Chemotherapy is treatment with drugs to destroy cancer cells. Systemic (whole-body) chemotherapy uses anti-cancer drugs that are injected into a vein or given by mouth. These drugs enter the bloodstream and reach all areas of the body, making this treatment potentially useful for cancers that have metastasized (spread) to distant organs.

Unfortunately, liver cancer resists most chemotherapy drugs. The drugs that have been most effective in shrinking the tumors are doxorubicin (Adriamycin), 5-fluorouracil, and cisplatin. But even these drugs shrink fewer than 1 of 5 tumors, and the responses often do not last long. Combinations of drugs continue to be studied, but in most studies, systemic chemotherapy has not helped patients to live longer.

Because of the generally poor response to systemic chemotherapy, doctors are now studying whether putting chemotherapy drugs directly into the hepatic artery might be more effective. This technique, known as hepatic artery infusion (HAI), is described in the section "What’s New in Liver Cancer Research and Treatment?"

Chemotherapy drugs kill cancer cells but also damage some normal cells, which can lead to side effects. These side effects depend on the types of drugs, the amount taken, and the length of treatments. Temporary side effects of chemotherapy might include:

• nausea and vomiting
• loss of appetite
• loss of hair
• mouth sores

Because chemotherapy can damage the blood-producing cells of the bone marrow, where blood cells are made, the blood cell counts might become low. This can result in:

• increased chance of infection (due to a shortage of white blood cells)
• bleeding or bruising after minor cuts or injuries (due to a shortage of platelets)
• fatigue and shortness of breath (due to low red blood cell counts)

Most side effects go away once treatment is stopped. Hair will usually grow back after treatment ends. Anyone who has problems with side effects should talk with their cancer care team. There are remedies for many of the temporary side effects of chemotherapy. For example, drugs can be given to prevent or reduce nausea and vomiting. Other drugs, called growth factors, can be given to help the bone marrow recover after chemotherapy. Be sure to ask your oncology doctor or nurse about medications to help reduce side effects, and let him or her know when you do experience side effects so they can be managed effectively.