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Liver Cancer

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The liver is a large organ shaped like a pyramid and located behind the ribs on the right side of the body. Divided into right and left lobes, its job is to help break down and store nutrients from food like sugars, starch, fats, and proteins. It makes proteins that help the body balance fluids; it also makes clotting factors to help blood to clot or thicken when you're bleeding.

One vital job of the liver is to filter out and eliminate toxins. When the liver isn't working properly, however, chemicals can build up and cause damage to the body. Because all the blood goes through the liver, it is unusually accessible to cancer cells. 

There are two main types of liver cancers.

Primary Liver Cancers
Cancer that starts in your liver.

  • Hepatocellular carcinoma (or hepatoma): Four out of every five primary liver cancers are hepatomas. Hepatomas begin in hepatocytes — main cells of the liver.
  • Intrahepatic cholangiocarcinoma: Ten to 20 percent of all liver cancers are cholangiocarcinomas, which start in the bile ducts (small tubes where bile leaves the liver and goes into the gallbladder and intestines during digestion).
  • Hepatoblastoma: This rare liver cancer is the type usually found in children.
  • Angiosarcoma: Another uncommon form of liver cancer that starts in blood vessels inside the liver.

Secondary or Metastatic Liver Cancers
Liver cancer that begins in a different organ, like the colon, breast, or lung, and then spreads to the liver is called a secondary liver cancer. It gets treated like the cancer from the original location (primary). Most liver cancers are metastatic from some other organ cancer. These get treated differently from primary tumors that originate in the liver. For example, when lung cancer has spread to the liver, it's treated as lung cancer.

Why Choose Sylvester Comprehensive Cancer Center?

Advanced radiation therapy options like ViewRay (one of just five centers nationwide), RapidArc®, and a Siemens 40-slice 4D-CT scanner, offering intensity modulated external radiation therapy (IMRT). Our leading-edge technology offers more efficient and effective treatments, shorter treatment times, pinpoint accuracy in targeting tumors, and less damage to surrounding healthy tissue.

More cancer clinical trials than any other South Florida hospital. If appropriate for your cancer and stage, our clinical trials provide you with the very newest ways to treat and potentially cure your cancer.

The only designated Cancer Center of Excellence in South Florida. We treat cancer, and only cancer, giving you the best potential outcomes. The likelihood of surviving cancer at least five years following treatment is 17 percent higher when treated at a Dedicated Cancer Center than at other hospitals. 

Multidisciplinary care teams with nationally recognized expertise. Collaboration saves lives. Your care team is made up of experts in your exact type of cancer, and every single aspect of it.

Access to precision medicine. We define your cancer and its treatment by the genes driving it, rather than solely its location and stage.

Nurse navigators to ensure you’re never alone on your cancer journey. We make sure all your records from outside Sylvester are received, coordinate specialty appointments and testing, and answer your questions.

Questions? We're here to help.

Our appointment specialists are ready to help you find what you need. Contact us today.

Treatments

With liver cancer, there are a variety of treatments that can be used individually or in combination to produce the best outcome for your specific kind of cancer. That's why careful diagnosis and staging are so important. Your specialist will explain your treatment choices, how successful they expect them to be, and the risks and side effects with each option.

  • Surgery

    Surgery is performed for primary tumors that start in the liver and secondary tumors (called metastatic) that have traveled to the liver from a different organ such as the colon, lung, or breast.

    • Partial hepatectomy: This procedure removes part of your liver. The remaining liver tissue functions as if it were whole and will regrow in most cases to the size of the original liver.

    • Staged partial hepatectomy: With large or multiple tumors, surgery can be performed in two stages. A multi-disciplinary team that includes a surgeon and an interventional radiologist works together. 

    • Liver transplantation: For certain patients with primary liver cancer that originated in the liver (and is confined to the liver), your surgeon may recommend removing the whole liver and replacing with a healthy donor liver. 
       
  • Ablation

    When surgery may be too risky, ablation uses different techniques to destroy abnormal liver tissue, including:

    • Radiofrequency ablation: High-energy radio waves heat the tumor, killing cancer cells.

    • Ethanol (alcohol) ablation: Also known as percutaneous ethanol injection (PEI). Concentrated alcohol kills cancer cells after being injected into the tumor.

    • Microwave ablation: Microwaves are applied directly to the tumor, producing heat that damages/kills cancer cells, or makes them more responsive to radiation or medical therapy.

    • Cryoablation: Freezes and destroys cancer cells under ultrasound guidance.
  • Embolization

    Embolization is an option for some patients whose larger tumors cannot be removed by surgery or ablation. Embolization tries to block or reduce the blood flow to cancer cells in the liver.

    • Chemoembolization: Delivers concentrated chemotherapeutic drug(s) to the tumor along with a blood vessel blocking agent – starving the tumor of its blood supply.

