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Providence Cancer Institute
Providence Cancer Institute
Where bright minds and big hearts come together
At Providence, we see more than a patient with a liver cancer diagnosis, we see the life you’re fighting for – and we have for nearly 100 years. That’s how long we’ve been providing world-class cancer care across Southern California. Today, our commitment continues with nationally accredited cancer programs in Los Angeles and Orange County and a multidisciplinary, patient-focused approach. Learn more about liver cancer care at Providence.
The cancer teams at Providence treat both primary and secondary liver cancers.
Primary liver cancer is cancer that begins in the liver. There are several types of primary liver cancer:
- Hepatocellular carcinoma (HCC): The most common type of liver cancer, hepatocellular carcinoma (HCC) can start as a single liver tumor that spreads to other parts of the liver, or as multiple cancer nodules that form throughout the liver.
- Cholangiocarcinoma: A rare form of liver cancer, cholangiocarcinoma begins in the bile ducts of the liver. Intrahepatic cholangiocarcinoma begins in the bile ducts inside the liver, while extrahepatic cholangiocarcinoma starts in ducts outside the liver.
- Angiosarcoma and hemangiosarcoma: Sarcomas are cancerous growths that develop in soft tissues like fat, muscle, or blood vessels. Angiosarcoma and hemangiosarcoma are rare, fat-growing tumors that form in the cells of the liver’s blood vessels.
The liver filters all of the blood that circulates through the body. Secondary liver cancer develops when cancer that began in another part of the body is spread to the liver through the blood. Secondary liver cancer is also called liver metastases.
The specific causes of liver cancer are not completely understood, but various factors are known to raise a person’s risk of primary liver cancer.
The most common liver cancer risk factors include:
- Chronic viral hepatitis: The most common risk factor for primary liver cancer is long-term infection with hepatitis B or hepatitis C. Hepatitis B is transmitted through blood and bodily fluids. Hepatitis C is spread through contaminated blood.
- Cirrhosis: Cirrhosis, a disease that develops when damaged liver cells are replaced by scar tissue, affects the liver’s ability to function properly and is a leading risk factor for liver cancer. Common causes of cirrhosis include long-term alcohol abuse, chronic viral hepatitis and fatty liver disease.
- Non-alcoholic fatty liver disease: Fatty liver disease is related to excess weight. Patients who are about 20 pounds or more overweight may store abnormal amounts of fat in the liver, which can cause scarring.
- Gender: Hepatocellular carcinoma is more common in men than in women.
- Ethnicity: Asian-Americans and Pacific Islanders have a higher risk of developing liver cancer than other ethnicities.
- Family history: Some people who have a family history of liver cancer or inherited metabolic diseases may have an increased risk of the disease.
Having any of these risk factors does not mean you will develop liver cancer, but if you are concerned about your risk, talk to your doctor.
There is no routine screening exam for liver cancer, but if you have any of the conditions that increase risk, talk to your physician about checking your liver health. The sooner liver cancer is detected, the easier it may be to treat.
Consider the following guidelines to help lower your liver cancer risk:
- Prevent or treat chronic viral infections, including hepatitis B and hepatitis C
- Eliminate or reduce alcoholic beverages
- Maintain a healthy body mass index and lose weight if you are overweight
Liver cancer may not be detected until it has reached an advanced stage, but learning about the symptoms of liver cancer may help increase awareness of them. Learn more about how liver cancer is diagnosed.
Liver cancer may have few or no symptoms in its early stages. As cancerous liver tumors grow, symptoms may include:
- Loss of appetite
- Feeling of fullness even after a small meal
- Nausea or vomiting
- Unintended weight loss
- Yellowing of the skin and eyes (jaundice)
- Feeling a growth or mass under the ribs
- Pain in the abdomen or near the right shoulder blade
- Swelling or fluid in the abdomen
If you notice a potential symptom of liver cancer, please call your primary care provider. While these symptoms don’t always indicate cancer — sometimes they are signs of something less serious, such as an infection — it’s important to have a Providence physician evaluate them. Don’t wait to see if they go away on their own. As with most cancers, the sooner liver cancer is found, the easier it can be to treat.
In addition to a physical examination and medical history, your physician may order one or more of the following diagnostic tests for liver cancer:
- Ultrasound: This imaging test uses sound waves to detect abnormal growths in the liver, which can be tested to determine if they are cancerous.
- Computed tomography (CT) scan: A CT imaging scan uses X-rays to provide information about the size, shape and location of growths in the liver and surrounding areas and can help determine if cancer has spread.
- Magnetic resonance imaging (MRI): Using radio waves and strong magnets, MRI provides detailed images of any growths in the liver or areas around it. MRI also can help determine if cancer has spread.
- Biopsy: If the physician suspects a growth may be cancer, they may perform a biopsy to remove a tissue sample from the growth for testing.
