Radiation (esp. proton therapy) can be a treatment option for liver cancer


Liver cancer is not among the most common cancers in the U.S. It is, however, among the deadliest.

This year, nearly 41,000 new cases of liver cancer will be diagnosed, breaking down to roughly 70 percent men and 30 percent women. Nearly 29,000 people will die.

What many people may not realize is that liver cancer can be a good candidate for proton therapy.

The most common type of liver cancer is called hepatocellular cancer, or HCC. HCC can occur as a single, large tumor or as smaller spots located throughout the liver. Although liver is a sensitive organ to radiation, the treatment can be used successfully in the cases of larger tumors that cannot be removed by surgery or successfully treated with chemotherapy—typically the first lines of defense. Other treatment options include tumor ablation and embolization along with targeted therapy and immunotherapy.

“There is a strong rationale for using radiation therapy in patients unsuitable for or with expected poor outcomes after standard local-regional therapies,” wrote Laura A. Dawson, considered an expert in the field of radiation therapy as it relates to treatment of liver cancer. “…Reports of tumor control at 2 to 5 years show the potential for cure after radiation therapy for early-stage HCC and liver metastases.”

The challenge in giving radiation to the liver is that it is absolutely necessary to protect as much healthy tissue as possible in order to maintain function of surrounding vital organs including the bowel and the stomach. This makes protons, which dispense their energy without an exit dose of radiation, ideal for addressing the disease.

Approximately 10-20 percent of liver cancer cases actually form in the bile duct and are referred to as intrahepatic cholangiocarcinoma. Radiation therapy, and therefore proton therapy, is an option for treating this type of cancer as well.

Even with a terminal prognosis, proton therapy’s ability to directly target a tumor and spare surrounding healthy tissue and organs, can add months or years to a patient’s life and improve significantly improve its quality.

One of the concerns in using regular (X-ray) radiation to treat the liver is how sensitive the normal surrounding liver tissue is to radiation. If not careful, regular X-rays can cause something called radiation induced liver disease (RILD) that can actually harm patients instead of helping them. Proton therapy significantly reduces the risk of this side effect because it enters the body at a lower dose and does not exit through the other side of the body, This makes using proton therapy safer and more effective for treating liver cancers.

We have treated several cases of liver cancer at Provision CARES proton therapy center, and I would encourage patients to call us with their questions or to arrange a consult so we can review their case.

With liver cancer, in particular, it’s important for patients and their families dealing with this diagnosis to educate themselves, research all their options and make sure they receive the treatment that is truly the best.