Moving on after treatment for liver cancer

For some people with liver cancer, treatment may remove or destroy the cancer. Completing treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer growing or coming back. (When cancer comes back after treatment, it is called a recurrence.) This is a very common worry for people who have had cancer.

It may take a while before your fears lessen. But it may help to know that many cancer survivors have learned to live with this uncertainty and are leading full lives. Our document, Living With Uncertainty: The Fear of Cancer Recurrence gives more details about this.

For others, the liver cancer may never go away completely. You may get regular treatment with targeted therapy, chemo, or other treatments to try to help keep the cancer in check. Learning to live with cancer that does not go away can be hard and very stressful. It has its own type of uncertainty.

Follow-up care

If you have finished treatment, your doctors will still want to watch you closely. During these visits, your doctors will ask about symptoms, do physical exams, and order blood tests or imaging tests (like CT scans or MRIs). Follow-up is needed to watch for treatment side effects and to check for cancer that has come back or spread as well as possible side effects of certain treatments.

If you have been treated with a surgical resection or a liver transplant and have no signs of cancer remaining, most doctors recommend follow-up with imaging tests and blood tests every 3 to 6 months for the first 2 years, then tests every 6 to 12 months. Follow-up is needed to check for cancer recurrence or spread, as well as possible side effects of certain treatments.

Almost any cancer treatment can have side effects. Some may last for a few weeks or months, but others can be permanent. Please tell your cancer care team about any symptoms or side effects that bother you so they can help you manage them. Use this time to ask your health care team questions and discuss any concerns you might have.

It is also important to keep health insurance. While you hope your cancer won't come back, it could happen. If it does, you don't want to have to worry about paying for treatment. Should your cancer come back, our document When Your Cancer Comes Back: Cancer Recurrence can help you manage and cope with this phase of your treatment.

Follow-up after a liver transplant

A liver transplant can be very good at both treating the cancer and replacing a damaged liver. But you will need intense follow-up after treatment. Along with watching your recovery from surgery and looking for signs that the cancer may have come back, your doctor will watch you closely to make sure your body is not rejecting the new liver.

You will need to take strong medicines to help prevent the rejection. These medicines can have their own side effects, such as weakening your immune system, which can make you more likely to get infections.

Your transplant team will talk to you about what to watch for in terms of symptoms and side effects and when you need to contact them. It is very important to follow their instructions closely.

Anti-viral treatment

If you have hepatitis B or C, your doctor may want to put you on medicines to treat or help control the infection.

Seeing a new doctor

At some point after your cancer is found and treated, you may find yourself in the office of a new doctor. It is important that you be able to give your new doctor the exact details of your diagnosis and treatment. Make sure you have this information handy and always keep copies for yourself:

• A copy of your pathology report from any biopsy or surgery
• Copies of imaging tests (CT or MRI scans, etc.), which can usually be stored on a CD, DVD, etc.
• If you had surgery, a copy of your operative report
• If you stayed in the hospital, a copy of the discharge summary that the doctor wrote when you were sent home
• If you had radiation treatment, a summary of the type and dose of radiation and when and where it was given
• If you had chemo or targeted therapies, a list of your drugs, drug doses, and when you took them