Case Details:

A 36 year old gentleman from Mozambique was previously treated for the left liver lobe Hepato-Cellular Carcinoma (HCC) by surgical resection. On subsequent follow up, he was found to have recurrence of the cancer along the surgical resection margin and also new tumors were found in the right lobe of liver. His serum AFP levels had also increased. The patient sought further opinion at Wockhardt Hospitals, South Mumbai – India.

Following a joint clinical multi-disciplinary team (tumor board) discussion, that included–

1. Dr. Imran Sheikh – Consultant Gastroenetrologist & HPB Surgeon

2. Dr. Behram Pardiwala – Consultant Physician

3. Dr. Amit Sahu – Consultant Neuro  & Peripheral Interventional Radiologist

Patient was offered Trans-Arterial ChemoEmbolization (TACE). Dr. Amit Sahu performed the minimally invasive TACE procedure successfully.

TACE procedure involves delivering chemotherapy drug directly into the blood vessels supplying the cancer.

The entire procedure was performed through a small injection in the groin and involved passing special catheter into specific arteries and injecting chemotherapeutic drug. Subsequently, blood supply to the cancer was also blocked off. As this procedure allows direct delivery of chemotherapy within the cancer, it significantly reduces the risk of side effects overall while allowing good concentration of drug into cancer. As many as five (5) tumors were identified within the liver during the procedure which were subjected to TACE procedure. The patient was awake and remained comfortable throughout the course of procedure. A CT scan later confirmed good deposition of drug. TACE being minimally invasive in nature allowed fast recovery of the patient and he was back to routine activities from the evening of procedure.

Discussion:

Hepato-Cellular Carcinoma (HCC) is the most common liver cancer, being overall the 5th most common cancer and accounting for 3rd most common cause of cancer related death worldwide. Behaviours & conditions contributing to the risk of developing liver cancer include being overweight or having obesity, having hepatitis B or C infection, smoking cigarette, drinking alcohol, having non-alcoholic fatty liver disease, liver cirrhosis from any cause, diabetes, eating foods having aflatoxin (such grains or nuts that are not stored properly). 

Early liver cancer usually remains silent, not causing any major signs and symptoms. So, by the time patient usually develop symptoms like weight loss, loss of appetite, vague pain in upper abdomen, nausea, vomiting, abdominal swelling and jaundice – the cancer may already be in an intermediate or advanced stage.

If detected early, treatment options like surgical removal of cancer, liver transplant and non-surgical thermal ablation performed by Interventional Radiologist (applying thermal energy to destroy cancer) offer good results. Beyond this stage Interventional options like Trans-Arterial Chemo-Embolization (TACE) , Radio-Embolization (TARE/SIRT) are employed to control cancer and provide survival benefits. Few oral chemo-therapy drugs are also available which are usually used in advanced stages where other treatment options might not be feasible. ‘It is very important to catch the cancer early by doing regular screening in patients who are having risk factors, so that they are eligible for appropriate surgical, interventional treatments’ stressed Dr. Amit Sahu. Wockhardt Hospital, having a multi-disciplinary team involving Gastro-enterologist, GI-Surgeon, Interventional Radiologist and Medical Oncologist is well equipped to provide a comprehensive treatment for HepatoCellular Carcinoma & other cancers likewise.

Second opinion:

Patient was thankful to the team of doctors at Wockhardt Hospitals – Mumbai, India as this was a complicated cancer and needed a high level of super speciality services and advanced diagnostics. Wockhardt Hospitals – India specializes in cancer treatment and is fully equipped to handle all types of cancers through a multidisciplinary approach and supportive care. Wockhardt Hospitals – South Mumbai has managed a lot of international cases in oncology both medical and surgical with excellent outcomes and survival rates.

For any medical opinion, the team is reachable on call/WhatsApp – +91 91360 91380 or email on treatment@wockhardthospitals.com