Keeping on Top of Your Condition
The Liver
The liver
is the largest organ in the body. It is found behind the ribs on the right
side of the abdomen.
The liver has two parts, a right lobe
and a smaller left lobe.
The liver has many important functions that keep a person healthy. It
removes harmful material from the blood. It makes enzymes
and bile
that help digest food. It also converts food into substances needed for
life and growth.
The liver gets its supply of blood from two vessels. Most of its blood
comes from the hepatic
portal vein. The rest comes from the hepatic
artery.
This picture shows the liver and nearby
organs.
|
Understanding Cancer
Cancer is a group of many related diseases. All cancers begin in cells,
the body's basic unit of life. Cells make up tissues,
and tissues make up the organs of the body.
Normally, cells grow and divide to form new cells as the body needs
them. When cells grow old and die, new cells take their place.
Sometimes, this orderly process goes wrong. New cells form when the
body does not need them, or old cells do not die when they should. These
extra cells can form a mass of tissue called a growth or tumor.
Tumors can be benign
or malignant:
-
Benign tumors are not cancer. Usually, doctors can remove
them. In most cases, benign tumors do not come back after they are
removed. Cells from benign tumors do not spread to tissues around them
or to other parts of the body. Most important, benign tumors are rarely
a threat to life.
-
Malignant tumors are cancer. They are generally more serious
and may be life threatening. Cancer cells can invade and damage nearby
tissues and organs. Also, cancer cells can break away from a malignant
tumor and enter the bloodstream or the lymphatic
system. That is how cancer cells spread from the original cancer
(the primary
tumor) to form new tumors (secondary
tumors) in other organs. The spread of cancer is called metastasis.
Different types of cancer tend to spread to different parts of the
body.
Most primary liver cancers begin in hepatocytes
(liver cells). This type of cancer is called hepatocellular
carcinoma or malignant hepatoma.
Children may develop childhood hepatocellular carcinoma or hepatoblastoma.
When liver cancer spreads (metastasizes)
outside the liver, the cancer cells tend to spread to nearby lymph nodes
and to the bones and lungs. When this happens, the new tumor has the same
kind of abnormal cells as the primary tumor in the liver. For example, if
liver cancer spreads to the bones, the cancer cells in the bones are
actually liver cancer cells. The disease is metastatic liver cancer, not
bone cancer. It is treated as liver cancer, not bone cancer. Doctors
sometimes call the new tumor "distant" disease.
Similarly, cancer that spreads to the liver from another part of the
body is different from primary liver cancer. The cancer cells in the liver
are like the cells in the original tumor. When cancer cells spread to the
liver from another organ (such as the colon, lung, or breast), doctors may
call the tumor in the liver a secondary tumor. In the United States,
secondary tumors in the liver are far more common than primary tumors.
Liver Cancer: Who's at Risk?
Researchers in hospitals and medical centers around the world are
working to learn more about what causes liver cancer. At this time, no one
knows its exact causes. However, scientists have found that people with
certain risk
factors are more likely than others to develop liver cancer. A
risk factor is anything that increases a person's chance of developing a
disease.
Studies have shown the following risk factors:
-
Chronic
liver infection (hepatitis)
-- Certain viruses
can infect the liver. The infection may be chronic. (It may not go
away.) The most important risk factor for liver cancer is a chronic
infection with the hepatitis
B virus or the hepatitis
C virus. These viruses can be passed from person to person
through blood (such as by sharing needles) or sexual contact. An infant
may catch these viruses from an infected mother. Liver cancer can
develop after many years of infection with the virus.
These infections may not cause symptoms,
but blood tests can show whether either virus is present. If so, the
doctor may suggest treatment. Also, the doctor may discuss ways of
avoiding infecting other people.
In people who are not already infected with hepatitis B virus,
hepatitis B vaccine
can prevent chronic hepatitis B infection and can protect against liver
cancer. Researchers are now working to develop a vaccine to prevent
hepatitis C infection.
-
Cirrhosis
-- Cirrhosis is a disease that develops when liver cells are damaged and
replaced with scar tissue. Cirrhosis may be caused by alcohol abuse,
certain drugs and other chemicals, and certain viruses or parasites.
About 5 percent of people with cirrhosis develop liver cancer.
-
Aflatoxin
-- Liver cancer can be caused by aflatoxin, a harmful substance made by
certain types of mold.
