How we treat Liver Cancer?

A multidisciplianry team, including radiation oncolgy, surgical oncology, and medical oncology, are essential to maximize patient outcomes.

At the Saint John’s Cancer Institute, in Santa Monica, California, we treat liver cancer as well as metastatic liver cancers.

Treatment plans are developed by teams of specialists and may include one or a combination of treatments, including minimally invasive procedures, such as robot-assisted surgery, chemotherapy, biological therapy, or radiation therapy.


Specific Treatment for Liver Cancer will be determined by your doctor, considering several factors.

  • Your age, overall health, and medical history
  • Extent of the disease
  • Your tolerance of specific medicines, procedures, or therapies
  • Expectations for the course of the disease
  • Your preferences for treatment

Once a diagnosis of liver cancer has been established, additional tests may be required to determine the extent, or stage, of the cancer and the presence of other liver conditions, such as hepatitis, cirrhosis, and diabetes. These conditions can all affect the choices and outcome of treatment.

Healthgrades’ 2023 surgical award for Saint John’s Health Center

Our goal is to do all we can to preserve your quality of life during treatment. We do that by using minimally invasive surgical procedures including laparoscopic and robotic surgery, highly precise radiation therapy techniques, and chemotherapy regimens that are designed to provide you with the best chance to control or cure your cancer and allow you to maintain your quality of life as much as possible.

Our surgical oncologists are training the next generation of surgeons in minimally invasive robotic surgery, preparing tomorrow’s experts in a multidisciplinary, advanced surgical approach to care. Saint Johns has been recognized as Healthgrades America’s 50 Best Hospitals for Surgical Care.

Liver Cancer Treatment


Surgery is a common method to remove the tumor from the liver. The operation to remove the cancer will likely include a small portion of healthy liver tissue that surrounds the tumor. This is optimal if the tumor site is small, and the remaining part of the liver is in good health and functioning well. Surgical recommendations may also depend on the location of the cancer within the liver, how well the liver functions, and your overall health. Other treatments may be recommended with surgery.

A Minimally Invasive Approach

robot-assisted surgery for liver cancer
Robot-assisted surgery for liver cancer provides a minimally invasive approach.

Many liver tumors can be surgically removed using a laparoscope or via robot-assisted surgery, which reduces the scale of the surgery, decreases recovery time, and reduces the length of stay needed in the hospital as compared with traditional surgery.

Providence Saint Johns’ surgeons were among the first to use laparoscopic techniques in the treatment of liver cancer. Ultrasound can also be performed laparoscopically which is the most sensitive modality to detect even the smallest liver tumors. Larger liver resections can also safely be performed using state-of-the-art techniques such as portal vein embolization (PVE) to increase the size of the remaining liver.

Tumors can also be destroyed without any surgery or general anesthesia. Heat ablation using radiofrequency or microwave needles can be performed under XRay guidance and as an outpatient.

If the liver is at risk of complete failure, it may need to be replaced with a transplant. The diseased liver is removed and replaced with a healthy liver from a donor. Eligible recipients will have clinical signs of liver failure, are well enough to have the surgery, and are not considered at risk of future alcohol or drug abuse. Most adults need only one liver lobe (hemisphere) from a donor. If the donated lobe is healthy, it will regenerate to its former size.

Radiation Therapy

Dr. Robert Wollman, Radiation Oncologists with the Varian Edge Linac
Dr. Robert Wollman, Board-certified Radiation Oncologist at Saint John’s Health Center, stands next to the Varian Edge Linear Accelerator

Radiation therapy (or radiotherapy) is a medical treatment that uses high-powered energy rays such as X-rays or protons to destroy cancer cells and shrink tumors. The radiation affects the cancer cells by preventing successful cell replication, causing the tumor to wither and shrink.

Using highly specialized technology, doctors can craft the radiation beam and optimize the dose directly to the tumor in the liver, while sparing the surrounding healthy tissue. Stereotactic body Radiotherapy (SBRT) involves focusing many beams of radiation simultaneously at one point in your body, creating an intersection of energy to destroy cancer cells. Radiation therapy might be an option if other treatments aren’t possible or if they haven’t helped. For advanced liver cancer, radiation therapy might help control symptoms.


Chemotherapy uses drugs to kill rapidly growing cells, including cancer cells. Chemotherapy can be administered through a vein in your arm, in pill form, or both. Advancements in chemotherapy can target specific parts of cancer cells, which provides very predictable results. Chemotherapy is sometimes used to treat advanced liver cancer and can be used with other types of treatment.


Embolization is a procedure that injects substances directly into an artery in the liver to block or reduce the blood flow to a tumor in the liver.

This works to shrink tumors by blocking their supporting blood vessels. Sometimes the blood flow to one of the portal veins can be blocked to allow the other lobe of the liver to grow. This is known as portal vein embolization and the opposite lobe of the liver can grow an additional 15 percent in just six weeks, allowing more extensive removal of liver tumors without risk of liver failure.

By blocking the part of the hepatic artery that feeds the tumor, the treatment works to shut down the growth of cancer cells, while healthy liver cells can get their blood supply from the portal vein, which supplies approximately 75 percent of blood flow to the liver. Because the portal vein does not flow into the heart, it brings nutrient-rich blood to the liver from the gastrointestinal tract and spleen. Embolization is an option for some patients with tumors that cannot be removed by surgery.

Targeted therapy model - GI and liver cancers
Targeted therapy involves drug treatments that hinders cancer progression.

Targeted drug therapy

Targeted drug treatments focus on specific abnormalities present within cancer cells. By focusing on these abnormalities, targeted drug treatments can block cancer progression and cause cancer cells to die. Some targeted therapies only work in people whose cancer cells have certain genetic mutations. At Saint John’s, we have the capacity to analyze the biology of cancer, develop counter treatments that can defeat it, and provide treatment that is specific to you and your cancer. Many targeted drugs are available for treating advanced liver cancer.

Localized treatments for Liver Cancer

Localized treatments for liver cancer are those that are administered directly to the cancer cells, including the area surrounding the cancer cells.

Localized treatment options for liver cancer include:

Thermal Ablation for liver cancer
Thermal Ablation for liver cancer

Thermal Ablation

Radiofrequency ablation uses electric current to heat and destroy cancer cells. Using imaging of the treatment area as a guide, such as ultrasound, the doctor inserts one or more thin needles that can reach the tumor and deliver an electric current from the tip of the probe. Other procedures to heat the cancer cells might use microwaves or lasers.


Cryoablation uses extreme cold to also destroy cancer cells. During the procedure, your doctor places an instrument (cryoprobe) containing liquid nitrogen directly onto liver tumors. Ultrasound images are used to guide the cryoprobe and monitor the freezing of the cells.


Immunotherapy uses your immune system to fight cancer. Your immune system may not attack your cancer because the cancer cells produce proteins that blind or evade the immune system. Immunotherapy works by interfering with that process, revealing the disease and allow the body to fight it. Immunotherapy treatments are generally reserved for people with advanced liver cancer.

Call today to learn more about the diagnosis and treatment of liver cancer. Our multi-disciplinary team is ready to support you.

If you have questions regarding Liver Cancer or treatment, please call today. Click here to request an appointment.