Liver cancer
Introduction:
The liver is just below the diaphragm, in the right side of the abdominal cavity. It has two main parts: a right lobe and a smaller left lobe. The liver has many important functions such as: fat and carbohydrate metabolism, removing harmful material from blood and making enzymes and bile. Liver is supplied with blood by two blood vessels: hepatic artery and hepatic portal vein. Hepatic vein carries blood away from liver.
Liver cancer is a form of cancer with a high mortality rate. Liver cancers can be classified into two types. They are either primary, when the cancer starts in the liver itself, or metastatic, when the cancer has spread to the liver from some other part of the body. In adults, most primary liver cancers belong to one of two types: hepatomas, or hepatocellular carcinomas (HCC) and cholangiomas, or cholangiocarcinomas. HCC starts in the liver tissue itself while cholangiomas develop in the bile ducts inside the liver.
Signs & Symptoms:
The following are the most common symptoms of a liver hepatoma:
� Pain in the right upper abdomen that may extend to the back and shoulder.
� Abdominal pain is the most common symptom of HCC.
� Loss of appetite.
� Weakness
� Weight loss
� Nausea and vomiting
� If the tumor blocks ducts of liver or gall bladder, patient may suffer from jaundice. Jaundice patients have yellow skin and eyes and dark urine.
� Fever
� Developing a collection of fluid, known as ascites, in the abdominal cavity.
� Bleeding into the digestive tract.
Methods of diagnosis:
First of all, doctors check the patient\'s history for risk factors, then they make some diagnostic tests including physical tests, blood tests and imaging tests.
Physical Examination: The doctor examines the patient�s abdomen to check the liver and spleen for any abnormal masses, lumps or ascites. The liver is usually swollen and hard in liver cancer patients. Doctors may also check skin and eyes for signs of jaundice.
Blood Tests: In blood tests, alpha-fetrprotein is usually checked as its high level is a sign of liver cancer.
CT Scan: An x-ray machine that helps the doctor to picture the liver and nearby organs and observe any tumors. In CT scan, patient is usually injected by a dye for clearer picture of the liver.
Ultrasound Test: Another imaging technique used to create a picture of the liver. Ultrasound depends on the property that tumors produce echoes different than that produced by healthy tissues.
MRI (Magnetic Resonance Imaging): This imaging device depends on magnetic resonance. A magnet is used to make detailed pictures of areas inside the body.
Angiogram: A dye is injected into the patient�s artery, then liver�s blood vessels show up on x-ray. Hence, doctors can discover any tumors in the liver.
Liver Biopsy: In biopsy, doctors remove a sample tissue and examine it under microscope to detect and cancer cells. If doctor uses a thin needle to obtain the tissue sample, this is called �fine needle aspiration,� however, if he uses a thick needle it is called then �core biopsy�.
Laparoscopy: The doctor makes a cut in the patient�s abdomen and inserts a small tube called a laparoscope to view patient�s liver. Then the doctor takes a small piece of tissue and examines it under the microscope for the presence of cancer cells.
Risk Factors:
Gender: Males are twice as likely as females to get liver cancer.
Age: Most liver cancers occur in people over 60 years old.
Cirrhosis: It is a disease that happens when fibrous tissue develops and destroys liver cells and constricts blood vessels. Cirrhosis may my caused by alcoholism, ingestion of poison, virus infection and certain parasites. About 5 percent of people with cirrhosis develop liver cancer.
Chronic Liver Infection (Hepatitis): Chronic infection with hepatitis B virus or hepatitis C virus represents the most important risk factor for liver cancer. Those viruses can be transmitted from person to person through blood or sexual contact. Besides, a mother can infect her baby during pregnancy.
Aflatoxin: Aflatoxin is a harmful material that can be formed on peanuts by certain types of mold. Aflatoxin increases the risk of developing liver cancer.
Treatment:
Treatment of liver cancer is based on several factors, including the type of cancer whether it is primary or metastatic, cancer stage and the patient\'s age.
Surgery: Surgical options are limited to patients whose tumors are contained within one lobe of the liver, and if the patient does not have either cirrhosis, jaundice, or ascites. The operation is called a partial hepatectomy, or partial removal of the liver because the surgeon removes either a lobe of the liver or cut out the area around the tumor.
Chemotherapy: Unlike the normal liver, hepatocellular carcinoma gets its blood supply from one blood vessel: hepatic artery. A tube (catheter) can be placed in the hepatic artery of the liver and an implantable infusion pump can be installed. The pump allows much higher concentrations of the cancer drug to be carried to the tumor than is possible with chemotherapy carried through the bloodstream. The drug that is used for infusion pump therapy is usually floxuridine (FUDR). Systemic chemotherapy can also be used to treat liver cancer. The most commonly used systemic chemotherapeutic agents are doxorubicin (Adriamycin) and 5-fluorouracil (5 FU). Systemic chemotherapy does not, however, significantly lengthen the patient\'s survival time.
Radiation Therapy: Radiation therapy is the use of high-energy rays or x-rays to kill cancer cells or to shrink tumors. Its use in liver cancer, however, is only to give short-term relief from some of the symptoms.
