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Chemotherapy Regional / Intra-Arterial Chemotherapy Regional chemotherapy uses drugs to treat the cancer, and is a non-surgical treatment for Hepatocellular Carcinoma. It takes advantage of direct access to the blood vessels to provide the arterial blood supply to the liver. Using steerable micro-catheters, the intervention radiologist is able to gain access to the arterial supply of the liver and then more selectively of the cancer in the liver. Getting the catheter appropriately positioned generally takes less than 30 minutes under light sedation. Treatment may be delivered over an additional 30 to 60 minutes from one or more selected locations. All catheters are removed at the end of the procedure, and the arterial penetration site is observed for 6 hours. Regional treatment may be repeated as necessary at 4 to 8 week intervals. The treatment may be chemotherapy infusion, or chemoembolization, where the chemotherapy drug is mixed with particles that block the blood vessels. The regional chemotherapy program is highly individualized, reflecting issues related to size and extent of the cancer, underlying liver disease, and the observed effectiveness in each patient: Definitive treatment by itself Cancer size reduction followed by needle ablation by radio-frequency heating or by cryosurgery Cancer control while awaiting liver transplant Preventative selective treatment of liver after resection Systemic Chemotherapy Under certain circumstances it may be appropriate to deliver chemotherapy to the whole body administering it either by mouth or by vein. Systemic chemotherapy may used in three situations: When the cancer is known to have spread to sites outside of the liver After liver transplant if the risk of recurrence is high Experimental studies testing new agents or already approved drugs which have not been tested in liver cancer Chemotherapy in liver cancer has not yet enjoyed the same degree of success as it has had against some other cancers. But it does help some patients. We offer chemotherapy for liver cancer after a careful discussion of risks and possible benefits.