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 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 less than 1 in 5 tumors, and the responses often do not last long. Researchers continue to study using combinations of drugs, but in most studies, systemic chemotherapy has not helped patients live longer.

Hepatic artery infusion

Because of the poor response to systemic chemotherapy, doctors have studied putting chemotherapy drugs directly into the hepatic artery to see if it might be more effective. This technique is known as hepatic artery infusion (HAI). The chemo goes to the entire liver through the hepatic artery, but the healthy liver breaks down most of the drug before it can reach the rest of the body. This gets more chemo to the tumor than systemic chemo without increasing side effects. The drugs most commonly used include floxuridine (FUDR), cisplatin, mitomycin C, and doxorubicin.

Although early studies have found that HAI is effective in shrinking tumors, more research is still needed. This technique may not be useful in all patients because it often requires surgery to insert a catheter into the hepatic artery, an operation that many liver cancer patients may not tolerate well.

Possible side effects of chemotherapy

Chemotherapy drugs work by attacking cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body, such as those in the bone marrow, the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells are also likely to be affected by chemotherapy, which can lead to side effects.

The side effects of chemotherapy depend on the type and dose of drugs given and the length of time they are taken. Common side effects include:

• hair loss
• mouth sores
• loss of appetite
• nausea and vomiting
• increased chance of infections (due to low white blood cell counts)
• easy bruising or bleeding (due to low blood platelet counts)
• fatigue (due to low red blood cell counts)

These side effects are usually short-term and go away after treatment is finished. There are often ways to lessen these side effects. For example, there are drugs that can be given to help prevent or reduce nausea and vomiting. Be sure to ask your doctor or nurse about drugs to help reduce side effects, and let him or her know when you do have side effects so they can be managed effectively.

Last Medical Review: 11/05/2009
Last Revised: 11/05/2009