Interventional therapy – the first choice for liver cancer treatment

  Hepatocellular carcinoma is one of the common malignant tumors in clinical practice. It starts insidiously and is often at an advanced stage when patients have symptoms, and the chance of surgery is often lost due to the large size of the tumor, invasion of the portal vein, jaundice and poor liver function. According to statistics, the average survival time of liver cancer patients without treatment is about 3 months, which is why it is called “the king of cancers”. In the past, systemic chemotherapy was mainly used for liver cancer that could not be treated surgically, but liver cancer is not highly sensitive to chemotherapy and is prone to systemic side effects such as vomiting, hair loss and bone marrow suppression, which are difficult for patients to tolerate and have poor therapeutic effect. Interventional therapy is a treatment method for hepatocellular carcinoma that emerged in the 1980s. Its main method is to insert a thin special catheter of about 2mm in diameter from the femoral artery to the hepatic artery under fluoroscopic surveillance and slowly infuse chemotherapeutic drugs. The incidence of systemic side effects is extremely low. After local chemotherapy, if the patient’s condition allows, iodine oil and gelatin sponge particles can be injected into the tumor blood vessels to block the tumor blood vessels and make the tumor ischemic and necrotic. In the embolization of liver cancer tumor vessels with iodine oil, doctors often mix chemotherapeutic drugs with iodine oil to form an emulsion, because iodine oil can selectively stay in the tumor vessels for 2-3 months, and the chemotherapeutic drugs mixed with it can be released slowly, so that the tumor can be treated with local chemotherapy for a long time and the tumor can be killed more effectively. Some people wonder if hepatic artery embolization will damage the liver function of patients. Generally speaking, the effect is not significant, because firstly, there are two sources of blood supply to liver, one is hepatic artery and the other is portal vein, and the blood supply of most hepatocellular carcinoma comes from hepatic artery more than 90%, while 70% of blood supply to normal liver tissue comes from portal vein and only 30% from hepatic artery, therefore, hepatic artery embolization mainly causes ischemic necrosis of hepatocellular carcinoma tissue, while necrosis of normal liver tissue rarely occurs. Secondly, during the embolization treatment, the doctor usually tries to insert the catheter into the artery supplying the tumor, so as to avoid embolization of normal liver tissue. After the above treatment, the catheter is removed, the femoral artery puncture site is compressed for about 10 minutes to stop bleeding, and then pressure is applied to bandage it. The patient can be released from the gauze and bandage and out of bed after 24 hours of lying flat, leaving no surgical incision and minimal pain. Most of the patients will experience pain and fever in the liver area within 1 week after the operation, which is due to tumor necrosis and can be improved with anti-inflammatory and analgesic drugs.  The above interventional treatments are applicable to liver cancer, liver metastases, and other solid tumors such as kidney cancer, gastric cancer, lung cancer, bone tumors and pelvic tumors that cannot be removed surgically. For recurrent liver cancer after surgery, interventional therapy is also the preferred treatment method. The emergence of this treatment method has greatly prolonged the survival period of liver cancer that cannot be surgically resected. Current statistics show that the 5-year survival rate is about 60%, the 3-year survival rate is about 30%, and a few cases can survive for 5 years or even be cured. For small hepatocellular carcinoma, its therapeutic effect is also very good, and its therapeutic effect can be comparable to that of surgical resection, which can save patients from the pain of surgical treatment. For some slightly large tumors, after several interventions, the tumor can shrink and get the chance of surgical treatment.  It should be noted that the key to liver cancer treatment is early detection and early treatment. For early stage liver cancer, both surgical and interventional treatment have good effects. People with high risk of liver cancer, such as patients with cirrhosis and hepatitis, should undergo ultrasound examination every six months to a year to detect the occurrence of liver cancer as early as possible. In addition, to prevent the occurrence of tumor, it is also a good habit to drink less alcohol, combine work and rest, have a regular life and do not overwork.