Chemotherapy for Liver Cancer

Chemotherapy (chemo) 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.

Liver cancer resists most chemo drugs. The drugs that have been most effective as systemic chemo in liver cancer are doxorubicin (Adriamycin), 5-fluorouracil, and cisplatin. But even these drugs shrink only a small portion of tumors, and the responses often do not last long. Even with combinations of drugs, in most studies systemic chemo has not helped patients live longer.

Hepatic artery infusion

Because of the poor response to systemic chemo, doctors have studied putting chemo 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 into the 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 but doesn’t increase side effects. The drugs most commonly used include floxuridine (FUDR), cisplatin, mitomycin C, and doxorubicin.

Early studies have found that HAI is often effective in shrinking tumors, but 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 be able to tolerate.

Side effects of chemotherapy

Chemo drugs attack 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 chemo, which can lead to side effects.

The side effects of chemo 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
• Diarrhea
• Increased chance of infections (from low white blood cell counts)
• Easy bruising or bleeding (from low blood platelet counts)
• Fatigue (from low red blood cell counts)

These side effects usually don’t last long and go away after treatment is finished. There are often ways to lessen them. For example, drugs 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.

Along with the possible side effects in the list above, some drugs may have their own specific side effects. Ask your health care team what you can expect.

You should report any side effects you notice while getting chemotherapy to your medical team so that you can be treated promptly. In some cases, the doses of the chemotherapy drugs may need to be reduced or treatment may need to be delayed or stopped to prevent side effects from getting worse.

Learn more about chemotherapy, explore the Chemotherapy section of our website.