Treatment of Liver cancer
Best hospitals and doctors for liver cancer treatment abroad
Leading hospitals
Cost for treatment
Liver cancer is a severe oncological disease characterized by an aggressive course, rapid onset of metastases, and damage to nearby and distant anatomical structures. New therapeutic interventions are developed for both early-stage and advanced-stage liver cancer. For instance, patients with stage IV liver cancer and recurrent tumors may receive targeted drugs, undergo immunotherapy or chemoembolization (as the additional treatment).
Content
- Symptoms
- Types of liver cancer
- Stages and prognosis
- Diagnostics
- Treatment methods
- Minimally invasive treatment
- Innovative treatment methods
- Where to treat liver cancer?
- The cost of treatment of liver cancer
- How to go abroad for treatment of liver cancer?
Liver cancer is a malignant neoplasm that begins in liver.
Stage 4 liver cancer is cancer that has spread to lymph nodes and distant organs.
Liver cancer treatment includes surgery, radiation therapy, ablation, embolization, targeted therapy, immunotherapy, and chemotherapy.
Cost of treatment with chemoembolization starts at €4,711. Price for unilateral hepatectomy starts at €12,076. Cost of radiofrequency ablation starts at €4,687.
Best hospitals in Europe are:
- University Hospital of Ludwig Maximilian University of Munich
- Helios Hospital Berlin-Buch
- University Hospital Rechts der Isar Munich
- University Hospital Frankfurt am Main
- Clinic of Advanced Biological Medicine Frankfurt am Main
Symptoms
Liver cancer has specific symptoms, but they appear only at advanced stages. The signs of liver cancer are quite nonspecific and can be easily confused with other diseases of this organ (e.g. with gallstone disease or exacerbation of chronic hepatitis).
Still, early symptoms of liver cancer include:
- Constant bloating and digestive discomfort
- Frequent diarrhea or constipation
- Nausea, which may be accompanied by vomiting (this is one of the most common symptoms in liver cancer)
- Decreased appetite
- Constant feeling of tiredness and even malaise
- Chills and fever are sometimes a sign of liver cancer
Note that the primary and secondary types of liver cancer have identical manifestations.
Types of liver cancer
By origin, primary and secondary liver cancer types are distinguished. Primary pathology includes all types of malignant tumors that have developed from the liver’s own tissues. Secondary cancer is metastases of tumors located elsewhere (e.g. metastases of breast cancer, prostate cancer, stomach cancer, colon cancer, esophageal cancer, etc.).
Primary liver cancer is classified as hepatocellular carcinoma (a tumor that grows from liver cells) and cholangiocarcinoma (cancer of the internal bile ducts).
In the majority of cases, primary hepatocellular cancer develops against the background of chronic hepatitis or cirrhosis of the liver. Therefore, the prognosis of the disease will largely depend on the state of the liver tissue at the time of tumor development.
Cholangiocarcinoma is much less common and usually affects elderly patients (70 years and older). In such cases, the prognosis depends largely on the general condition of the patient.
Besides, the clinical prognosis is influenced by the morphological form of the tumor. The prognosis for patients with nodular liver cancer will be better than for patients with diffuse one since the latter excludes the possibility of surgical treatment for liver cancer.
As in the case of other oncological diseases, the clinical prognosis for patients with liver cancer depends on the properties of the tumor cells. With undifferentiated cancer, the prognosis is always worse than with moderately differentiated cancer.
Diagnostics and treatment of secondary (metastatic) liver cancer have their own peculiarities. In such cases, the prognosis is often poor.
Stages and prognosis
At stage I of the disease, a single malignant node is formed in the affected organ. Its size does not exceed 2 cm, and it also does not affect the blood vessels (does not grow in them or does not violate their integrity). At this stage of the disease, doctors can achieve complete recovery with the help of radical surgery for liver cancer.
At stage II, the primary tumor grows, but its size does not exceed 5 cm. The patient does not have metastases spreading through the blood or lymph. It is more difficult to treat such a disease. Not only surgical treatment is required, but also additional chemotherapy and other measures. However, with proper treatment the chances of recovery are very high.
At stage III of liver cancer, the neoplasm exceeds the size of 5 cm or the patient has metastatic foci in the regional lymph nodes. The clinical prognosis for liver cancer worsens significantly, but doctors are doing everything to achieve recovery or prolong the patient's life as much as possible.
In stage IV liver cancer, doctors detect distant metastatic foci in the lungs or other organs. It is still impossible to cure such cancer. Even with an advanced stage of oncology, doctors still come to the aid of the patient. Patients receive palliative treatment, which relieves unpleasant symptoms and prolongs life.
Diagnostics
The diagnostics begins with physical examination and anamnesis collection. During palpation, the organ is dense and enlarged. Large tumors can be palpable. The distinctive clinical picture arises at the advanced stages. The onset of the disease has no characteristic clinical signs and often goes unnoticed.
The most informative liver cancer diagnostics includes computed tomography with hepatotropic contrast agents. The study allows determining the nature of liver cancer, its exact localization and spreading. This is especially important when surgery is planned. If after a CT scan the doctor has doubts about the nature of the tumor, a biopsy is performed with harvesting the material from the pathological site for further cytological examination.
The patient may also undergo an ultrasound examination. If metastases are suspected, chest X-ray, colonoscopy, and abdominal sonography are prescribed. Several laboratory tests are carried out as well as tumor marker tests, tests for viral hepatitis, complete blood count, and biochemical blood tests.
