LIVER CANCER

Why CyberKnife?

The right treatment for liver cancer may vary depending on a number of factors: type of liver cancer and its stage, overall patient health, patient age, etc. The liver is located in the abdominal cavity, and is consequently in motion being near the lungs and bowels. Using radiation therapy to treat liver tumors that can move up to two inches with every breath requires a system capable of tracking the tumor even while in motion.

The CyberKnife System

The CyberKnife System is the most advanced stereotactic radiosurgery system available today. Using image-guiding technology and advanced robotic tracking, CyberKnife adjusts to the movements of the tumor to ensure that high doses of radiation are delivered to the tumor with extreme precision and sub-millimeter accuracy. This accuracy reduces exposure to surrounding tissues, organs, and nerves.

CyberKnife is a great alternative to surgery, but it can also be used as a combination of treatments with surgery and/or chemotherapy. It is non-invasive and performed on an outpatient basis, completed in 1-5 treatment sessions within one week. Other radiotherapy systems may require the use of uncomfortable hardware to help keep the body from moving during treatment; however, no such equipment is necessary with CyberKnife. The patient simply lies down and relaxes as the robotic arm tracks the tumor’s movements while delivering high doses of radiation targeted directly at the tumor.

Inoperable Liver Tumors

Many liver tumors are deemed inoperable due to their advanced stage and/or the overall health of the patient. The CyberKnife System is an alternative to surgery for treatment of liver cancer. Using advanced technology, CyberKnife is able to track and treat liver tumors with high doses of radiation. CyberKnife’s ability to track the tumor in real time results in precise accuracy, minimizing radiation exposure to surrounding tissue. Our board-certified cancer doctors will evaluate your diagnosis, the stage of your cancer, your overall health, and other factors when determining the best treatment for an inoperable liver tumor.

Recurrent Liver Tumors

If liver cancer has been successfully treated or removed, there is still a chance that it may return in the same place or elsewhere. If a liver tumor returns after treatment, it is called a recurrent liver tumor. Your doctors will want to followup with you even after successfully removing or eliminating cancer cells. Should you experience a recurrence, your case will be further assessed and evaluated before determining which treatment option or treatment combination is best for your recurrent liver cancer. Fortunately, CyberKnife may still be an option even when conventional radiation is not.

Metastatic Liver Tumors

Metastatic cancer is when the cancer has spread to other parts of the body from its place of origin. Metastatic cancer cells are the same cells as those found in the original tumor. Metastatic liver tumors can also be treated with CyberKnife in addition to other therapies; however, our team of board-certified radiation oncologists will work with you to find the right treatment option for your unique condition.

Treatment Process

Treatment with CyberKnife is completely non-invasive and is performed on an outpatient basis. Once your treatment plan has been programmed into the CyberKnife System, all you need to do is lie back, relax, and let the advanced robotics deliver high doses of radiation with extreme precision all in a pain-free environment. CyberKnife treatment is completed in 1 to 5 sessions within a week period. Patients are free to leave after each session and resume their daily activities and tasks as they normally would.

Treatment at Phoenix CyberKnife and Radiation Oncology Center includes treatment planning, treatment sessions, and post-treatment follow-up appointments. During treatment planning, you will receive a CT scan which will generate an image of your tumor. Our board-certified radiation oncologists will then create a custom treatment plan using CyberKnife to most effectively treat your liver tumor. While undergoing treatment with CyberKnife, the system’s robotic arm will move around you delivering high doses of radiation from multiple angles, while tracking the tumor’s subtle movements to maximize precision and accuracy. No stabilizing hardware or frames are required.

After each session, the patient may carry on with their day and continue to do so once all sessions have been completed. Follow-up appointments will then be arranged to ensure the radiation has produced the desired effect in eliminating cancer cells.

What Is Liver Cancer?

The liver is located in the upper right quadrant of the abdominal cavity. Tumors found in the liver can be difficult to remove with surgery unless detected in the earliest stages. Conventional radiation therapies also struggle in treating liver tumors without risking damage to surrounding tissues and organs, such as the lungs and bowels. The liver is constantly in motion due to the respiratory movements of the lungs, which requires treatment that is able to adjust and track the tumor’s movements. Fortunately, the CyberKnife System can treat liver cancer while minimizing exposure to nearby tissues and organs, and without the use of painful compression devices to keep your body still.

Causes

Up to 60% of all primary liver cancers originate from Hepatitis B or C. Because of the low Hepatitis rates in the United States, liver cancer is one of the less common cancers in the U.S., accounting for only 2% of new cancer diagnoses each year. Outside of the U.S., and predominantly in developing countries, liver cancer is the third leading cause of cancer deaths, making it much more common globally than it is domestically.

Other causes of liver cancer include cirrhosis, which is most often caused by alcohol abuse in the U.S. Risk of infection increases with those who have histories of obesity, diabetes, smoking, and several hereditary conditions, such as hemochromatosis and primary biliary cirrhosis.

Survival Rates

According to estimates, 33,190 people will be diagnosed with liver cancer in the U.S. this year, with 23,000 estimated deaths. One in six patients lives five years or more following diagnosis of liver cancer; however, liver cancer survival rates continue to improve: in 1991, five-year liver cancer survival was one in twenty.

Most people who are diagnosed with liver cancer are over the age of 55, and men are twice as likely to be diagnosed with liver cancer than women. One of the reasons for the low liver cancer survival rate is that only 42% of cases are localized when discovered, while one in five cases has already metastasized by the time it is discovered, and one in four has spread to regional lymph nodes, significantly lowering patient outcome.

Treatment Options

Surgical removal of the tumor and some surrounding healthy tissue is common in patients whose tumors haven't spread. This is done in hope that no cancerous tissue will remain in the liver. Due to recent improvements in treatment, the five-year survival rate after this surgery can be above 50%; however, cancer recurrence following surgery is still more than 70%. Because of the severity of this cancer, the numbers can seem unsettling, and all treatment options should be considered before making a decision on how to best treat each liver cancer diagnosis. Radiation techniques can often be surprisingly effective for those patients who are unable to pursue surgery.

CyberKnife SBRT Treatments Prove Effective for Liver Cancer

Hepatocellular carcinoma (HCC) is the name for the most common type of liver cancer, which often results from risk factors such as Hepatitis B, Hepatitis C and cirrhosis.

Historically, surgery has been the most effective treatment for HCC, with a five-year survival rate of 50 percent to 70 percent for Stage I, 30 percent to 50 percent for Stage II, 10 percent to 30 percent for Stage III, and 10 percent for Stage IV. The most aggressive surgery is a total hepatectomy plus liver transplant, which has significantly lower five-year survival rates of between 20 percent and 45 percent.

While chemotherapy alone has not shown to be effective in treating this type of liver cancer, when combined with external beam radiation therapy it offers a much better response rate. However, the liver can only tolerate a certain amount of traditional external beam radiation therapy.

In recent years, the advent of conformal radiation treatment delivery systems, such as the CyberKnife System, which delivers stereotactic body radiation therapy (SBRT) and intensity modulated radiation therapy (IMRT) are showing promise in treating this type of liver cancer. SBRT and IMRT enables precise delivery of radiation directly to the tumor, which allows doctors to target the tumor with a high dose of radiation, while minimizing the exposure of normal surrounding tissues and organs.

The CyberKnife System one of the top solutions for delivering SBRT. CyberKnife treatments are given daily for up to five days, on an outpatient basis. The treatments are painless, requiring no cutting or anesthesia, and result in minimal side effects. Each treatment session takes only about 45 minutes to deliver.

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