    • Radioembolization: Similar to chemoembolization but with radiation instead of drugs.

    • Portal vein embolization: Often used for borderline liver resection candidates. The blood supply is blocked on one side of the tumor, allowing the other side to grow to a fully functional size for surgery.

  • Radiation Therapy 

    Advanced technology tools working for you include RapidArc®, an external beam (delivered from a machine outside the body) technology delivering intensity modulated radiation therapy (IMRT). IMRT shortens treatment times to one-half to one-eighth that of conventional radiation therapy, resulting in better tumor targeting and less damage to healthy tissue.

  • Chemotherapy (Systemic Medical Therapy)

    Chemotherapy can be administered intravenously (infusion needle) or by a pill and is usually a combination of cancer-fighting medicines. Chemotherapy is also sometimes given to surgical patients, after the procedure, to eliminate any remaining cancer cells and reduce the chances that cancer will come back.  

    • If you require infusion chemotherapy, you can receive it at the Comprehensive Treatment Unit (CTU) at Sylvester's main location in Miami. It's a 12,000-square-foot unit that includes 33 recliners and 11 private rooms. You can also have your infusion treatments at the Kendall, Plantation, Hollywood, Coral Springs, and Deerfield Beach locations.            

  • Targeted Therapy 

    These treatments are designed to attack the molecular changes that make cancer cells grow and spread. Some of these medicines are given with chemotherapy medicines and others are used alone. The purpose is to stop cancer from growing. Targeted therapy can help chemotherapy get inside the tumor to be even more effective.                            


Tests

Determining treatment options and the best chances of recovery depend on the stage of cancer (whether the cancer is confined to the liver or has spread). Cancer recurrence and your general health also influence treatment options. Beyond a thorough physical examination and medical history, procedures for diagnosing liver cancer may include the following:

  • Serum Tumor Marker Test 

    A blood sample is checked for certain levels of specific substances released into the blood, such as alpha-fetoprotein (AFP). Elevated levels of this protein may be a sign of liver cancer or a  noncancerous condition. In some cases, the AFP level is normal even though there is liver cancer.      

  • Liver Function Tests

    Also called liver enzyme tests, this group of blood tests detects inflammation and damage to the liver. They can also check how well the liver is working.

  • CT (CAT) Scan of the Abdomen 

    A series of detailed pictures ta ken inside the abdomen from different angles. A dye swallowed or injected helps the organs or tissues show up more clearly.

  • PET (Positron Emission Tomography) Scan 

    This technique identifies malignant tumor cells in the body by using a small amount of radioactive glucose (sugar) injected into a vein. Tumor cells that are malignant appear brighter because they are more active and take up more glucose than normal cells do.

  • MRI (Magnetic Resonance Imaging) 

    An MRI uses a combination of a magnet, radio waves, and a computer to produce a series of detailed pictures of the liver. Dye is then injected into a vein to create a detailed picture of blood vessels in and near the liver.

  • Ultrasound Exam

    With this procedure, high-energy sound (ultrasound) waves are bounced off internal tissues or organs to form a picture of body tissues.     

  • Biopsy 

    Often, a sample of suspicious cells is surgically removed for viewing under a microscope. Fine-needle aspiration, core needle or laparoscopy (a minimally invasive procedure) remove the tissue.   

Accepted Insurances

Note: Health plans that are currently contracted with UHealth are listed below. However, please check with your insurance provider to verify that UHealth is part of your provider network.

