Liver cancer treatments

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on April 29, 2022.

Liver cancer treatments include chemotherapy, radiation therapy, surgery, interventional radiology, gastroenterology procedures and targeted therapy. You may also be a candidate for immunotherapy. A multidisciplinary team of liver cancer treatment experts will answer your questions and recommend treatment options based on your unique diagnosis and needs.

Surgery for liver cancer

There are two ways to use surgery to treat liver cancer:

Partial hepatectomy

A partial hepatectomy is performed if there’s one tumor in the liver (which hasn’t grown into blood vessels). Overall health and liver function also must be stable enough for the patient to undergo surgery, so that when some of the liver is removed, the part left behind is strong enough to continue performing its essential duties.

To perform an open liver resection surgery, a surgeon makes an incision below the rib cage, across the right side of the upper abdomen. An ultrasound device is used to find the liver tumor(s). The diseased portion of the liver is removed, along with some adjoining healthy liver tissue. A partial hepatectomy may also be performed as a less invasive, laparoscopic or robotic surgery procedure.

Some side effects and complications that may occur after a partial hepatectomy include:

  • Bleeding and/or blood clots
  • Infection
  • Pneumonia
  • New liver cancer (a new cancer may develop after the surgery, as the liver still has the underlying disease)

Liver transplant

If the cancer is too large or widespread within the liver to remove it via a partial hepatectomy, a liver transplant may be recommended.

A liver transplant is a surgery to remove the liver completely and replace it with a new, healthy liver from a donor. It may be an option if:

  • The cancer is caught in an early stage and hasn’t spread beyond the liver.
  • The patient’s liver is damaged or unhealthy due to the cancer or other conditions.
  • A donor is found.
  • The patient is in overall good health and meets other criteria.

Liver transplants are typically used when the cancer hasn’t spread to nearby blood vessels and either:

  • There’s only one tumor in the liver that is smaller than 5 cm
  • There are two to three tumors in the liver that are each smaller than 3 cm

If you undergo a liver transplant, the potential complications include, among others:

  • Rejection of the transplanted liver
  • Bleeding
  • Infection
  • Blood clots

If your cancer care team recommends a liver transplant, you may receive other treatments as needed until a donor liver becomes available.

Ablation for liver cancer

Ablation is a liver cancer treatment that uses different techniques to destroy tumors.

These techniques kill cancer cells through:

  • Radiofrequency ablation (radio waves)
  • Microwave therapy, using heat
  • Percutaneous ethanol injection of pure alcohol
  • Cryoablation, using freezing temperatures
  • Electroporation therapy, using electrical pulses

Ablation may be a good option if the liver tumors are smaller than 3 cm wide. In combination with embolization, ablation may be used on tumors slightly larger (3-5 cm across). You may also receive ablation if you’re waiting for a donor liver.

Compared with surgery, ablation is less effective as a liver cancer cure. Severe effects of ablation therapy are rare, but some of the potential side effects include:

  • Belly pain
  • Liver infection
  • Fever

Embolization for liver cancer

Embolization therapy involves a substance being injected into or near the tumor to limit its blood supply, which prevents it from getting the essential nutrients and oxygen that cells need to grow and survive.

Embolization may be considered a good option if the liver is functioning adequately but the tumor cannot be removed by surgery or is too large (bigger than 5 cm across) to be treated by ablation. In some cases, ablation and embolization may be used together.

Since embolization cuts off or reduces the blood supply, the liver’s healthy tissue may also be damaged. While severe effects of embolization are rare, declining liver function is a potential complication.

Other side effects may include:

  • Belly pain
  • Fever
  • Nausea
  • Liver infection
  • Blood clots

Radiation therapy for liver cancer

Radiation therapy uses rays of energy, similar to X-rays, to destroy cancer cells. To treat liver cancer, radiation may be delivered in one of two ways.

  • External radiation: This type of therapy targets radiation at the cancer, using a machine outside of the body.
  • Radioembolization: This involves small radioactive beads injected near the tumor that emit radiation and destroy nearby cancer cells or block tumor growth.

Radiation may be used to treat liver cancer if:

  • The cancer cannot be treated with surgery, ablation or embolization.
  • Ablation or embolization treatments were previously used without success.
  • The cancer has spread to the brain, bones or other areas of the body.
  • You need to relieve painful symptoms.
  • You have tumor thrombus that is blocking the portal vein (tumor thrombus is a grouping of liver cancer cells).

In the same way it damages cancer cells, radiation therapy may also harm healthy cells, leading to side effects. Most side effects typically subside after treatment concludes, but some may persist. Some of the common short-term side effects of radiation therapy for liver cancer include:

  • Skin changes or irritation where radiation is delivered
  • Nausea, vomiting and diarrhea
  • Fatigue
  • Appetite loss

When the liver is treated with radiation therapy, there’s also a risk of a more severe (and potentially fatal in some cases) complication called radiation-induced liver disease (RILD). RILD typically develops three to four months post-treatment. If you’re planning on undergoing radiation therapy for liver cancer, your care team will provide you with a more comprehensive list of side effects and what to expect.

Learn more about radiation therapy for liver cancer treatment.

