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The Liver and Cancer
The liver is the largest organ in the body and
is essential for general health. The liver removes harmful material
from the blood, aids in digestion of food and converts food
into nutrients for a healthy and active life. However, cancer
can severely impair the liver's ability to perform these crucial
functions, and often times when cancer originates in or spreads
to the liver, the tumors in the liver can lead to death. When
cancer originates in the liver it is called primary liver cancer.
Cancer that has spread to the liver from other parts of the
body is called secondary, or metastatic, cancer in the liver.
Colorectal cancer and uveal melanoma are examples of cancers
that start in one part of the body and frequently metastasize
to the liver. An estimated 245,000 new cases of liver cancer
are diagnosed yearly in the US, nearly 225,000 of which are
metastatic cancers.
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Existing Treatments and Clinical Trials
At this time, cancer in the liver can be cured
only by surgery, before it has spread to other parts of the
body and assuming that the patient is healthy enough to have
an operation. Treatments other than surgery may be able to control
the growth of the disease and help patients live longer and
feel better, but 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 and
innovative treatments that provide an alternative to existing
therapies.
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Delcath Percutaneous Hepatic Perfusion
Physicians at the National Cancer Institute (NCI)
are experimenting with Delcath Percutaneous Hepatic Perfusion
(PHP), also known as Peripheral Hepatic Perfusion, in patients
that have tumors primarily in their liver. A chemotherapy medicine
called melphalan, which is approved by the FDA, has been used
in the past to treat cancer in the liver with some success. This
drug is normally given through an IV and has had some serious
side effects. In order to decrease the side effects to the entire
body, physicians have given melphalan directly into the blood
vessels in the liver, which allowed for the delivery of very high
doses of melphalan to the liver and less melphalan to the rest
of the body. This direct treatment required surgery and thus the
chemotherapy could only be given once.
Delcath PHP is a different method of giving chemotherapy
directly to the liver without having a major operation. Special
catheters are positioned in the blood vessels going into and out
of the liver through small puncture holes in the skin and the
melphalan is given through these catheters. A previous study (Phase
I study) determined the safe dose of chemotherapy to use with
the system. The current studies at the NCI are designed to see
if this dose of melphalan using Delcath PHP is effective in treating
and/or shrinking liver tumors, and looking at the number and severity
of side effects using the system.
Delcath Percutaneous Hepatic Perfusion (PHP) is
an experimental therapy.
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