Chemotherapy for Liver Cancer

Liver cancer is one of the most common cancers in Singapore, and is often difficult to treat because symptoms usually appear in later stages when treatment is least effective. Common treatments include surgery, chemotherapy, radiation, targeted therapy, and ablation. In this article, we will focus on chemotherapy—a treatment that uses drugs to attack cancer cells, halt their growth, and keep them from returning.

When Is Chemotherapy Necessary?

Chemotherapy for liver cancer is typically recommended for patients who:

• Are not suitable candidates for surgery
• Have not responded to localised treatments such as ablation or embolization
• No longer benefit from targeted therapy

How to Prepare for Chemotherapy

Undergoing chemotherapy can be physically and emotionally demanding, but coping with the changes and side effects after treatment is possible with proper preparation. Here is how:

• Learn About the Treatment

  If chemotherapy is recommended, your healthcare team will discuss your treatment plan, including the type of chemotherapy you will receive, its potential benefits, and side effects. You should use this opportunity to discuss any concerns or uncertainties you might have and to understand how to prepare for the treatment process.

• Finding Support and Connecting with Others

  Consider researching and joining support groups to connect with individuals who share similar experiences. Doing so can help ease anxieties and offer valuable insights and emotional support.

• Manage Financial Challenges

  Chemotherapy for liver cancer can be financially burdensome and emotionally stressful. It is helpful to research available resources, including insurance coverage, government programs, or charitable foundations to help with medical expenses.

• Coordinate Work Arrangements

  Inform your employer about your treatment plan, as you may need time off. To minimise disruptions, plan ahead by delegating tasks, organising your workload, and setting realistic expectations. This will help you manage your responsibilities effectively during your treatment.

• Establish a Treatment Routine

  Stay on top of your treatment by keeping track of appointments and medication schedules. Prioritise rest and ensure you get enough sleep to support your body’s healing. It is also helpful to have someone assist you during treatment. Prepare by having easy-to-make meals, comfortable clothing, and essential personal care items readily available.

How Is Chemotherapy Administered?

Chemotherapy is typically given in cycles, consisting of a treatment period followed by a rest period to allow the body to recover. Each cycle may last two to three weeks, and the overall chemotherapy treatment can last for approximately six months.

For liver cancer, chemotherapy may be administered in two ways:

• Systemic Chemotherapy

  Systemic chemotherapy involves administering drugs either through an IV or orally. Intravenous drugs are commonly delivered via a central venous catheter, a tube inserted into a large vein in the neck, chest, or groin. These drugs travel through the bloodstream, targeting cancer cells throughout the body, including areas beyond the liver.

• Regional Chemotherapy

  Regional chemotherapy targets cancer cells in specific areas by delivering drugs directly to the artery supplying the tumour. This approach minimises exposure of the drugs to the rest of the body, thereby reducing side effects. A common method for liver cancer is hepatic artery infusion (HAI). In HAI, an infusion pump is surgically implanted under the skin of the abdomen. This pump is then connected to a catheter that is inserted into the hepatic artery, the main blood vessel that supplies blood to the liver.

What Factors Affect the Success Rate of Chemotherapy?

The success rate of chemotherapy for liver cancer can vary depending on several factors. It is essential to understand these factors to make informed decisions about treatment options.

• Cancer Grade

  : A high-grade cancer generally indicates more aggressive cancer growth. It is more resistant to chemotherapy, potentially reducing the treatment’s effectiveness.

• Cancer Stage

  : Earlier-stage cancers often have a better prognosis and may respond more favourably to chemotherapy. Conversely, advanced-stage cancers may be more challenging to treat.

• Age

  : Younger patients generally tolerate chemotherapy better than older patients, potentially leading to improved outcomes. However, individual factors and overall health can also play a role.

• Overall Health

  : Patients with good overall health may be more likely to respond well to chemotherapy and experience fewer side effects. Conversely, individuals with underlying health conditions may require careful monitoring and adjustments to their treatment plan.

It is important to note that individual responses to treatment can vary. Discuss these factors with your healthcare provider to develop a personalised treatment plan that best suits your needs.

How to Manage Side Effects of Chemotherapy

The side effects of chemotherapy can vary among individuals. Understanding potential side effects and implementing appropriate management strategies can significantly improve your quality of life during treatment. Here are some common symptoms associated with chemotherapy and how to manage them:

• Hair Loss

  : Chemotherapy can cause hair loss on the head, eyebrows, eyelashes, and other areas of the body. You can try exploring cold cap therapy to help reduce hair loss. It is also advisable to use soft-bristle brushes and avoid harsh chemicals.

• Mucositis

  : This is an inflammation of the lining of the mouth and digestive tract; it can cause pain, ulcers, and difficulty swallowing. To manage mucositis, consider eating soft, bland foods, avoiding spicy, acidic, or salty foods, and using a recommended mouthwash.

• Loss of Appetite

  : Chemotherapy can reduce your appetite and cause taste changes. It would be helpful to eat small, frequent meals throughout the day. If the food tastes metallic, try using non-metallic utensils.

• Nausea and Vomiting

  : These common side effects can be managed with prescribed medication. You may also be advised to avoid triggers like strong odours, certain foods, and stress. Drinking plenty of fluids, including apple juice and tea, can also help manage symptoms.

• Weakened Immune System

  : Chemotherapy can weaken your immune system, making you more susceptible to infections. Practise good hygiene, such as washing your hands frequently. Additionally, avoid crowds and people who are sick and get recommended vaccinations.

• Increased Risk of Bleeding

  : Chemotherapy can affect blood clotting, increasing the risk of bleeding. It is best to avoid activities that may cause injury. Should you have any unusual bleeding, inform your doctor as soon as possible.

• Fatigue

  : This is a common side effect that can be managed with adequate rest. Make sure you get enough sleep and avoid strenuous activities.

It is important to note that these are general strategies for managing chemotherapy side effects. Consult your healthcare team for personalised advice and support to effectively manage these symptoms.

If you or someone you know has been diagnosed with liver cancer, it is crucial to consult with a liver cancer specialist. Our doctor, Dr Kieron Lim, offers personalised guidance on treatment options, including chemotherapy, surgery, radiation therapy, and targeted therapies. Give us a call today at 68360080 to schedule a consultation and explore the most effective approaches to managing your condition.