From the latest targeted therapies to the most innovative approaches emerging through clinical trials, Providence leverages the full power of today’s most advanced, evidence-based therapies to treat liver cancer. Your personalized treatment plan may include any or all of the following:
- Liver resection surgery
- Ablation
- Radiation therapy
- Transarterial treatment of liver tumors
- Immunotherapy and targeted therapy
- Clinical trials
- Supportive services
The Hepatobiliary and Pancreatic Surgery (HPB) Program provides state-of-the-art surgical treatment for patients with primary and metastatic cancers of the liver, gallbladder, bile duct and pancreas. The program also treats benign disease including cysts, biliary strictures and bile duct injuries.
Liver resection, also called partial hepatectomy, is surgery to remove liver tumors. The remaining healthy liver tissue is left in place. This type of liver surgery is most appropriate for patients who have a single tumor and an otherwise healthy liver. Hepatobiliary surgery also may be performed to bypass a blockage in the liver caused by a tumor, scarring or inflammation and is usually used for palliative care.
Hepatobiliary surgery is highly complex and specialized. It is important to choose a surgeon who is very experienced in these procedures, as well as a healthcare system that has a high volume of hepatobiliary surgeries.
Embolization is a procedure that blocks the flow of blood to a tumor. Radioembolization combines embolization with radiation therapy. During this minimally invasive procedure, tiny beads filled with the radioactive isotope yttrium Y-90 are placed inside the blood vessels that feed the tumor to block the blood supply while delivering a high dose of radiation to the tumor.
Microwave ablation (MWA) is a minimally invasive procedure using heat from microwaves to destroy liver cancer cells. Using a CT scan or ultrasonic guidance, the surgeon inserts a specialized, needle-like probe through the skin into the exact location of the liver tumor. MWA is an effective treatment option for small liver tumors or when surgery is not a good option.
TACE combines embolization, which cuts off blood supply to a tumor, with chemotherapy, which kills cancer cells. An interventional radiologist performs TACE by giving chemotherapy through a catheter directly into the artery that supplies blood to the tumor, then closing off the artery.
Despite its name, SRS is not a surgical procedure. It is a type of radiation therapy that delivers a highly targeted radiation dose precisely to the cancer cells while protecting nearby healthy tissue from radiation damage.
Radiofrequency ablation is a minimally invasive procedure that uses an electric current to vaporize (ablate) cancer cells and tumors.
IMRT uses 3D imaging and a dedicated computer-controlled radiation machine (linear accelerator) to deliver thousands of small radiation beams together, each at different intensities that conform to the precise size, shape and location of cancerous tumors, while minimizing side effects to healthy tissue.
Immunotherapy uses medicines that help your own immune system identify and destroy cancer cells. The immune system turns proteins on immune cells (known as “checkpoints”) on or off to trigger an immune response. Cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. Immunotherapy drugs called “checkpoint inhibitors” target these checkpoints to keep cancer cells from using them.
Targeted therapies destroy cancer cells or stop their growth by targeting defects in cancer cells. They are taken in pill form.
Our services are provided by a cancer care team that not only understands the importance of comprehensive support, but also values each patient’s individual needs.
Genetics plays an important role in your medical health and that of your family members to help you understand the influence of hereditary gene changes linked to cancer. Genetic counseling and testing are available for all hereditary cancer syndromes and familial patterns of cancer. Our genetic counselors combine genetic test results, personal factors, family history, and counseling to generate a personalized genetic risk assessment with estimates of future cancer risks for both individuals and family members. The process of genetic counseling creates risk estimates as well as improved patient and physician understanding, which leads to individualized medical management, empowered cancer prevention, and appropriate risk reduction strategies. Learn more to see if genetics counseling is right for you.
Clinical trials are research studies that test the safety and effectiveness of new medical treatments. Patients who volunteer for clinical trials often gain access to the newest advancements and investigational therapies. At Providence, our physicians work closely with our world-class research team to make appropriate clinical trials a regular part of our patients’ care options.
To learn more visit Providence Research and Clinical Trials
Your personalized treatment plan will depend on factors that are unique to you, from your specific diagnosis to your personal health and preferences. But one thing that most patients can count on is that it will take a team. And that’s where Providence shines.
Your team may include multiple experts who specialize in very specific aspects of treatment, as well as nurses, dietitians, counselors and others, all collaborating on your care. Collaboration is key, and we do it well. One way is through regular tumor boards, where members of your team, as well as Providence specialists from outside your team, gather to review patient cases and to share clinical opinions, recommend treatments or symptom-management strategies, suggest opportunities for clinical trials and optimize care coordination.
If this starts to feel overwhelming, rest assured — we’ve got you. To help guide you through the whole process, we will also team you up with a cancer navigator. Your cancer navigator helps you with care coordination, answers your questions, refers you to helpful support services, and provides emotional support and more to help ease the stress of cancer treatment.
Treatment options and services may differ based on location including Providence Little Company of Mary and Providence Holy Cross where City of Hope partnerships have been established for cancer care. For more information, please contact the Patient Engagement Center or click on the selected location.
We welcome your questions! Call 844-987-0482 for more information or complete the online form.
Cancer navigators who provide individual support, compassionate care and coordination every step of your cancer journey.
Access to the most advanced technology and treatment options, including research, precision medicine, genetic counseling and clinical trials.