Aflatoxin can form on peanuts, corn, and other nuts and grains. In Asia
and Africa, aflatoxin contamination is a problem. However, the U.S. Food
and Drug Administration (FDA) does not allow the sale of foods that have
high levels of aflatoxin.
-
Being male -- Men are twice as likely as women to get liver
cancer.
-
Family history -- People who have family members with liver
cancer may be more likely to get the disease.
-
Age -- In the United States, liver cancer occurs more often in
people over age 60 than in younger people.
The more risk factors a person has, the greater the chance that liver
cancer will develop. However, many people with known risk factors for
liver cancer do not develop the disease.
People who think they may be at risk for liver cancer should discuss
this concern with their doctor. The doctor may plan a schedule for
checkups.
Liver Cancer Symptoms
Liver cancer is sometimes called a "silent disease" because in an early
stage
it often does not cause symptoms. But, as the cancer grows, symptoms may
include:
-
Pain in the upper abdomen on the right side; the pain may extend to
the back and shoulder
-
Swollen abdomen (bloating)
-
Weight loss
-
Loss of appetite and feelings of fullness
-
Weakness or feeling very tired
-
Nausea and vomiting
-
Yellow skin and eyes, and dark urine from jaundice
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Fever
These symptoms are not sure signs of liver cancer. Other liver diseases
and other health problems can also cause these symptoms. Anyone with these
symptoms should see a doctor as soon as possible. Only a doctor can
diagnose and treat the problem.
Diagnosis
If a patient has symptoms that suggest liver cancer, the doctor
performs one or more of the following procedures:
-
Physical exam -- The doctor feels the abdomen to check the
liver, spleen,
and nearby organs for any lumps or changes in their shape or size. The
doctor also checks for ascites,
an abnormal buildup of fluid in the abdomen. The doctor may examine the
skin and eyes for signs of jaundice.
-
Blood tests -- Many blood tests may be used to check for liver
problems. One blood test detects alpha-fetoprotein
(AFP). High AFP levels could be a sign of liver cancer. Other blood
tests can show how well the liver is working.
-
CT
scan -- An x-ray
machine linked to a computer takes a series of detailed pictures of the
liver and other organs and blood vessels in the abdomen. The patient may
receive an injection of a special dye so the liver shows up clearly in
the pictures. From the CT scan, the doctor may see tumors in the liver
or elsewhere in the abdomen.
-
Ultrasound
test -- The ultrasound device uses sound waves that cannot
be heard by humans. The sound waves produce a pattern of echoes as they
bounce off internal organs. The echoes create a picture (sonogram)
of the liver and other organs in the abdomen. Tumors may produce echoes
that are different from the echoes made by healthy tissues.
-
MRI
-- A powerful magnet linked to a computer is used to make detailed
pictures of areas inside the body. These pictures are viewed on a
monitor and can also be printed.
-
Angiogram
-- For an angiogram, the patient may be in the hospital and may have
anesthesia.
The doctor injects dye into an artery so that the blood vessels in the
liver show up on an x-ray. The angiogram can reveal a tumor in the
liver.
-
Biopsy
-- In some cases, the doctor may remove a sample of tissue. A pathologist
uses a microscope to look for cancer cells in the tissue. The doctor may
obtain tissue in several ways. One way is by inserting a thin needle
into the liver to remove a small amount of tissue. This is called fine-needle
aspiration. The doctor may use CT or ultrasound to guide the
needle. Sometimes the doctor obtains a sample of tissue with a thick
needle (core
biopsy) or by inserting a thin, lighted tube (laparoscope)
into a small incision
in the abdomen. Another way is to remove tissue during an
operation.
A patient who needs to have a biopsy may want to ask the doctor
some of the following questions:
-
Why do I need a biopsy? How will the biopsy affect my treatment
plan?
-
What kind of biopsy will I have?
-
How long will it take? Will I be awake? Will it hurt?
-
Is there a risk that the biopsy procedure will cause the cancer
to spread? What are the chances of infection or bleeding after the
biopsy? Are there any other risks?
-
How soon will I know the results?
-
If I do have cancer, who will talk with me about treatment?
When? |
Staging
If liver cancer is diagnosed, the doctor needs to know the stage, or
extent, of the disease to plan the best treatment. Staging
is an attempt to find out the size of the tumor, whether the disease has
spread, and if so, to what parts of the body. Careful staging shows
whether the tumor can be removed with surgery.
