Combo Treatment Helps Liver Cancer Patients

Chemotherapy, laser treatment combine to boost lifespans

TUESDAY, Oct. 28, 2003 (HealthDayNews) -- New research supports radiologists who are trying to treat liver cancer by using a "smart bomb" treatment that first shrinks the tumor and then tries to burn it away.

The one-two punch extended the lives of patients, claims a German study that appears in the November issue of Radiology.

The combination therapy also greatly reduces recovery time when compared to the standard surgery treatment, says Dr. Jonathan Susman, an assistant professor of radiology at Columbia University in New York City.

Liver cancer remains one of the most deadly cancers, however, and even cutting-edge treatments don't prevent recurrence in many patients with the most advanced forms of the disease.

"Traditionally, patients have been plagued by poor survival," says Dr. J.F. Geschwind, director of cardiovascular and interventional radiology at The Johns Hopkins Hospital in Baltimore. Even after doctors remove the liver tumors through surgery, they return within five years in 75 percent of cases, he says.

Liver cancer is especially difficult to treat because it's often the result of existing liver disease, such as cirrhosis or hepatitis. "You can even consider it a side effect, no question about it," Geschwind says.

In other cases, liver cancer develops when tumors migrate from other parts of the body, especially the colon or breast.

An estimated 17,300 cases of primary liver cancer -- which do not spread from elsewhere in the body -- are diagnosed in the United States each year, according to the American Cancer Society. Most patients are men. An estimated 14,300 Americans will die of the disease this year.

Doctors can try to burn up the tumors with lasers and high-frequency radio waves. However, tumors with diameters of more than 3 or 4 centimeters are often too large to be treated effectively.

"You never know how much of the tumor you burned," Geschwind says. "If you leave a little bit of the tumor behind, it returns with a vengeance."

In the new study, the researchers from University Hospital in Frankfurt recruited 162 liver cancer patients whose tumors were large and the result of cancer that had spread from elsewhere in the body. The doctors tried to shrink the tumors and then, if possible, destroy them with lasers.

All the patients had a treatment called chemoembolization to shrink the tumors. "We inject the chemotherapy right into the tumor cells, and then cut off the oxygen supply by blocking the blood flow," says Susman, who uses that approach to treat his patients.

In the new study, the tumors shrunk in more than half of the patients. Doctors went on to treat their tumors by burning them with lasers. Susman uses a similar approach, utilizing radio-frequency waves instead of lasers.

"I treat [the tumor] from the inside first to hamper its defenses and shrink it down, so that I can use a device to burn it away and completely eradicate it. It is the medical equivalent of a smart bomb," he says.

Blocking blood flow to the tumor helps in the burning process, Susman adds. "The blood supply works like the radiator in your car, pulling heat away. When we block the blood supply you no longer have the radiator circulating. You heat the tumor more easily because the heat doesn't go away."

The patients who underwent the combination treatment lived for a median of 26.2 months, while the other patients who only received the chemoembolization lived a median of 12.8 months.

Those survival rates may seem low, Susman says, but they'd be higher in patients with smaller tumors. Also, the treatment lets patients avoid surgical removal of tumors, which requires months of recovery time and poses great risks, he adds.

The German researchers say the dual treatment has applications for lung, bone and lymph node tumors as well.

More information

To learn more about liver cancer, visit the American Cancer Society and the National Cancer Institute.

Related Stories

No stories found.
logo
www.healthday.com