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Sunday, May 4, 2008

Surgery as a treatment for secondary liver cancer

Secondary cancer in the liver is most often treated with chemotherapy and not with an operation, as more than one area of the liver is usually affected.

Liver transplants (removal and replacement of the liver) are not used for people who have secondary liver cancer. This is because when it has been tried in the past, the cancer usually came back soon afterwards due to the drugs that are used to prevent the body rejecting the transplanted liver.

Sometimes, it is possible to remove the affected part of the liver with surgery. This sort of surgery is called a liver resection and is most commonly used to remove secondary liver tumours that have come from a primary cancer in the bowel. If the cancer cells are in a single area of the liver the surgery may sometimes cure the cancer.

You can discuss with your doctor whether surgery may be helpful in your particular situation.

Recent improvements in liver surgery mean that several tumours can sometimes be removed from more than one area of the liver in a single operation. Chemotherapy is sometimes used to shrink tumours before surgery to make the operation safer and more successful.

Liver resection is a major operation that takes from 3­­-7 hours, and is carried out in specialist liver surgery hospitals. It is only suitable for a small number of people with liver cancer. There are usually no long-term side effects following liver resection, as the remaining liver can regrow within a few months of the operation and carry out all its normal functions.

Before any operation, make sure you have discussed it fully with your doctor so that you understand what it involves. Remember, no operation or procedure will be done without your consent.

After your operation

After your operation you may be taken to the intensive care ward or high-dependency unit for about 24 hours. This is because the liver has a very good blood supply and there is a risk that it may bleed after surgery. The doctors and nurses will keep a very close check on your blood pressure.

You will have a dressing over the operation site on your abdomen, and if necessary one or more drainage tubes will drain fluid and blood from the wound site into drainage bags. The nurses will regularly measure the amount of any blood in these bags. When the drainage has almost stopped the tube(s) will be removed, usually after a few days.

You will also have a drip (intravenous infusion) going into a vein in your arm to give you fluids and essential nutrients. This will be removed once you are eating and drinking properly again – usually within a few days.

A small tube called a catheter, will be put into your bladder to drain your urine into a collecting bag. This will save you having to get up to pass urine. The tube is usually removed after a few days.

It is normal to have some pain or discomfort after an operation on the liver. You will be given regular injections of painkillers for several days after the operation to prevent and relieve pain. You may also be given injections of anti-sickness drugs (anti-emetics).

Most people are able to go home 10-14 days after their operation and need painkillers for the next few weeks. It may take up to 6 weeks before people start to get back to normal.

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