This is very important because most liver cancers cannot be removed with
surgery.
The doctor may determine the stage of liver cancer at the time of
diagnosis, or the patient may need more tests. These tests may include
imaging
tests, such as a CT scan, MRI, angiogram, or ultrasound. Imaging tests can
help the doctor find out whether the liver cancer has spread. The doctor
also may use a laparoscope to look directly at the liver and nearby
organs.
Liver Cancer Treatment
Many people with liver cancer want to take an active part in decisions
about their medical care. They want to learn all they can about their
disease and their treatment choices. However, the shock and stress that
people often feel after a diagnosis of cancer can make it hard for them to
think of everything they want to ask the doctor. Often it helps to make a
list of questions before an appointment. To help remember what the doctor
says, patients may want to take notes or ask whether they may use a tape
recorder. Some patients also want to have a family member or friend with
them when they talk to the doctor -- to take part in the discussion, to
take notes, or just to listen.
Liver Cancer Prognosis
At this time, liver cancer can be cured only when it is found at an
early stage (before it has spread) and only if the patient is healthy
enough to have an operation. However, treatments other than surgery may be
able to control the disease and help patients live longer and feel better.
When a cure or control of the disease is not possible, some patients and
their doctors choose palliative
therapy. Palliative therapy aims to improve the quality of a
person's life by controlling pain and other problems caused by the
disease.
The doctor may refer patients to doctors who specialize in treating
cancer, or patients may ask for a referral. Specialists who treat liver
cancer include surgeons,
transplant
surgeons, gastroenterologists,
medical
oncologists, and radiation
oncologists.
Getting a Second Opinion
Before starting treatment, a patient may want to get a second opinion
about the diagnosis, the stage of cancer, and the treatment plan. Some
insurance companies require a second opinion; others may cover a second
opinion if the patient requests it.
There are a number of ways to find a doctor for a second opinion:
-
The doctor may refer patients to one or more specialists. At cancer
centers, several specialists often work together as a team.
-
The Cancer Information Service (1-800-4-CANCER) can tell callers
about treatment facilities, including cancer centers and other programs
supported by the National Cancer Institute, and can send printed
information about finding a doctor.
-
A local medical society, a nearby hospital, or a medical school can
usually provide the names of specialists.
-
The Official ABMS Directory of Board Certified Medical
Specialists lists doctors' names along with their specialty and
their educational background. This resource is available in most public
libraries. The American Board of Medical Specialties (ABMS) also offers
information by telephone and on the Internet. The public may use these
services to check whether a doctor is board certified. The telephone
number is 1-866-ASK-ABMS (1-866-275-2267). The Internet address is http://www.abms.org/newsearch.asp.
Liver Cancer Treatment Choices
The doctor can describe treatment choices and discuss the results
expected with each treatment option. The doctor and patient can work
together to develop a treatment plan that fits the patient's needs.
Cancer of the liver is very hard to control with current treatments.
For that reason, many doctors encourage patients with liver cancer to
consider taking part in a clinical
trial. Clinical trials are research studies testing new
treatments. They are an important option for people with all stages of
liver cancer.
The choice of treatment depends on the condition of the liver; the
number, size, and location of tumors; and whether the cancer has spread
outside the liver. Other factors to consider include the patient's age,
general health, concerns about the treatments and their possible side
effects, and personal values.
Usually, the most important factor is the stage of the disease. The
stage is based on the size of the tumor, the condition of the liver, and
whether the cancer has spread. The following are brief descriptions of the
stages of liver cancer and the treatments most often used for each stage.
For some patients, other treatments may be appropriate.
Localized resectable cancer
Localized resectable
liver cancer is cancer that can be removed during surgery. There is no
evidence that the cancer has spread to the nearby lymph nodes or to other
parts of the body. Lab tests show that the liver is working well.
Surgery to remove part of the liver is called partial hepatectomy.
The extent of the surgery depends on the size, number, and location of the
tumors. It also depends on how well the liver is working. The doctor may
remove a wedge of tissue that contains the liver tumor, an entire lobe, or
an even larger portion of the liver.
In a partial hepatectomy, the surgeon leaves a margin of normal liver
tissue. This remaining healthy tissue takes over the functions of the
liver.
