Liver Cancer

(especially secondary to colorectal cancer)

Colorectal or large bowel cancer is one of the common cancers seen in New Zealand with approximately 2500 new cases being registered each year. Unfortunately, spread of the cancer to the liver (liver secondaries) is already apparent when the diagnosis is made in some 25% of patients and will develop in a further 25-30% of patients with the passage of time. However, unlike most other types of cancer which spread to the liver, large bowel cancer spreads first to the liver and is often confined to that site for some length of time. For this reason treatment directed at the liver itself is often worthwhile, even though in most situations a cure can not be achieved. Unless surgecial treatment is given, survival times range between three and 24 months, with most patients, so affected, dying within 9-12 months.

Conventionally patients have only been offered supportive treatment aimed at improving symptoms, or systemic chemotherapy. Until recently these treatments had very little impact on survival. Systemic chemotherapy is now becoming much more effective but it still can only hope to control the disease for a limited period of time. At the Wakefield Clinic we have a special interest in liver cancer and have taken a more active stance toward the treatment of liver secondaries than most other centres in New Zealand. For a number of years we have been offering and investigating several different treatments some of which are not available elsewhere in the country. We continue to monitor the effectiveness of these new treatments and depending on the pattern of spread in the liver we use them either individually or in combination. We at The Wakefield Clinic have acquired a large experience with these treatments and believe good benefit is achieved in most patients. However, it is not yet widely accepted that they confer survival advantage because large scale randomised trials have not been performed. The treatments we offer do not preclude the use of systemic chemotherapy, although we would not normally suggest using them together. Better results are probably obtained if they are used sequentially, this gaining the maximum benefit from each.

The Wakefield Clinic has become a national and even in some respects an international leader in the use and investigation of a number of new and innovative treatments for liver cancer. These include:

• Resection
• Cryotherapy
• Selective Internal Radiation Therapy (SIRT)
• Hepatic artery chemotherapy (HAC)

These all evolved because of the relative ineffectiveness of systemic chemotherapy for liver cancer. Even though systemic chemotherapy is now much more effective than was previously the case, there is good reason to consider these treatments either before systemic chemotherapy is instituted, or after it has been seen to fail. They are most often appropriate and used in the context of patients with either primary liver cancer (hepatoma) or secondaries from colorectal (large bowel) cancer which are localised to the liver. Occasionally patients with other types of primary cancer (eg breast, ovary, carcinoid tumour) present with disease only in the liver, in which case they may also be suitable for the treatment.

We are active in publishing our results and research in the international medical literature. Some of these articles may be of interest to you. Visit our Download page to view these files.

To download our Liver Cancer Patient booklet and other files, please visit our download page.