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Liver cancer-How an Interventional Radiologist can help?

Dr M C Uthappa

Having 12 years of experience in UK and 15 years of experience in India, I can confidently answer it in many ways.

The answer is simple in many ways, provided you find one who has a specific interest and expertise in the management of Liver cancer and more importantly works with a multidisciplinary team. An interventional radiologist is one who has full knowledge of image interpretation (be it an ultrasound scan, CT scan, CT-PET scan or MRI scan) and in addition someone who can treat liver cancer in many ways without the need for surgery in some cases and also treat in cases that are unfortunately not suitable for surgery. Here is a list of ways that we can help:

  1. First and foremost an interventional radiologist can actually tell you, if there is a liver cancer or not by looking at the images.
  • If in doubt we can help with getting a biopsy (sample of the growth in liver) usually using ultrasound guidance. I cannot think of a better qualified person to do this procedure safely than an interventional radiologist.
  • We can treat (cure) small tumors by ablation using radiofrequency, microwave, cryotherapy or IRE in some cases. Some of these procedures can also be done without the need for general anaesthesia.
  • Any liver cancer that cannot be treated with surgery like resection or liver transplant, we can treat with intra-arterial chemotherapy called
  • TACE or intra-arterial radiotherapy called TARE or Radioembolisation.These procedures are done with just local anaesthesia and mild intravenous sedation with just one day of hospital stay in most cases.
  • Many of these procedures also help the liver specialist and liver surgeon to bridge some cases to potential cure like liver transplantation while one is waiting to get a suitable liver donation. Here the interventional radiologist plays a key role in working with integrated liver care team across many hospitals in India.

In summary i can say that its best if any patient with liver cancer today should take an opinion from an interventional radiologist before undergoing treatment for liver cancer as they will give an unbiased opinion and more importantly they will work with a liver team. now that we have discussed this i will next time share my thoughts on how to screen for early detection of liver cancer.