Targeted therapy for liver cancer

Targeted therapy may treat some types of liver cancer using drugs or other substances designed to “target” the genetic changes (mutations) within the liver cancer cells that make them different from normal cells.

These drugs may block the specific genes or proteins that play a role in the cancer’s growth and survival. Based on biopsies and other tests, your doctor will tell you if you’re a good match for a targeted drug.

The two types of targeted therapy most commonly used to treat liver cancer are:

  • Kinase inhibitors, which block the functioning of kinase proteins, a type of protein in the body that facilitates tumor growth
  • Monoclonal antibodies, which are man-made proteins that replicate a protein that is naturally produced by the immune system and are used to affect a tumor’s capacity to make new blood vessels (thwarting its ability to grow).

Immunotherapy for liver cancer

Immunotherapy uses substances made in the body or created in a lab to boost the patient’s immune system or help it detect and attack cancer cells.

These drugs help attack cancer cells in different ways. They are typically used for more advanced liver cancer cases that have spread to other organs or parts of the body.

Learn more about the stages of liver cancer.

Gastroenterology for liver cancer

A number of gastroenterology procedures may be recommended to treat liver cancer. They include:

Treatments for rare liver cancer

Treatments for rare types of liver cancer depend on varying factors, such as the type of cancer, its stage and the health of the patient and his or her liver. Rare liver cancers include:

Fibrolamellar HCC: This rare type of hepatocellular carcinoma may be more responsive to treatment than other types of liver cancer.

Angiosarcoma: This aggressive and very rare form of liver cancer is often diagnosed at an advanced stage.

Treatments options for rare liver cancers may include:

  • Surgery
  • Radiation therapy
  • Chemotherapy

Learn more about liver cancer types

Secondary liver cancer treatments

When cancer spreads to the liver from another part of the body, the disease is considered liver metastasis, or secondary liver cancer. Along with the brain, bones and lungs, the liver is one of the most common locations in the body for cancer to spread. Liver metastases are more common than primary liver cancer. Common cancers that often spread to the liver include those of the breast, colon, rectum, lung, skin (melanoma) and kidney.

Treatment for secondary liver cancer depends on many factors, including:

  • The overall health of the patient
  • The number, size and locations of the secondary tumors
  • The extent of damage to the liver
  • Cancer treatments already received
  • Where the cancer originated

Liver metastases are not considered liver cancer. Instead, the disease named for the location of the primary tumor. For instance, breast cancer that spreads to the liver is considered breast cancer, not liver cancer.

Treatment options for secondary liver cancer include:

Treatment for liver metastases, in some cases, may be considered palliative, used to relieve symptoms and improve quality of life.

Liver cancer clinical trials

Clinical trials are a critical testing ground for determining the safety and effectiveness of new treatments and drugs for cancer and many other diseases. As part of our commitment to providing innovative treatments, our doctors may recommend that you enroll in carefully selected clinical trials for liver cancer to offer you access to treatment options that may otherwise be unavailable to you.

Patients who meet specific criteria may be considered for a clinical trial on an individual basis and may qualify at any stage of disease or treatment. Ask your doctor whether a liver cancer clinical trial is a good option for you. as well as about the risks and various requirements involved.

Search clinical trials

Side effect management

Liver cancer experts work closely with the integrative care team to proactively anticipate potential side effects and address issues so you can better tolerate treatments. Integrative care services designed to help manage liver cancer-related side effects include:

  • Nutritional support
  • Behavioral health
  • Naturopathic support
  • Pain management

Learn more about integrative care

Liver cancer treatment at our City of Hope GI Cancer Centers

At City of Hope, we understand that liver cancer and other malignancies of the gastrointestinal tract create unique challenges for patients, and that treatment options are very specific to each disease. That’s why each City of Hope hospital has a GI Cancer Center dedicated to diagnosing, treating and supporting the quality of life of patients with liver and other GI cancers. Committed to offering state-of-the-art treatments for patients with liver cancer, our multidisciplinary team of board-certified medical oncologists, surgical oncologists, radiation oncologists and supportive care clinicians work with our patients to deliver quality clinical care with a patient-centered approach. After your diagnosis, your GI Cancer Center care team will discuss your options with you and help you develop a personalized care plan tailored to your individual needs.

Because of the digestive tract’s role in processing food and waste, many patients with gastrointestinal disease have difficulty with digestive function. That’s why nutrition therapy is a key component of our GI Cancer Centers’ approach. Each center is staffed by oncology-trained dietitians who work with patients in developing a healthy, balanced and appetizing nutrition plan. If patients become malnourished, the dietitian is available to help them establish healthy lifestyle and eating habits to help improve their condition.

The GI Cancer Center teams also work closely with other supportive care clinicians to manage additional disease- and treatment-related side effects, such as nausea and vomiting. These supportive care experts may include a pain management physician, naturopathic provider, behavioral health provider and spiritual support provider.

Qualified patients may enroll in carefully selected clinical trials. Your care team will discuss whether you qualify for any of our ongoing clinical trials and, if so, help you enroll.

If you're interested in learning more about liver cancer treatment at City of Hope, or if you want a second opinion about your diagnosis and treatment plan, call us or chat online with a member of our team.

Expert cancer care


CALL NOW: 855-680-1184