Liver cancer can develop in any patient with cirrhosis. In addition, patients with chronic hepatitis B can develop liver cancer in the absence of cirrhosis if they have very high levels of hepatitis B virus in the blood. It is therefore important that all patients with cirrhosis and chronic hepatitis B undergo screening tests for liver cancer on a regular basis. This is best performed by certain blood tests and an ultrasound of the liver. If the blood tests or ultrasound suggest that a liver cancer may have developed additional testing by magnetic resonance imaging (MRI) is required.
Screening for liver cancer in patients with cirrhosis and chronic hepatitis B virus is important because finding liver cancer early, when it is still small and before it has spread outside of the liver, offers the best chance to cure the liver cancer and provide effective treatment.
Various treatments for liver cancer are available. The specific treatment depends upon the size of the cancer. Small liver cancers can be cured by ablation. This is when material is injected into the cancer to kill it. Larger liver cancers, especially when cirrhosis is present, can also be cured with liver transplant. However, if the cancer is too large or has spread outside the liver the cancer will recur and the liver transplant will not be successful. These larger cancers can be treated with a combination of embolization and a new oral chemotherapy agent.
Dr. Shiffman has over 2 decades of experience in managing patients with liver cancer. Embolization procedures for small or large cancers are available through at the Liver Institute of Virginia. Patients in whom liver transplant is an option can undergo testing to evaluate them as a candidate for liver transplant at the Liver Institute of Virginia before being referred to a liver transplant center.