Thousands of Americans are currently fighting liver cancer.
It’s a disease that is expected to increase significantly over the next decade. The good news, a growing number of treatments are available.
“Cancers affecting the liver and biliary tract are becoming more common and we have only just seen the tip of the iceberg,” said Jean Botha, M.D., director of hepatobiliary surgery at The Nebraska Medical Center and assistant professor of surgery at UNMC. “The prevalence of chronic liver diseases will contribute to a dramatic rise in liver cancer rates over the next 10 to 15 years.”
While the prognosis for some patients will be grim, many will find hope at The Nebraska Medical Center. A leader in overall liver care, the medical center’s comprehensive liver treatment program gives families access to experienced specialists, the latest treatments and a range of options.
“We have an extensive selection of therapies, the best course available. That’s what really sets our program apart,” said Alan Langnas, D.O., chief of transplantation at The Nebraska Medical Center and professor of surgery at UNMC. “Our liver team sees the most advanced, complex and challenging cases. We have a dedicated group of people working extremely hard to help the desperately ill.”
Sixty-four-year-old Jim Mick of South Salem, Ohio, arrived at The Nebraska Medical Center with hope in his heart, but dreading more bad news. His emotional journey had started at home with the discovery of a liver tumor. It was a roller coaster from the start. First, a biopsy that indicated there was no cancer followed by a second test that showed differently. Mick started mulling over his treatment options.
“I knew I might need a transplant so I looked at several medical centers. I filled out various evaluation forms but not everyone responded,” he said. “My doctor recommended Nebraska and from my first visit, I was impressed by the level of care and expertise.”
The Nebraska Medical Center’s liver team takes a “full service approach to patient care,” said Michael Sorrell, M.D., co-founder of the Adult Liver and Small Bowel Transplantation Program at the medical center and professor of internal medicine at UNMC. “From diagnosis to treatment, we can do everything all in one place, which provides continuity and peace of mind. We see it as an aspect of care that is vitally important for our patients.”
Specialists represent key areas that are necessary for proper diagnosis and care: pathology, hepatology, radiology, internal medicine, nutrition, surgery, oncology and transplantation. Experts in these fields work closely together and meet regularly to develop an individualized plan featuring the latest treatment techniques.
“Just because you have a tumor doesn’t mean you’re going to need a transplant,” Dr. Sorrell said. “That’s why a comprehensive liver center like ours is critical. We utilize new and innovative therapies to supplement ‘tried and true’ methods.”
Adding to Jim Mick’s medical challenge was the discovery of a second mass on his liver. His oncologist ordered a specialized form of chemotherapy called trans-arterial chemoembolization (TACE) to prevent the tumors from becoming larger.
With TACE, interventional radiologists at The Nebraska Medical Center deliver the chemotherapy agent directly to the tumor. The radiologist then seals off the “front and back door” of the tumor by obstructing its blood supply. Starved of its primary life source and filled with cancer-fighting drugs, the tumor should shrink. That’s exactly what happened for Mick. Both of his tumors decreased in size, a critical factor in allowing him to remain a liver transplant candidate.
Other non-surgical techniques helping liver cancer patients at The Nebraska Medical Center are:
- Radioembolization — Millions of tiny seeds, the size of microns and infused with radiation, are directed into the tumor via catheter to battle cancer cells. This approach has been shown to shrink tumors by nearly 50 percent without damaging healthy tissue.
- Radiofrequency Ablation (RFA) — A device called a needle electrode is inserted into the tumor through the patient’s skin. Once inside, small, metal tines fan out and deliver heat (radiofrequency energy), which destroys the tumor cells.
Anthony Adelson, M.D., interventional radiologist at The Nebraska Medical Center and associate professor of radiology at UNMC, said these techniques can be invaluable to patients.
“Interventional radiology procedures play an instrumental role in treating patients that no one else can help,” he said. “Often times we can help make a patient more comfortable during their final days, or we may give that patient a second chance by shrinking a tumor or preventing it from growing.”
Surgery is a necessity for some patients, but even in the operating room what’s right for one person may not be the best option for another. Medical center surgeon Wendy Grant, M.D., is one of the surgeons with years of experience and expertise.
“Liver surgery is technically challenging,” said Dr. Grant, transplant and liver surgeon at The Nebraska Medical Center and assistant professor of surgery at UNMC. “We’re fortunate to have a specialized liver team to cover every facet of care. We have a strong track record of performing many different procedures safely.”
These techniques include:
- Minimally invasive surgery — Surgeons at The Nebraska Medical Center are leaders in this field. The use of laparoscopy in removing a liver tumor allows for a much smaller incision, two to three inches, versus a cut across the abdomen. For patients, this means less stress on the body and a quicker recovery time. This method can also be used in biopsies.
- Liver resection — Using a traditional open surgery technique, the surgeon removes only the diseased portion of the liver. This eliminates the cancer before it spreads — and allows the healthy section of the liver to regenerate, or grow back to its normal size.
- Transplantation — Possibly the best-known cure for liver cancer, the entire organ is removed and replaced with a liver that is disease-free. The Nebraska Medical Center and UNMC have been performing successful liver transplants since 1985 and are recognized as having one of the top solid organ transplantation programs in the United States.
“We’re building on a program that’s based on more than 20 years of clinical experience and knowledge,” said Fedja Rochling, M.D., gastroenterologist at The Nebraska Medical Center and assistant professor of internal medicine at UNMC. “Not only do we have surgical expertise, but also skilled pre and post-operative care provided by highly experienced critical care nurses who interact daily with patients and families.”
For Jim Mick, a liver transplant received in June of 2005 was the best option. More than a year later, he remains cancer-free.
“I wouldn’t be alive if it wasn’t for the liver team,” he said. “I think so much of the medical center and of Omaha. The medical team there is so talented and humble. Everyone is very caring, very compassionate and professional. You know instantly that they love what they’re doing.”
For more information on The Nebraska Medical Center’s comprehensive liver program, go to www.nebraskamed.com.
Patients wanting to see a member of the liver team should call 1-800-922-0000.