As we honor Liver Cancer Awareness Month, what do you want our patients and families to pause and remember?
The number of people being diagnosed with liver cancer is increasing across the globe. The two most common types of liver cancer are hepatocellular carcinoma and intrahepatic cholangiocarcinoma. We should take pause and remember patients and families who have been impacted by these types of liver cancer. To those affected personally or through an affected family member or friend, I would like them to understand that there are a lot of scientific research and clinical trials going on around the globe and here at Yale to better understand the biology and improve the treatment of these types of cancers – and to understand that patients can now live longer and be cured.
What inspires you to work as a surgical oncologist?
The desire to provide a potential cure for cancer patients and, for those who cannot be cured, to improve the quality of their life – so they can spend more years on this earth more with loves ones. It is a privilege and honor to offer surgery to help patients in their battle against cancer. It’s a very gratifying way to work – to take care of people. I also find it gratifying to be involved with cancer research that positively impacts cancer patients across the globe and advances society. We are able to cure patients through cancer research.
What advances have made the biggest impact in the treatment of patients with liver cancer over the last five years, and what is the outlook for in the next five years?
There have been several improvements in treating patients with liver cancer. First, are advances in surgical techniques, including laparoscopic and robotic surgery – offered here at Yale – that lead to a more expeditious recovery and no compromise to cancer outcome. Next, is the improvement of systemic treatment options. There is promising data from recent clinical trials that immunotherapy can be added to the treatment regimens for hepatocellular cancer patients, sometimes after surgery, to prolong their survival. Furthermore, we are also finding that for some patients with cholangiocarcinoma (cancer of the bile ducts) can receive their systemic treatment prior to major liver surgery, with favorable outcomes. In addition, for some patients with unresectable cancer, we are able to surgically place a catheter into the hepatic artery to provide liver directed chemotherapy. Another advance in liver cancer care is the work being done by the hepatology community where patients with chronic viral liver disease now have options (i.e., Harvoni) to eradicate themselves of hepatitis C – I suspect ultimately when we see long term results of this treatment, we will find a reduced incidence of hepatocellular carcinoma in patients with a history of a hepatitis C infection.
Are there any breakthroughs in early detection?
In recent years, we have been using blood tumor markers and ultrasound to screen for early detection. It is preliminary right now, but there are additional blood tests and sophisticated cross sectional imaging which are being studied to detect cancer at an early stage. It will be an important complement to the treatment we now have.