For a few patients, liver transplantation
may be an option. For this procedure, the transplant surgeon removes the
patient's entire liver (total hepatectomy) and replaces it with a healthy
liver from a donor. A liver transplant is an option only if the disease
has not spread outside the liver and only if a suitable donated liver can
be found. While the patient waits for a donated liver to become available,
the health care team monitors the patient's health and provides other
treatments, as necessary.
Localized unresectable cancer
Localized unresectable
liver cancer cannot be removed by surgery even though it has not spread to
the nearby lymph nodes or to distant parts of the body. Surgery to remove
the tumor is not possible because of cirrhosis (or other conditions that
cause poor liver function), the location of the tumor within the liver, or
other health problems.
Patients with localized unresectable cancer may receive other
treatments to control the disease and extend life:
-
Radiofrequency
ablation -- The doctor uses a special probe to kill the
cancer cells with heat. The probe contains tiny electrodes that destroy
the cancer cells. Sometimes the doctor can insert the probe directly
through the skin. Only local
anesthesia is needed. In other cases, the doctor may insert the
probe through a small incision in the abdomen or may make a wider
incision to open the abdomen. These procedures are done in the hospital
with general
anesthesia.
Other therapies that use heat to destroy liver tumors include laser
or microwave
therapy.
-
Percutaneous
ethanol injection -- The doctor injects alcohol (ethanol)
directly into the liver tumor to kill cancer cells. The doctor uses
ultrasound to guide a small needle. The procedure may be performed once
or twice a week. Usually local anesthesia is used, but if the patient
has many tumors in the liver, general anesthesia may be needed.
-
Cryosurgery
-- The doctor makes an incision into the abdomen and inserts a metal
probe to freeze and kill cancer cells. The doctor may use ultrasound to
help guide the probe.
-
Hepatic
arterial infusion -- The doctor inserts a tube (catheter)
into the hepatic artery, the major artery that supplies blood to the
liver. The doctor then injects an anticancer drug into the catheter. The
drug flows into the blood vessels that go to the tumor. Because only a
small amount of the drug reaches other parts of the body, the drug
mainly affects the cells in the liver.
Hepatic arterial infusion also can be done with a small pump. The
doctor implants the pump into the body during surgery. The pump
continuously sends the drug to the liver.
-
Chemoembolization
-- The doctor inserts a tiny catheter into an artery in the leg. Using
x-rays as a guide, the doctor moves the catheter into the hepatic
artery. The doctor injects an anticancer drug into the artery and then
uses tiny particles to block the flow of blood through the artery.
Without blood flow, the drug stays in the liver longer. Depending on the
type of particles used, the blockage may be temporary or permanent.
Although the hepatic artery is blocked, healthy liver tissue continues
to receive blood from the hepatic portal vein, which carries blood from
the stomach and intestine.
Chemoembolization requires a hospital stay.
-
Total hepatectomy with liver transplantation -- If localized
liver cancer is unresectable because of poor liver function, some
patients may be able to have a liver transplant. While the patient waits
for a donated liver to become available, the health care team monitors
the patient's health and provides other treatments, as
necessary.
Advanced cancer
Advanced cancer is cancer that is found in both lobes of the liver or
that has spread to other parts of the body. Although advanced liver cancer
cannot be cured, some patients receive anticancer therapy to try to slow
the progress of the disease. Others discuss the possible benefits and side
effects and decide they do not want to have anticancer therapy. In either
case, patients receive palliative care to reduce their pain and control
other symptoms.
Treatment for advanced liver cancer may involve chemotherapy,
radiation
therapy, or both:
-
Chemotherapy uses drugs to kill cancer cells. The patient may
receive one drug or a combination of drugs. The doctor may use
chemoembolization or hepatic arterial infusion. Or the doctor may give
systemic
therapy, meaning that the drugs are injected into a vein and
flow through the bloodstream to nearly every part of the body. The
doctor may call this intravenous
or IV chemotherapy.
Usually chemotherapy is an outpatient
treatment given at the hospital, clinic, or at the doctor's office.
However, depending on which drugs are given and the patient's general
health, the patient may need to stay in the hospital.
-
Radiation therapy (also called radiotherapy) uses high-energy
rays to kill cancer cells. Radiation therapy is local
therapy, meaning that it affects cancer cells only in the
treated area. A large machine outside the body directs radiation to the
tumor area.
