Services
The Tucker Gosnell Hepatobiliary Cancer Clinic provides comprehensive, expert services available all in one outpatient evaluation by a multidisciplinary team of specialists and subspecialists. This Clinic combines the strengths of surgery, chemotherapy and radiation in the care of patients with cancer of the liver and bile duct for the best possible outcomes.

Our services include:

• Multidisciplinary evaluation of patients with cancers of the liver and bile ducts.
• Multidisciplinary evaluation of patients with metastatic disease to the liver.
• Evaluation by liver surgeons for consideration of resecting primary or metastatic cancer.
• Access to interventional radiologists for chemoembolization and radiofrequency ablation.
• Second opinion for cancers of the liver and bile duct.

Advanced Treatments

Diagnostics: Sophisticated Imaging and Computer Technologies

• High-speed two- and three-dimensional CT studies
• Positron Emission Tomography/Computed Tomography
  (PET/CT)
• Magnetic Resonance Imaging (MRI)
• CT colonography (virtual colonoscopy)
• Laparoscopic Ultrasound
• Radiofrequency Ablation
• Lymphotrophic Nanoparticle Enhanced MRI
  (Molecular Imaging)

Experienced Surgeons and Teams Produce the Best Outcomes
Surgeons in the Tucker Gosnell Center perform more liver resections than any other hospital in New England.

Listed below are the type of surgical procedures available.

• Hyperthermic Isolated Liver Perfusion
  The cancer centeris one of only four centers in the United States to perform hyperthermic isolated liver perfusion for advanced liver cancer, a procedure that involves isolating the liver from the body’s circulation and perfusing it with extraordinarily high chemotherapy doses. Read More
• Radiofrequency Ablation
  The cancer center surgeons performed the first radiofrequency ablation of a liver tumor in the United States, a procedure that uses radio waves to heat and destroy unresectable liver tumors. These surgeons and scientists continue to lead advances in this procedure. Read More
• Abdominal Transplantation
  The transplant surgeons developed a living-related liver transplant program that avoids relatively long wait times associated with cadaveric organs. Surgeons perform living-donor split-liver transplants for patients with hepatacellular carcinoma.
• Percutaneous Portal Vein Embolization
  Preoperative portal vein embolization increases the capacity of the healthy liver lobe or remnant by inducing atrophy of the lobe to be resected. Interventional radiologists perform this procedure when resection involves seventy percent or more of the liver.
• Neoadjuvant Chemotherapy
  Liver metastases from colorectal cancer that are unresectable are treated with more effective chemotherapy regimens. Responses to chemotherapy are sufficient to allow subsequent resection of the metastasis by the cancer surgeons in select patients.
• Ex-Vivo Procedure
  This complex operation involves removal of the liver from the body, followed by careful dissection of the liver on a sterile back bench to remove the tumor. This operation is performed for tumors in difficult locations that would otherwise be considered unresectable.

Radiation Oncology
Radiation oncologists sub-specialize by disease area, giving them an experience in disease- and structure-specific treatments.

The cancer center is home to the only proton radiation facility in the Northeast, the Francis H. Burr Proton Therapy Center, and one of only three in the United States. Irregularly shaped lesions with awkward configurations near critical structures, including certain liver tumors, are well suited for proton beam therapy.

Types or Radiation Oncology Procedures:

• Four-dimensional (4D) proton beam radiotherapy is currently being used at the cancer center to improve treatment delivery for upper GI tumors. This technology allows the proton treatment to be “gated” so that proton delivery occurs only in a particular phase of breathing, thereby improving accuracy and preventing radiation of normal tissue.
• Proton radiation is currently being used to treat liver tumors in a phase I trial. Current investigations regarding the potential ability of 4D proton beam radiation may allow for treatment schedules that shorten a five-and-a-half week course of radiation to a single week for pancreatic cancer.
• Photon Beam Radiation Therapy
  Intraoperative Radiation Therapy (IORT)
  The cancer center is one of only a few hospitals in the world — and the only in the Northeast — to offer this therapy. During surgery, radiation is delivered to locally advanced unresectable tumors in a dedicated operating room designed specifically for this purpose. Results show that this modality can offer long-term survival (6% at five years) in patients who otherwise would have no hope. Read More
• Intensity modulated radiation therapy (IMRT)
  The radiation oncologists have extensive experience with IMRT, which delivers varying dosages of radiation at the same time to different parts of the treatment area. Read More

Support & Coping
The treatment of liver cancers has an impact on all aspects of the patient’s life, as well as the entire family.

To find information on the upcoming Gastrointestinal Cancer support group, other education workshops, and wellness services offered this month, please view the HOPES calendar.