  • Aetna WC
  • Aetna Affiliates/Signature Adm (ASA)
  • Aetna Behavioral Health
  • Aetna Elect Choice (EPO)
  • Aetna Florida Healthy Kids
  • Aetna HMO
  • Aetna Medicaid HMO
  • Aetna Medicare HMO
  • Aetna Medicare PPO
  • Aetna POS
  • Aetna PPO
  • Aetna UM Employee HMO 1
  • Aetna UM Employee HMO 2
  • Aetna UM Employee POS HRA
  • Aetna/Coventry Institutes of Excellence (IOE)
  • Amerigroup Florida Healthy Kids
  • Amerigroup Medicaid HMO
  • Argus Vision
  • AvMed Choice
  • AvMed HMO/POS
  • AvMed MDC and JHS Groups
  • AvMed Medicare HMO
  • AXIS
  • BCBS Blue Options Network Blue PPO
  • BCBS BlueCare HealthOptions HMO
  • BCBS BlueChoice PPC/PPO
  • BCBS Miami Dade Blue PPO Limited Benefits Plan
  • BCBS of Florida (All products except "SELECT" Plans)
  • BCBS of Florida (Commercial plans exclude HIX Select)
  • BCBS Traditional PHS/PPO
  • Beacon Health (ValueOption)
  • Beech Street PPO
  • Broward Health Medical Center
  • CarePlus Medicare HMO
  • Catholic Hospice
  • CCP/CMS Title XIX (Medicaid Enrolled in South Florida)
  • CCP/CMS Title XXI (Non Medicaid Enrolled in South Florida)
  • CCP/MMA (Broward County residents)
  • Charlotte County Sheriffs Office PPO
  • Cigna Affiliates
  • Cigna Behavioral Health
  • Cigna Dental HMO/PPO
  • Cigna EPO
  • Cigna HMO
  • Cigna Life Source (Intracorp is part of Cigna Lifesource)
  • Cigna MDCPS Jackson Sr. High
  • Cigna POS
  • Cigna PPO
  • Cigna Shared Administration
  • Clear Health Alliance SNP Medicaid HMO
  • Concordia Behavioral Health
  • CorVel WC
  • Coventry First Health WC
  • Coventry Health Care of Florida (HIP) HMO/POS
  • Coventry Health Care of Florida (HIP) PPO
  • Coventry Health Plan of Florida (Foundation) HMO
  • Coventry Health Plan of Florida (Foundation) POS
  • Coventry National PPO
  • Coventry Summit Medicare HMO
  • Coventry Vista Medicare HMO
  • Coventry First Health PPO
  • Delta Dental PPO
  • DentaQuest (ADI)
  • DIKLA
  • Dimension WC
  • Dimension Plus PPO
  • EHN PPO
  • EQUIAN (Health Systems International)
  • Europe Assistance/Global Corporate Solutions (Care Management Network)
  • eyeQuest
  • FCCI WC
  • Florida Healthcare Plan (Affiliate of BCBSFL)
  • Florida PACE (FPC)
  • Freedom Health Medicaid HMO
  • Freedom Health Medicare HMO
  • Gallagher Bassett WC (MDCPS & FCSRMC)
  • Global Excel Mgt PPO
  • Great West (Cigna) HMO/POS
  • Guardian Life PPO
  • HAA Preferred Partners
  • Health First Health HMO/POS
  • Health First Health Medicare HMO
  • Health First Health PPO
  • Health Net Veterans Choice HMO
  • Heritage Summit Healthcare WC
  • Humana Behavioral Health (LifeSynch)
  • Humana Dental/CompBenefits/OHS
  • Humana EPO
  • Humana HMO
  • Humana Medicaid HMO
  • Humana Medicare HMO
  • Humana National Transplant
  • Humana PPO
  • Humana Premier
  • iCare Health Solutions
  • Interlink Health Services
  • International Kids Fund (IKF)
  • League Medical Concepts Federal Inmates
  • Life Trac
  • Magellan Behavioral Health
  • Magellan Complete Care SNP Medicaid HMO
  • MDAbroad
  • Medica Medicare HMO
  • Medical Development In't (MDI)-Federal Inmates
  • Medicus
  • Metlife Dental PPO
  • MHNet Behavioral Network (MHNet)
  • Molina
  • Molina Market Place
  • Molina Medicaid HMO
  • Molina Medicare HMO
  • Morgan White International
  • MultiPlan PPO
  • Naphcare (Federal Prisoners)
  • National Healthcare Solutions Inc.
  • Neighborhood HealthPlan HMO/POS
  • Neighborhood HealthPlan PPO
  • North Broward Hospital District PPO
  • Olympus Managed Healthcare
  • Optum
  • Positive Healthcare SNP Medicaid HMO
  • Positive Healthcare SNP Medicare HMO
  • Prestige Health Choice Medicaid HMO
  • Prime Health Services WC
  • Quality Health Management
  • Religious Order of Jehovah's Witnesses PPO
  • Rockport Healthcare Group WC
  • Royal Caribbean Cruises PPO
  • Sanus Health Corporation
  • Seasons Hospice
  • Simply Healthcare Medicaid HMO
  • Solstice Dental HMO/PPO
  • Start Healthcare Network
  • Sunshine
  • Sunshine AMBETTER
  • Sunshine Healthy Kids HMO
  • Sunshine Medicaid HMO
  • Sunshine Medicare HMO
  • Tricare South Prime HMO
  • Tricare South Standard PPO
  • United Behavioral Health (UBH)
  • UnitedHealthcare Affiliates
  • UnitedHealthcare Healthy Kids HMO
  • UnitedHealthcare HMO/POS
  • UnitedHealthcare Medicaid HMO
  • UnitedHealthcare Medicare Nursing Home Plan
  • UnitedHealthcare PPO
  • University of Miami Athletic Dept PPO
  • VUMI
  • Wellcare/Staywell Healthy Kids HMO
  • Wellcare/Staywell Medicaid HMO
  • Wexford Health State Inmates
  • Worldwide Managed Care