Recurrent cancer
Recurrent cancer means the disease has come back after the initial
treatment. Even when a tumor in the liver seems to have been completely
removed or destroyed, the disease sometimes returns because undetected
cancer cells remained somewhere in the body after treatment. Most
recurrences occur within the first 2 years of treatment. The patient may
have surgery or a combination of treatments for recurrent liver
cancer.
These are some questions a person may want to ask the doctor
before treatment begins:
-
Is there any evidence the cancer has spread? What is the stage
of the disease?
-
Do I need any more tests to determine whether I can have
surgery?
-
What are my treatment choices? Which do you recommend for me?
Why?
-
What are the expected benefits of each kind of treatment?
-
What are the risks and possible side effects of each
treatment?
-
Will I need to stay in the hospital?
-
How will you treat my pain?
-
What is the treatment likely to cost? Is this treatment covered
by my insurance plan?
-
How will treatment affect my normal activities?
-
Would a clinical trial (research study) be appropriate for
me? |
People do not need to ask all of their questions or understand all of
the answers at once. They will have other chances to ask the health care
team to explain things that are not clear and to ask for more
information.
Side Effects of Liver Cancer Treatment
Because cancer treatment may damage healthy cells and tissues, unwanted
side effects often occur. Side effects depend on many factors, including
the type and extent of the treatment. Side effects may not be the same for
each person, and they may even change from one treatment session to the
next. The health care team will explain the possible side effects of
treatment and how they will help the patient manage them.
Surgery
It takes time to heal after surgery, and the time needed to recover is
different for each person. Patients are often uncomfortable during the
first few days. However, medicine can usually control their pain. Patients
should feel free to discuss pain relief with the doctor or nurse. It is
common to feel tired or weak for a while. Also, patients may have diarrhea
and a feeling of fullness in the abdomen. The health care team watches the
patient for signs of bleeding, infection, liver failure, or other problems
requiring immediate treatment.
After a liver transplant, the patient may need to stay in the hospital
for several weeks. During that time, the health care team checks for signs
of how well the patient's body is accepting the new liver. The patient
takes drugs to prevent the body from rejecting the new liver. These drugs
may cause puffiness in the face, high blood pressure, or an increase in
body hair.
Cryosurgery
Because a smaller incision is needed for cryosurgery than for
traditional surgery, recovery after cryosurgery is generally faster and
less painful. Also, infection and bleeding are not as likely.
Percutaneous Ethanol Injection
Patients may have fever and pain after percutaneous ethanol injection.
The doctor can suggest medicines to relieve these problems.
Chemoembolization and Hepatic Arterial Infusion
Chemoembolization and hepatic arterial infusion cause fewer side
effects than systemic chemotherapy because the drugs do not flow through
the entire body. Chemoembolization sometimes causes nausea, vomiting,
fever, and abdominal pain. The doctor can give medications to help lessen
these problems. Some patients may feel very tired for several weeks after
the treatment.
Side effects from hepatic arterial infusion include infection and
problems with the pump device. Sometimes the device may have to be
removed.
Systemic Chemotherapy
The side effects of chemotherapy depend mainly on the drugs and the
doses the patient receives. As with other types of treatment, side effects
are different for each patient.
Systemic chemotherapy affects rapidly dividing cells throughout the
body, including blood cells. Blood cells fight infection, help the blood
to clot, and carry oxygen to all parts of the body. When anticancer drugs
damage blood cells, patients are more likely to get infections, may bruise
or bleed easily, and may have less energy. Cells in hair roots and cells
that line the digestive tract also divide rapidly. As a result, patients
may lose their hair and may have other side effects such as poor appetite,
nausea and vomiting, or mouth sores. Usually, these side effects go away
gradually during the recovery periods between treatments or after
treatment is complete. The health care team can suggest ways to relieve
side effects.
Radiation Therapy
The side effects of radiation therapy depend mainly on the treatment
dose and the part of the body that is treated. Patients are likely to
become very tired during radiation therapy, especially in the later weeks
of treatment. Resting is important, but doctors usually advise patients to
try to stay as active as they can.
Radiation therapy to the chest and abdomen may cause nausea, vomiting,
diarrhea, or urinary discomfort. Radiation therapy also may cause a
decrease in the number of healthy white blood cells, cells that help
protect the body against infection. Although the side effects of radiation
therapy can be distressing, the doctor can usually treat or control
them.
Pain Control
Pain is a common problem for people with liver cancer. The tumor can
cause pain by pressing against nerves and other organs. Also, therapies
for liver cancer may cause discomfort.
