Liver Cancer

The liver is a large organ that secrets bile into the gallbladder. Bile is used by the small intestine to help digest fats. Liver cancer often has few, if any, symptoms until it has progressed beyond the early stages. When they do appear, symptoms include:

  • Loss of appetite
  • Unexplained weight loss
  • Upper abdominal pain
  • Abdominal swelling
  • Nausea and vomiting
  • Fatigue
  • Jaundice (yellowing of the skin and whites of the eyes)
  • White, chalky stools

Primary liver cancer most commonly develops when there is underlying liver disease. The specialists at Indiana University Health Melvin & Bren Simon Cancer Center identify patients at risk for this cancer through surveillance programs for Hepatitis C and nonalcoholic steatohepatitis (NASH), which is liver inflammation caused by a buildup of fat in the liver. IU Health Simon Cancer Center has one of the largest surveillance programs in the region for these two diagnoses.

Diagnosing hepatocellular carcinoma, which is a primary cancer of the liver, can be determined by:

  • Radiographic studies, such as computed tomography (CT) or magnetic resonance imaging (MRI) scans. These images help determine the appropriate treatment option.
  • Biopsy. In some patients, it is necessary to examine liver tissue under a microscope to determine the presence of cancer.

Liver Cancer Treatment

IU Health Simon Cancer Center is the only liver oncology program in Indiana with a dedicated effort in primary liver cancer. This program offers not only the greatest depth and breadth of treatment options but also the largest number of clinical protocols to improve diagnosis, treatment and understanding of toxicity for primary and metastatic liver tumors.

IU Health Simon Cancer Center has the strongest liver transplant program in the United States with respect to outcomes and the most robust liver-directed therapy program in the Midwest region. We hold a multidisciplinary conference each week, where off-campus physician partners can present patient cases or hear how we manage certain patients. This centralized gathering of physicians from a larger geographic area allows many of our patients to receive their care closer to home, in one convenient location.

For liver cancer, treatments include:

  • Liver transplant. Replacement of a cancerous liver with a new liver from a donor is considered the most effective treatment for liver cancer and the underlying liver disease from which most liver cancers develop. Transplant eligibility is based on the size and number of tumors. We offer one of the nation’s top programs with respect to the number of liver transplants performed for cancer.
  • Surgical resection. Removal of part of the liver.
  • Stereotactic body radiation therapy (SBRT). Special equipment delivers high-dose radiation directly to the tumor without affecting the surrounding healthy tissue.
  • Catheter-based techniques. A small flexible tube delivers drugs or other materials directly to the cancerous area of the liver.
  • Radiofrequency ablation and microwave ablation. Radio waves or microwaves heat a small area of the liver, which destroys cancerous cells.

Secondary cancers to the liver originate in another site and spread to the liver through the blood stream. IU Health Simon Cancer Center is a center of excellence for treatment of secondary cancers, including:

  • Metastatic colorectal cancer. Cancer that has spread from a portion of the intestines.
  • Metastatic neuroendocrine tumors. Cancer that has spread from the lungs, appendix, small intestine (duodenum), rectum, pancreas and other parts of the body. Treatments at IU Health Simon Cancer Center can successfully shrink these cancers, or palliate (lessen) symptoms associated with them.

In addition to treatment of liver cancer, we offer excellent palliative care that brings you, your family and your doctors together to decide your care plan. Palliative care is focused on providing patients with relief from the symptoms, pain and stress of a serious illness—whatever the diagnosis. The goal is to improve quality of life for patients and families.

Liver Cancer Research

Our commitment to research and advancements in liver cancer distinguishes our program from other cancer centers. We perform many clinical trials, examining new technologies and new medical therapies that have the potential to advance clinical care. Our ongoing science and clinical research includes:

  • Early biomarkers (biological characteristics usually measured through a blood test) of cancer risk in patients with inflammatory liver disease
  • Tissue and serologic markers of cancer recurrence in patients after transplant and resection (removal of part of an organ)
  • The impact of liver-directed therapies on post-transplant outcomes specific to particular cancers
  • The impact of liver transplant on survival
  • Serologic (blood-based) biomarkers in high-risk patients
  • Serologic and tissue biomarkers that predict the stage of cancer at diagnosis
  • Serologic and tissue biomarkers that predict patient response to systemic treatment

More information about cancer research can be found on the Indiana University School of Medicine website.

Our liver specialists participate in local and national clinical trials. If you qualify for a trial, you may have the opportunity to receive new experimental treatments not currently in general use.