Before know about proton beam therapy for liver cancer treatment we have to know about liver cancer.

What is liver cancer?

Cancer that originates in the liver is termed  liver cancer. The liver is one of the largest organs of the body and it lies below the diaphragm and in the upper right quadrant of the abdomen. Several cancer types can occur in the liver. Hepatocellular carcinoma is the most common type of liver cancer, originating in the main type of liver cell (hepatocyte).

Typically, liver cancer is categorized as primary or secondary. Primary liver cancer starts in the liver cells. Secondary cancer of the liver or liver metastasis develops when the cancer cells spread to the liver from another organ. Different types of primary liver cancer are found depending on the different cells that make up the liver.

The liver cancer grows in the body without much of symptom or sign thus patient does not know he is suffering from liver cancer. By the time patient develops symptom the cancer becomes advanced.

The signs to be aware about is – jaundice, weight loss, itchy skin, abdominal lump.

What are the treatment options available for liver cancer?

The most common type of liver cancer is hepatocellular carcinoma (HCC), also known as hepatoma, which accounts for 75% of all primary liver cancers. Liver cancer treatment depends on a number of factors like size, site, location, the functionality of the liver.

Diagnosis of liver cancer

There are blood tests to assess liver function and to study tumour markers like – Alfa feto protein (AFP) or Ca19-9, CEA.

CT scan and PET scan is done to assess spread of the disease called staging.

Treatment of liver cancer

The standard model of treatment for liver cancer includes surgery, radiation, chemotherapy, Transarterial chemoembolization (TACE) or  Trans arterial radioembolization (TARE), liver transplantation.

Additionally, in patients with hepatocellular carcinoma (HCC) which is a type of liver cancer with the highest mortality rate and limited treatment options, proton beam therapy is emerging as a significant option.

Why proton beam therapy?

Proton radiation therapy (which provides more focused radiation using high-speed positively charged particles).

During PBT, protons are accelerated by a machine called a synchrotron or cyclotron. The protons’ high velocity creates high energy. This energy causes the protons to travel to the intended body depth. The protons then give in the tumour the targeted dose of radiation. There is less radiation dose outside the tumour with proton therapy. In X-rays radiation therapy, the x-rays continue to give radiation doses as they leave the body of the person, which means that radiation also affects healthy tissues in the region, which may cause side effects. This is not the case in PBT. PBT provides minimal dose to nearby healthy organs compared to X-ray therapy (XRT), which is especially pertinent for the treatment of liver cancers since the mean and low dose to the liver is among the most significant factors of radiation-induced liver disease (RILD). High-dose PBT in patients with HCC has been shown to achieve excellent long-term tumour control with minimal toxicity. Growing evidence recommends PBT in patients with unresectable cholangiocarcinoma or hepatic metastasis, especially to those with larger tumours who are unlikely candidates for XRT.

Undergoing PBT is a painless process, and the number of sessions depends upon the size, type and stage of liver cancer. PBT is an essential treatment option for cancer which are near critical organs. It is also possible to use PBT to treat these cancers:

• Cancer of the central nervous system like malignant meningioma, chordoma, etc.
• Cancer of the eyes
• Cancer in the head and neck region
• Lung cancer
• Prostate cancer
• Spinal and pelvic cancer (which occur in the bone and soft-tissue)
• Non-cancerous brain tumours

To know more about liver cancer treatment with proton beam therapy, feel free to write to us at [email protected] or give us a call at +91- 9769516280

Reviewed by Dr. Rakesh Rai. MS, FRCS, MD, CCT, ASTS Fellow (USA).