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TREATMENTS

Treatment of liver injury
Most liver cancers develop in patients with chronic liver disease. Chronic liver injury and liver scarring (cirrhosis) are fertile environments for the development of liver cancer. Current treatments are aimed at reducing chronic injury and attempt to prevent cirrhosis. These treatments include interferons, ribavirin and lamivudine. These medications are given as an injection or a pill and require supervision of a doctor.

Treatment of liver cancer
Once liver cancer develops there are 3 main treatment options. First, surgery that involves the removal of the tumor or even liver transplant in which the entire liver is surgically removed and replaced with a new liver from a donor, offers the best hope of a cure. The size and location of the tumor, the health of the remaining liver, if the tumor has spread and the overall health of the patient determines if this is an option. Second, tumor ablation in which the cancer cells in the tumor are directly killed by radiofrequency, freezing or chemical injection are relatively new treatment options. Tumor ablation techniques involve placing a fine probe into the center of the tumor and injecting cold or toxic chemical that destroy the tumor cells. Third, radiation and chemotherapy have been used. Radiation can shrink a tumor but is not a curative procedure. Similarly, chemotherapy has been shown to shrink liver cancers, but it is unclear if this increases patient survival.

Although most cancers develop in patients with liver scarring (cirrhosis), some patients develop liver cancer without first developing cirrhosis. Johns Hopkins researchers have a particular interest in this type of liver cancer.



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