Liver Cancer Treatment Program

Overview

The Tucker Gosnell Center for Gastrointestinal Cancers offers a collaborative and caring approach to the diagnosis and treatment of patients with confirmed or suspected liver cancer. Patients in our program are cared for by a multidisciplinary team of experts, including medical oncologists, liver surgeons, radiation oncologists, as well as pathologists and radiologists.

Consistently recognized as one of the best in the country by U.S. News & World Report, we provide the latest, most effective treatments including many innovative approaches to clinical care and promising new therapies, including:

• The Liver Surgery Program at Mass General Hospital provides state-of-the-art surgical treatment for both cancerous and non-cancerous liver diseases
• The Hepatic Artery Infusion Pump Program, a highly specialized, multidisciplinary collaboration that uses hepatic artery pumps to treat primary and metastatic tumors of the liver by delivering high doses of chemotherapy directly to the liver. Mass General is the only hospital in the region that offers hepatic artery infusion pumps as a treatment approach for liver cancer
an innovative surgical procedure that treats primary and metastatic liver cancers
• Proton beam radiation treatment at the Proton Therapy Center, New England’s only proton radiation facility
• Radiofrequency ablation, a non-surgical option for patients when surgery, chemotherapy and/or chemotherapy are not appropriate or well-tolerated
• Innovative endoscopy approaches, provided by New England’s only Advanced Endoscopy Service, in collaboration with Mass General’s Digestive Healthcare Center
• Rapid diagnosis and staging of biopsied tumors by pathologists who specialize in liver tumors
• Liver transplantation
• Laparoscopic liver resections
• Complex liver resections involving vascular reconstructions for patients with tumors that might have been deemed “unresectable”
• Experimental therapeutic agents offered through clinical trials

Expertise in Diagnosing and Staging Liver Cancers

Our pathologists sub-specialize in the diagnosis of liver cancer, and are internationally recognized and consulted. They participate in weekly tumor board meetings, sharing information about each patient’s unique cancer with the entire care team to help guide treatment planning.

All members of our diagnostic radiology team are nationally recognized for expertise in using the most advanced imaging tools to diagnose and stage liver cancer and to detect tumor changes. Our imaging technologies include:

• High-speed two- and three-dimensional CT studies with volumetric analyses
• Positron Emission Tomography/Computed Tomography (PET/CT)
• Magnetic Resonance Imaging (MRI)
• Intraoperative Ultrasound
• Lymphotrophic Nanoparticle Enhanced MRI (Molecular Imaging)
• Other services include:
• Tumor perfusion imaging with CT and MRI
• Spectral imaging with CT
• 3D imaging for pre-surgical planning and for monitoring treatment effects

Medical Oncology

For many patients diagnosed with liver cancer, chemotherapy may be the most effective treatment. Some new therapies that are currently available or in development are designed to block mutations and pathways that cause tumor cells to proliferate. By targeting tumor gene mutations with these "smart drugs", our doctors are beginning to understand how to eradicate malignant cells in some patients' tumors without using traditional chemotherapy and radiation. Pre-operative chemotherapy may be recommended to shrink tumors before surgery to help surgeons ensure a complete removal.

Excellence in Surgical Care

The depth and experience of our surgical team to perform advanced surgery to treat liver cancer makes us a major referral center for complex medical problems. The team provides state-of-the-art evaluation, treatment and post-surgical services.

Our liver cancer surgeons have pioneered many now-standard procedures and minimally invasive surgical techniques that aid in rapid recovery and nerve preservation so patients often can retain normal organ function. Surgeons at Mass General perform more liver resections than any other hospital in Massachusetts. Studies indicate that such high-volume experience often results in better outcomes for patients. Our high volume experience and advanced laparoscopic skills help ensure the best outcome for each patient. We also offer one of the few operating rooms specially designed to facilitate complex procedures, allowing surgeons to work side-by-side with multiple surgical subspecialists.

