As we celebrate Liver Cancer Awareness Month, what do you want our patients and their families to pause and remember?
Liver cancer is one of the leading causes of death worldwide, accounting for over 700,000 deaths each year. In the United States, it remains both the fastest growing cause of cancer and the fastest growing cause of cancer death. The liver cancer landscape is starting to change as new diseases such as obesity, diabetes and metabolic syndrome continue to increase. It is imperative that patients and providers understand that liver cancer is preventable and that understanding the risk factors for this disease and treating them early should be the primary goal. The field of liver cancer treatment has also made notable strides in recent years and the plethora of clinical trials, many of which are in advanced stages of research, is truly inspiring. We continue to anticipate improvements in our approach to managing this deadly complication, and we should feel privileged to be among the most innovative and experienced researchers and physicians, and to have such generous patients who have helped pave the way for the discovery of a cure.
How do you collaborate with the liver cancer team at Smilow Cancer Hospital to care for your patients?
The backbone of the liver cancer program is our multidisciplinary and highly collaborative team approach to the care of each of our patients. Our program includes a dedicated weekly conference where our patients are discussed within a group of highly specialized physicians including hepatologists, radiologists, medical oncologists, interventional radiologists, hepatobiliary / transplant surgeons, surgical oncologists, pathologists and radiation oncologists. Although, as hepatologists, we are the primary caretakers of these patients in diagnosing and managing underlying liver disease, preventing and treating complications, and providing long-term follow-up to monitor recurrence and maintain liver function, we are constantly in collaboration with the aforementioned people. providers to coordinate treatments and optimize the care of our patients.
What advances have had the greatest impact in the treatment of patients with liver cancer over the past 5 years?
Treatments including liver resection, liver transplantation, ablation and trans-arterial therapies have made significant progress both technically and with the introduction of minimally invasive approaches. These improvements have not only increased the number of candidates who can undergo curative treatment, but have also improved the safety and effectiveness of our therapies. However, the most marked progress has been made in the area of ââsystemic therapy which is used to treat patients with more advanced stages of liver cancer. Over the past few years, several new drugs have been approved – 10 currently approved by the FDA to be exact – and, in May 2020, a new combination therapy of Atezolizumab, which is an immune checkpoint inhibitor, and Bevacizumab. , which is a growth factor inhibitor vascular-endothelial agent, has become the new first-line agent showing significant improvement in prolonged survival in our patients. There is an abundance of ongoing Phase 3 trials exploring the role of immunotherapy in the treatment of liver cancer and I anticipate further modifications to our therapeutic approaches in the near future.
Clinical trials can often be the best treatment option, how do you explain this to patients who may be hesitant?
Clinical trials are needed not only to advance our understanding of the disease, but also to advance and improve care. I think knowledge is power and I do my best to explain the rationale for the trials, to review what the trials entail, to provide patients with adequate material to review for themselves and to leave more time to answer questions that may arise.
Is there any advice or support that you are trying to extend to all of your patients and their families? Words of hope?
It is an extremely exciting time for the liver cancer field. We have just started to scratch the surface for a better understanding of this disease. We have made significant progress not only in the treatment of liver cancer, now with the ability to extend meaningful options to patients with all stages of this disease, but also in our ability to modify and even eradicate key factors. of risk for the development of both chronic liver disease and liver cancer. The medical field is dedicated to improving outcomes and the abundance of advanced trials dedicated to liver cancer makes me optimistic that our approaches to care and outcomes will continue to improve.