Treatment methods
After carrying out all the diagnostic procedures, determining the size and spreading of the tumor, the doctors elaborate a therapeutic scheme. To treat liver cancer doctors choose:
- Surgical removal of part of the liver or the entire organ, followed by possible liver transplantation
- Radiation treatment (selective internal or external one)
- Radio- of chemoembolization of the vessels that are feeding the tumor
- Systemic chemotherapy drugs that kills cancer cells
- Targeted immunotherapy
- Cytoreductive surgery and chemotherapy
Minimally invasive treatment
When doctors treat liver cancer, they give preference to the most effective methods of treatment. Sometimes it is possible to use minimally invasive methods, which do not harm the patient much and allow recovery within a relatively short period. They are used in the presence of contraindications to conservative treatment, for example, with cirrhosis, general serious health problems, and/or old age. The minimally invasive methods of therapy include:
- Laser therapy, when a malignant lesion is removed using directed laser energy
- Cryoablation, when the tumor is frozen with liquid hydrogen passed through a special probe (it has an ultra-low temperature)
- Radiofrequency ablation, in which the tumor is burned out by high-frequency waves
- Electroporation, in which malignant cells are destroyed by exposing them to short but intense electrical impulses
- Radiosurgical methods, which include the innovative CyberKnife
- The progressive method of proton treatment
Innovative treatment methods
Radiation treatment and chemotherapy are usually used at the advanced stages of the disease. Thanks to a combination of operative and conservative methods, doctors can increase the chances of a full recovery, as well as reduce the risk of recurrence of the neoplasm.
Of course, both radiation and chemotherapy may have serious side effects. These methods of treatment have a systemic, toxic effect on the body. They can cause multiple functional complications, e.g. disrupt the functions of the bone marrow, gastrointestinal tract, and cause other side effects.
Liver cancer treatment can be carried out using new progressive methods that reduce the severity of side effects and make it possible to target the tumor precisely.
In chemoembolization, doctors inject chemotherapeutic drugs (cytostatics) mixed with microemboli into the hepatic artery. Thanks to this injection technique, the drugs continue to act on the tumor for about a month. Chemoembolization gives about 2 additional years of survival in 30% of patients, even without surgery. Chemoembolization may be used as the supplementary therapeutic measure in patients with stage IV liver cancer.
In cryosurgery, the doctor cools the neoplasm to an ultra-low temperature with liquid nitrogen, which leads to the death of malignant tissues. This method of liver cancer treatment can be used when the tumor size is under 5 cm. The three-year survival rate when using it is about 20%.
With percutaneous alcoholization, the doctor injects ethyl alcohol into the tumor nodes. This process is performed under the ultrasound guidance, and may require several procedures. The five-year survival rate is 30% (the same as for surgery).
Brachytherapy is an innovative method of radiation therapy that minimizes the negative effects of radiation on healthy organ tissues. The doctor inserts small catheters with the radiation sources in the tumor tissue. Due to this, gamma rays act locally, within the borders of a malignant neoplasm.
Targeted treatment of liver cancer involves the use of angiogenesis inhibitors. These are drugs that can suppress the formation of new vessels that feed the tumor. This slows down the progression of liver cancer and, in combination with other methods, allows achieving good treatment results.
Viral therapy is a new advanced treatment method that involves the use of a modified smallpox virus. This pathogen is capable of destroying cancer cells without harming healthy tissues. This method is currently at the stage of clinical trials, but it demonstrates encouraging treatment results.
Where to treat liver cancer?
In the treatment of liver cancer, it is important to choose the right medical facility among the best hospitals.
We recommend the following hospitals for the treatment of liver cancer:
- University Hospital of Ludwig Maximilian University of Munich, Germany
- University Hospital Heidelberg, Germany
- University Hospital Bonn, Germany
- University Hospital Carl Gustav Carus Dresden, Germany
- Charite University Hospital Berlin, Germany
Feel free to visit the Booking Health website to learn more about the clinical practice of the hospitals.
The cost of treatment of liver cancer
The prices for the treatment of liver cancer depend on the stage of the disease and the treatment plan prescribed by the doctor according to the clinical indications. The approximate price for treatment will be estimated after hospitals receive patient’s medical information and results of the diagnostics. Based on this, the specialists will draw up a preliminary medical plan and give a price for treatment:
- The cost of unilateral hepatectomy for liver cancer is between 15,450 EUR and 31,400 EUR.
- The cost of chemotherapy for liver cancer is between 7,300 EUR and 8,000 EUR.
- The cost of percutaneous embolization (coiling) for liver cancer is between 24,200 EUR and 40,900 EUR.
The average price of rehabilitation after liver cancer treatment is 1,190 EUR per day, the minimum price is 1,041 EUR per day, and the maximum price is 1,553 EUR per day.
How to go abroad for treatment of liver cancer?
You don't have to organize the treatment abroad by yourself. If you want to, you can use the services of a medical tourism company, which will be cheaper, safer, and easier.
Booking Health is one the most experienced and reliable medical tourism companies out there.
Booking Health provides full support throughout your treatment and offers additional services, such as translation services, transfers, visa issuing, booking accommodation for you and an accompanying person, as well as advice on any administrative issues.
If you are interested, leave a request on the Booking Health website to get more detailed info.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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