Surgical procedures for liver cancer include:

• Hepatic artery infusion pump placement
• Surgical removal of tumors (liver resection)
• Radiofrequency Ablation
• Liver Transplantation
• Percutaneous Portal Vein Embolization to induce liver regeneration before surgery
• Ex-Vivo liver resections

In some instances, a liver transplant could be the best option for some people with small liver cancers. Your care team will discuss all appropriate options with you to determine the best course of treatment.

Learn more about liver cancer surgery.

Pioneering Radiation Therapies

Our team of radiation oncologists offers a variety of state-of-the-art radiation treatments to kill cancer cells and to shrink tumors. Radiation therapy may be given alone, or in combination with surgery and chemotherapy. Our radiation oncologists use the most advanced therapies to treat liver cancer, many of which are available at few select hospitals.

Depending on the nature of a patient’s cancer, our team may suggest:

• External radiation (external beam therapy), a treatment that delivers high levels of radiation directly to the cancer cells.
• Proton beam radiation, a precise form of radiation therapy designed to target tumors while helping to preserve surrounding healthy tissue. Irregularly shaped lesions with awkward configurations near critical structures, including certain liver tumors, are well suited for proton beam therapy.
• Four-dimensional (4D) proton beam radiotherapy
• Intensity modulated radiation therapy (IMRT)

Learn more about radiation therapy.

Multidisciplinary Patient Care

Our team approach ensures that every patient benefits from an individualized, coordinated and compassionate treatment plan, with care provided by leading experts from many specialties. We consider patients and their family and friends involved in their care to be part of this team. Depending on the stage and other characteristics of your liver cancer, this treatment plan may include surgery, chemotherapy, radiation, or a combination of these therapies. Physicians and other caregivers meet together regularly as a team to review films and discuss all cases to ensure the best treatment planning.

Your care team may include:

• Pathologists and diagnostic radiologists who sub-specialize in gastrointestinal (GI) cancers to provide a precise diagnosis of your cancer
• Interventional radiologists who specialize in minimally invasive interventions such as liver biopsy, radiofrequency ablation, and chemoembolization
• Surgical Oncologists who are leading the way in performing and developing the most advanced surgical approaches for liver cancer
• Transplant specialists from the Mass General Liver Transplant Program
• Hepatologists who specialize in diagnosis and management of liver conditions, such as hepatitis, jaundice, and cirrhosis
• Endoscopists skilled in performing minimally-invasive diagnostic and interventional procedures
• Medical Oncologists who plan the most effective chemotherapy and immunotherapy treatments
• Radiation Oncologists who specialize in delivering the optimal therapeutic dose while protecting healthy tissue
• Oncology nurses and nurse practitioners who care exclusively for patients with cancer
• Oncology psychiatrists and social workers experienced in helping with the cognitive side effects of cancer and treatment, as well the emotional and spiritual aspects of the cancer experience
• A nutritionist to help you with questions about diet and nutrition during treatment
• Palliative care providers to improve quality of life

Members of your care team meet regularly with you and contact your referring physician on an ongoing basis to ensure clear communication and seamless coordination of care.

Our multidisciplinary team of liver cancer specialists provides individualized care and compassionate support services tailored to the needs of each patient. Our liver cancer treatment program combines clinical expertise with the most advanced medical technologies, research and clinical trials available to offer every patient the most appropriate therapies. We are dedicated to ensuring that patients fully understand their diagnosis and treatment options.

Patients are usually seen within one week of referral.

Developing Better Therapies through Research

Our research program in liver cancer is a multifaceted effort designed to better understand cancer biology, discover new therapies and improve treatment. The research program in liver and all GI cancers is one of New England’s largest, allowing us to bring promising new treatments to patients as quickly as possible.

Clinical Trials

The Cancer Center is a leading provider of clinical trials in New England for liver cancers, making clinical trial evaluation of new therapies a key treatment option. The goal of the clinical trial is to seek and answer scientific questions and to find better ways to prevent, diagnose, or treat cancer.

Current clinical trials for liver and other GI cancer include:

• Proton beam therapy to treat liver and pancreatic cancers
• Genetic evaluation for GI cancers
• Antiangiogenesis drugs in combination with radiation for GI cancers

Find Clinical Trials for Liver Cancer.