Liver Cancer Program

Liver health is at the center of everything we do. Yale certified transplant hepatologists specialize in the complex relationship between liver disease and liver cancer, two conditions that frequently occur together. From the very first appointment, a hepatologist will evaluate overall liver function, assess eligibility for advanced treatments including liver transplantation, and remain an active part of the care team long after treatment is completed. After treatment, our onco-hepatology team provides continued care to manage underlying liver disease, preserve liver function, and monitor closely for any signs of recurrence, and to re-treat promptly if necessary.

For many patients with liver or bile duct cancer, surgery offers the best chance for long-term survival or cure. Our surgeons are among the most experienced in the country in advanced liver surgical techniques. Liver resection, or the surgical removal of the tumor and surrounding liver tissue, is a highly effective option for patients whose cancer is confined to the liver and whose overall liver function is strong.

For patients with early-stage liver cancer who also have advanced liver disease, liver transplantation offers a significant opportunity for cure for both the cancer and the liver disease itself. Our program offers both deceased donor and living donor transplants, giving more patients access to this life-changing procedure. For patients who are not candidates for transplantation, surgical resection remains an excellent option with strong survival outcomes.

Not every patient requires surgery, and our interventional radiologists offer a powerful range of minimally invasive, image-guided treatments that can be highly effective and sometimes even curative. Transarterial chemoembolization, or TACE, delivers chemotherapy through a small catheter directly to the liver tumor, concentrating treatment precisely where it is needed most while limiting effects on the rest of the body. Radiofrequency ablation, known as RFA, is a well-established and effective treatment for smaller tumors, using heat energy to destroy cancer cells with minimal impact on the surrounding liver. For patients with tumors in challenging locations, NanoKnife therapy, also known as irreversible electroporation, represents the cutting edge of minimally invasive cancer care. This state-of-the-art technology delivers precise, high-voltage electrical pulses that target and destroy cancer cells while carefully preserving the healthy liver tissue immediately surrounding the tumor. Together, these techniques give Interventional Radiology physicians a broad and sophisticated toolkit to meet the unique needs of each patient.

For patients whose cancer has spread beyond the liver, or for whom local therapies alone are not sufficient, our medical oncologists offer the latest and most advanced systemic treatment options available. These include targeted biologic therapies designed to attack the specific features of cancer cells, as well as immunotherapies, innovative treatments that work by activating a patient’s own immune system to recognize and fight the cancer. As a leading academic cancer center and the only National Cancer Institute-designated comprehensive cancer center in Connecticut, Yale also offers patients access to groundbreaking clinical trials, providing opportunities to benefit from breakthrough treatments that may not yet be available anywhere else.

When radiation therapy is part of the treatment plan, our radiation oncologists use some of the most advanced technology in the world to deliver treatment with extraordinary precision. Stereotactic body radiotherapy, or SBRT, delivers powerful, highly focused doses of radiation directly to the tumor while minimizing exposure to healthy liver tissue and surrounding organs. This approach allows our team to treat tumors aggressively while protecting each patient’s overall health and quality of life.

An accurate and detailed diagnosis is the foundation of every effective treatment plan. Our pathologists provide expert analysis of tumor tissue to confirm each patient’s diagnosis and characterize the cancer type at the cellular level. For patients with intrahepatic cholangiocarcinoma, tumor genotyping plays a particularly important role. By identifying the specific genetic profile of the tumor, Yale pathologists help guide the multidisciplinary treatment team toward the most targeted and effective treatment strategies available.

Advanced imaging is essential at every stage of liver cancer care. Yale radiologists use the most sophisticated imaging technologies available, including dynamic liver imaging, which captures how tumors respond to blood flow and helps to pinpoint cancer with remarkable precision, and contrast-enhanced liver ultrasound, a non-invasive tool that provides detailed, real-time pictures of liver tumors. These capabilities provide the clearest and most complete picture of each patient’s disease.

At Yale Cancer Center and Smilow Cancer Hospital, we believe deeply that caring for the whole person is just as important as treating the disease. Our comprehensive supportive care team is here for individuals and their loved ones from the moment of diagnosis and throughout every phase of the cancer journey.

Social workers are available to help navigate practical challenges, financial concerns, and the emotional weight that a cancer diagnosis can bring. Registered dietitians provide personalized nutritional guidance to help maintain strength and wellness during treatment. Physical therapists focus on preserving activity and physical strength throughout the course of care. Art therapy offers creative outlets for emotional healing and well-being, and our pastoral care team provides spiritual support for families of all backgrounds and beliefs.