The patient's doctor or a specialist in pain control can relieve or
reduce pain in several ways:
-
Pain medicine -- Medicines often can relieve pain. (These
medicines may make people drowsy and constipated, but resting and taking
laxatives can help.)
-
Radiation -- High-energy rays can help relieve pain by
shrinking the tumor.
-
Nerve block -- The doctor may inject alcohol into the area
around certain nerves in the abdomen to block the pain.
The health care team may suggest other ways to relieve or reduce pain.
For example, massage, acupuncture,
or acupressure
may be used along with other approaches. Also, the patient may learn to
relieve pain through relaxation techniques such as listening to slow music
or breathing slowly and comfortably.
Nutrition
People with liver cancer may not feel like eating, especially if they
are uncomfortable or tired. Also, the side effects of treatment can make
eating difficult. Foods may smell or taste different. Nevertheless,
patients should try to eat enough calories and protein to control weight
loss, maintain strength, and promote healing. Also, eating well often
helps people with cancer feel better and have more energy.
Careful planning and checkups are important. Liver cancer and its
treatment may make it hard for patients to digest food and maintain their
weight. The doctor will check the patient for weight loss, weakness, and
lack of energy.
The doctor, dietitian, or other health care provider can advise
patients about ways to have a healthy diet during treatment.
Continuing Care
Continuing care for patients with liver cancer depends on the stage of
their disease and the treatments they have received. Followup is very
important after surgery to remove cancer from the liver. This is because
the cancer can return in the liver or in another part of the body. People
who have had liver cancer surgery may wish to discuss the chance of
recurrence with the doctor. Followup care may include blood tests, x-rays,
ultrasound tests, CT scans, angiograms, or other tests.
For people who have had a liver transplant, the doctor will test how
well the new liver is working. The doctor also will watch the patient
closely to make sure the new liver is not being rejected. People who have
had a liver transplant may want to discuss with the doctor the type and
schedule of followup tests that will be needed.
For patients with advanced disease, the health care team will focus on
keeping the patient as comfortable as possible. Medicines and other
measures can help with digestion, reduce pain, or relieve other
symptoms.
Support for People with Liver Cancer
Having a serious disease such as liver cancer is not easy. Some people
find they need help coping with the emotional and practical aspects of
their disease. Support groups can help. In these groups, patients or their
family members get together to share what they have learned about coping
with the disease and the effects of treatment. Patients may want to talk
with a member of their health care team about finding a support group.
Groups may offer support in person, over the telephone, or on the
Internet.
Patients may worry about caring for their families, holding on to their
jobs, or keeping up with daily activities. Concerns about treatments and
managing side effects, hospital stays, and medical bills are also common.
Doctors, nurses, and other members of the health care team will answer
questions about treatment, working, or other activities. Meeting with a
social worker, counselor, or member of the clergy can be helpful to those
who want to talk about their feelings or discuss their concerns. Often, a
social worker can suggest resources for emotional support, financial aid,
transportation, or home care.
The Promise of Cancer Research
Laboratory scientists are studying the liver to learn more about what
may cause liver cancer and how liver cancer cells work. They are looking
for new therapies to kill cancer cells.
Doctors in hospitals and clinics are conducting many types of clinical
trials. These are research studies in which people take part voluntarily.
In these trials, researchers are studying ways to treat liver cancer that
have shown promise in laboratory studies. Research has led to advances in
treatment methods, but controlling liver cancer remains a challenge.
Scientists continue to search for more effective ways to treat this
disease.
Patients who join clinical trials have the first chance to benefit from
new treatments. They also make an important contribution to medical
science. Although clinical trials may pose some risks, researchers take
very careful steps to protect people.
Currently, clinical trials involve chemotherapy, chemoembolization, and
radiofrequency ablation for the treatment of liver cancer. Another
approach under study is biological
therapy, which uses the body's natural ability (immune
system) to fight cancer. Biological therapy is being studied in
combination with chemotherapy.
Patients who are interested in joining a clinical study should talk
with their doctor.
The Cancer Information Service at 1-800-4-CANCER can answer
questions about cancer clinical trials and can provide information from
the PDQ database.
Keeping on Top of Your Condition
Keeping in tune with your disease or condition not only makes treatment less intimidating but also increases its chance of success, and has been shown to lower a patients risk of complications. As well, as an informed patient, you are better able to discuss your condition and treatment options with your physician.
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