Q: My uncle, age 85 years, has been diagnosed with hepatocellular carcinoma. He is diabetic with sugar levels in the range of 225 to 300 mg/dl. He is on insulin treatment. He is very tall & heavily built. Please give us the best options of treatment &/or surgery.

A:The treatment of hepatocellular carcinoma depends on the stage of cancer: 1. If it is localized, radical surgery i.e., removal of the portion of liver is advised that can be potentially curative. 2. Other option for small lesions at this age can be radio frequency ablation. 3. For unresectable disease that is advanced, one can consider for chemotherapy - intravenous or intra-arterial, the latter is considered superior. 4. New and relatively non toxic drugs such as sandostatin, xeloda are also available.