team of doctors and health professionals who specialise in different aspects of treating liver cancer.

The MDT give advice on treatment options that would benefit you the most. Of course, you have the final decision about the type of treatment you receive.

Liver cancer treatment types

• Surgical resection - There is a chance that the cancer can be removed if the damage to your liver is minimal and the cancer is contained to a small part of your liver. This procedure is known as surgical resection.
• Liver transplant - This removes your liver and replaces it with a healthy donor liver. It is a major operation. Patients need to be assessed carefully and be fit enough to be considered.
• Non-curable liver cancer - The majority of liver cancer patients cannot be cured. This is usually because the cancer has become too advanced. However, palliative care treatment can help extend life for many years and control symptoms of pain.
• Ablative therapy - Ablative therapy destroys cancers cells. It cannot cure liver cancer but is effective in prolonging life and controlling pain. We use three different types at the hospital:
• Argon beam ablation - destroys tissue with an electrical current passed through a stream of argon gas to the tissue
• Laser ablation removes material from the liver by irradiating it with a laser beam
• Radio frequency ablation uses heat made by radio waves to kill cancer cells.
• Radiotherapy - This uses beams of radiation to kill cancer cells. Radiotherapy is given at the Clatterbridge Cancer Centre.
• Chemotherapy - This is the use of drugs to kill cancer cells, or stop them from multiplying. It will not cure your cancer, but may control or even reduce the cancer size. Chemotherapy is given at the Clatterbridge Cancer Centre.
• Chemoembolisation - This is a type of chemotherapy. Powerful cancer-killing medicines are directly injected into the liver. Chemoembolisation has proved very effective in slowing the spread of liver cancer and in relieving symptoms of pain. It is given at the Clatterbridge Cancer Centre.

Clinical Trials

You may be asked to take part in a clinical trial. Clinical trials help us learn more about the best way to treat specific conditions. Learn more about the Clinical Research Unit by visiting the website here

Members of the MDT include:

• consultant surgeons specialising in the care of patients with liver cancer
• clinical oncologist - a specialist in the treatment of cancer using non-surgical techniques such as radiotherapy and chemotherapy
• interventional radiologist - a specialist x-ray doctor who delivers x-ray guided treatment for liver cancer
• a pathologist - a specialist in diseased tissue
• a psychologist
• a palliative care doctor – a specialist in controlling symptoms of non-curable illnesses.
• a clinical nurse specialist – a liver cancer specialist. The nurse will act as your first point of contact.

You are assigned a specialist nurse who stays with you every step of your treatment journey. The nurse is your key-worker and is available to answer any questions you may have about your treatment.

Visit the Marie Curie website here

Visit the MacMillan Cancer website here 

Visit the Cancer Research UK website here

Visit the NHS Choices - Cancer website here