Is Liver Cancer Surgery Really That Dangerous? the Risks and Options

Is liver cancer surgery really that dangerous?

Is liver cancer surgery really that dangerous? My father has been diagnosed with two tumors in his liver.
Initially, he had hopes of using a photon knife, but that dream was shattered.
Later, he considered embolization, but due to an unknown tumor in the bile duct, the doctor advised that it was quite risky.
Consequently, my father decided to forgo surgery and is now taking medication at home.
I would like to ask the doctor how to handle this situation.
Is it really just a matter of waiting for the liver tumors to grow larger, or even spread throughout the body?

nini, 30~39 year old female. Ask Date: 2001/05/22

Dr. Yang Guojun reply Gastroenterology and Hepatology

Your father has three possible scenarios.
The first (most likely) is that liver cancer cells have metastasized within the liver; in this case, the treatment method would be chemotherapy, and the survival period is not long.
The second scenario is that cholangiocarcinoma has spread within the liver, which is also an advanced stage and may be resistant to chemotherapy, with a survival period of about 6 to 9 months.
The third scenario (least likely) is that all three tumors are benign, in which case close observation would be sufficient.
If multiple tumors are malignant, due to the rich blood supply in the liver, they may have already disseminated throughout the body, indicating that metastasis has likely occurred upon discovery.

Reply Date: 2001/05/22

More Info

Liver cancer surgery can indeed be associated with significant risks, particularly in patients with underlying liver conditions such as cirrhosis or multiple tumors. In your father's case, the presence of two tumors in the liver, along with an unknown tumor in the bile duct, raises the complexity of his treatment options and the potential risks involved.

Understanding the Risks of Liver Cancer Surgery
1. Underlying Liver Disease: If your father has liver cirrhosis, this condition can severely compromise liver function, making any surgical intervention riskier. The liver is responsible for many vital functions, including detoxification, protein synthesis, and the production of biochemicals necessary for digestion. Surgery can further stress an already compromised liver.

2. Tumor Characteristics: The size, location, and type of tumors also play a crucial role in determining the risk of surgery. Tumors that are larger or located near major blood vessels may pose a higher risk of complications during surgery.

3. Surgical Risks: Common risks associated with liver surgery include bleeding, infection, and complications related to anesthesia. Additionally, there is a risk of liver failure post-surgery, especially in patients with pre-existing liver conditions.

4. Alternative Treatments: Given the complexity of your father's situation, alternative treatments such as transarterial chemoembolization (TACE) or radiofrequency ablation (RFA) may be considered. These options can sometimes be less invasive and may help manage the tumors without the need for major surgery.

Current Management and Future Considerations
Since your father has opted for medication and is not pursuing surgery, it is crucial to ensure that he is under regular medical supervision. Here are some steps to consider:
1. Regular Monitoring: Regular imaging studies (like ultrasounds or CT scans) and blood tests (including liver function tests and tumor markers) should be conducted to monitor the progression of the disease. This will help in assessing whether the tumors are growing or if new tumors are developing.

2. Symptom Management: If your father experiences symptoms such as pain, jaundice, or significant weight loss, these should be addressed promptly. Palliative care can also be an option to improve the quality of life.

3. Consultation with Specialists: It may be beneficial to consult with a hepatologist or an oncologist who specializes in liver cancer. They can provide insights into the latest treatment options and clinical trials that may be available.

4. Lifestyle Modifications: Encouraging your father to maintain a healthy lifestyle, including a balanced diet, regular physical activity (as tolerated), and avoiding alcohol, can help support his liver health.

Conclusion
While the risks associated with liver cancer surgery can be significant, especially in patients with cirrhosis and multiple tumors, it is essential to explore all available treatment options and maintain close communication with healthcare providers. Waiting and monitoring the situation is a valid approach, but it should be done under medical supervision to ensure timely interventions if the condition changes. Your father's healthcare team can provide the most personalized advice based on his specific medical history and current health status.

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