Are you having back pain with any of the following?
We understand that you are experiencing one or more of the health issues that might be impacting your back pain.
We recommend that you discuss these health issues with your doctor before proceeding with this program.
Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.
Cancer may begin in the liver (primary). More commonly, it spreads to the liver from another area of the body (secondary).
Your treatment depends on the type and severity of the cancer. Once we learn all we can about your liver cancer, we’ll recommend a treatment plan that’s right for you.
The most common treatment for early-stage liver cancer is surgery. Additional treatment options are:
We know cancer diagnosis can be overwhelming. We’re here to give you the best care available. We’ll also provide you and your loved ones with the support you need throughout your treatment.
We may perform surgery to remove early stage liver cancer if you have good liver function.
Partial hepatectomy surgery removes the tumor and some surrounding healthy tissue. The amount of liver removed depends on the number, size, and location of the tumor.
The remaining liver takes over functioning for the entire liver. The liver is the only internal organ capable of growing back (regenerating) lost tissue. It takes a few weeks to return to normal size.
Liver transplantation surgery removes the entire liver (total hepatectomy). The liver is replaced with healthy liver tissue from a donor. If the donor is:
Living donor transplants are extremely rare. There are also few livers available from deceased donors. You may have other treatment while waiting for a new liver.
Liver surgery is a major operation, and recovery takes time. Your hospital stay depends on the extent of surgery and if you have any complications.
Possible side effects of partial hepatectomy include:
Another concern is that the abnormal tissue in the tumor isn’t completely removed during surgery. This may cause a new liver cancer to form.
For a liver transplant, possible side effects are:
Drugs help suppress your immune system to prevent your body from rejecting the new liver tissue. Possible side effects of these drugs are:
We monitor you closely for side effects to immediately treat any problems.
We may recommend treatment to destroy the tumor without removing it (ablation) when the tumors are small or can’t be removed with surgery.
Radiofrequency ablation uses heat to burn the tumor. We insert a thin probe through the skin and into the tumor. Radio waves pass through the probe to heat and destroy the tumor.
Cryosurgery (or cryotherapy) destroys the liver tumor by freezing it. We insert a metal probe through the skin and into the tumor. Extremely cold gases pass through the probe to freeze and destroy the tumor.
Chemoablation injects a chemical substance directly into the tumor to kill cancer cells.
Ablation rarely causes serious complications, but possible side effects are:
Let us know if you experience any problems after your procedure.
Embolization therapy blocks blood supply to the tumor. Without nutrients and oxygen, the cancer cells die. It doesn’t affect blood flow to normal liver cells.
We may recommend this treatment if your tumors:
Arterial embolization. We thread a tiny tube into an artery in the liver and inject small particles to block blood supply.
Chemoembolization. We inject a chemotherapy drug and small particles into the artery. The chemotherapy remains in your liver longer.
Radioembolization. We inject small radioactive beads into the artery. The beads become wedged in blood vessels close to the tumor and kill cancer cells.
Possible side effects include:
Radiation therapy uses high-energy beams to kill cancer cells.
We use targeted radiation techniques to avoid harming healthy liver and surrounding tissue, such as:
Despite its name, surgery isn’t used with the stereotactic radiosurgery procedure. It may be used more than once.
Possible side effects are:
Radiation therapy may worsen chemotherapy side effects when given at the same time. Symptoms usually go away after treatment ends. We can help manage side effects.
Chemotherapy uses drugs to kill cancer cells. However, liver cancer cells often don’t respond well to traditional chemotherapy.
Instead, we may deliver chemotherapy directly to the tumor inside the body (hepatic artery infusion). It blocks blood supply to the tumor, so the cancer cells die.
Traditional chemotherapy can cause:
Hepatic artery infusion causes fewer side effects. The liver breaks down most of the chemotherapy drugs before it reaches other parts of the body.
When chemotherapy drugs travel to the gallbladder, possible side effects are infection and inflammation.
Targeted therapy delivers drugs that attack specific parts of cancer cells.
For advanced liver cancer, it slows down growth of the tumor and blocks its blood supply. By cutting off its food supply, targeted therapy essentially starves the tumor.
Because targeted drugs identify and attack specific cancer cells, there’s less damage to healthy cells. Side effects may include:
We will watch you closely for side effects. Let us know as soon as you notice symptoms so we can manage them.
We’re always looking for new and better ways to treat liver cancer. Clinical trials are research studies that test new treatments and procedures. We can talk about available clinical trials that may be right for you.
If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.
If specialty care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.
During your office visit, we will discuss your medical and family history and I will perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options and develop a treatment plan that is right for you.
If you need to talk with me after your visit or procedure, please call my office. You can also e-mail me with nonurgent issues from this website whenever it is convenient for you.
For general medical advice, our Appointment and Advice line is available 24 hours per day, 7 days per week.
If you have urgent concerns or issues while my office is closed, or need general medical advice, you can call the Appointment and Advice line. You will be connected with a nurse who can give you immediate advice.
If you are experiencing a serious problem or an emergency, call 911 or go to the nearest Emergency Room when the clinic is not open.
Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.
Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.
When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.
We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.
If refills are needed in the future, you can:
For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the Radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.
If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.
As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.
My Doctor Online is available at any time that is most convenient for you. From my home page you can:
If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.