Liver Transplant: Most liver cancer patients have liver cirrhosis also and would not tolerate surgery. Liver transplant is the removal of the patient�s diseased liver and transplanting a donor liver instead.
Percutaneous Ethanol (Alcohol) Injection: In this technique, pure alcohol is injected into the tumor through a very thin needle with the help of ultrasound or CT visual guidance. Alcohol destroys the tumor by dehydrating its cells.
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Introduction:
The liver is just below the diaphragm, in the right side of the abdominal cavity. It has two main parts: a right lobe and a smaller left lobe. The liver has many important functions such as: fat and carbohydrate metabolism, removing harmful material from blood and making enzymes and bile. Liver is supplied with blood by two blood vessels: hepatic artery and hepatic portal vein. Hepatic vein carries blood away from liver.
Liver cancer is a form of cancer with a high mortality rate. Liver cancers can be classified into two types. They are either primary, when the cancer starts in the liver itself, or metastatic, when the cancer has spread to the liver from some other part of the body. In adults, most primary liver cancers belong to one of two types: hepatomas, or hepatocellular carcinomas (HCC) and cholangiomas, or cholangiocarcinomas. HCC starts in the liver tissue itself while cholangiomas develop in the bile ducts inside the liver.
Signs & Symptoms:
The following are the most common symptoms of a liver hepatoma:
� Pain in the right upper abdomen that may extend to the back and shoulder.
� Abdominal pain is the most common symptom of HCC.
� Loss of appetite.
� Weakness
� Weight loss
� Nausea and vomiting
� If the tumor blocks ducts of liver or gall bladder, patient may suffer from jaundice. Jaundice patients have yellow skin and eyes and dark urine.
� Fever
� Developing a collection of fluid, known as ascites, in the abdominal cavity.
� Bleeding into the digestive tract.
Methods of diagnosis:
First of all, doctors check the patient\'s history for risk factors, then they make some diagnostic tests including physical tests, blood tests and imaging tests.
Physical Examination: The doctor examines the patient�s abdomen to check the liver and spleen for any abnormal masses, lumps or ascites. The liver is usually swollen and hard in liver cancer patients. Doctors may also check skin and eyes for signs of jaundice.
Blood Tests: In blood tests, alpha-fetrprotein is usually checked as its high level is a sign of liver cancer.
CT Scan: An x-ray machine that helps the doctor to picture the liver and nearby organs and observe any tumors. In CT scan, patient is usually injected by a dye for clearer picture of the liver.
Ultrasound Test: Another imaging technique used to create a picture of the liver. Ultrasound depends on the property that tumors produce echoes different than that produced by healthy tissues.
MRI (Magnetic Resonance Imaging): This imaging device depends on magnetic resonance. A magnet is used to make detailed pictures of areas inside the body.
Angiogram: A dye is injected into the patient�s artery, then liver�s blood vessels show up on x-ray. Hence, doctors can discover any tumors in the liver.
Liver Biopsy: In biopsy, doctors remove a sample tissue and examine it under microscope to detect and cancer cells. If doctor uses a thin needle to obtain the tissue sample, this is called �fine needle aspiration,� however, if he uses a thick needle it is called then �core biopsy�.
Laparoscopy: The doctor makes a cut in the patient�s abdomen and inserts a small tube called a laparoscope to view patient�s liver. Then the doctor takes a small piece of tissue and examines it under the microscope for the presence of cancer cells.
Risk Factors:
Gender: Males are twice as likely as females to get liver cancer.
Age: Most liver cancers occur in people over 60 years old.
Cirrhosis: It is a disease that happens when fibrous tissue develops and destroys liver cells and constricts blood vessels. Cirrhosis may my caused by alcoholism, ingestion of poison, virus infection and certain parasites. About 5 percent of people with cirrhosis develop liver cancer.
Chronic Liver Infection (Hepatitis): Chronic infection with hepatitis B virus or hepatitis C virus represents the most important risk factor for liver cancer. Those viruses can be transmitted from person to person through blood or sexual contact. Besides, a mother can infect her baby during pregnancy.
Aflatoxin: Aflatoxin is a harmful material that can be formed on peanuts by certain types of mold. Aflatoxin increases the risk of developing liver cancer.
Treatment:
Treatment of liver cancer is based on several factors, including the type of cancer whether it is primary or metastatic, cancer stage and the patient\'s age.
Surgery: Surgical options are limited to patients whose tumors are contained within one lobe of the liver, and if the patient does not have either cirrhosis, jaundice, or ascites. The operation is called a partial hepatectomy, or partial removal of the liver because the surgeon removes either a lobe of the liver or cut out the area around the tumor.
Chemotherapy: Unlike the normal liver, hepatocellular carcinoma gets its blood supply from one blood vessel: hepatic artery. A tube (catheter) can be placed in the hepatic artery of the liver and an implantable infusion pump can be installed. The pump allows much higher concentrations of the cancer drug to be carried to the tumor than is possible with chemotherapy carried through the bloodstream. The drug that is used for infusion pump therapy is usually floxuridine (FUDR). Systemic chemotherapy can also be used to treat liver cancer. The most commonly used systemic chemotherapeutic agents are doxorubicin (Adriamycin) and 5-fluorouracil (5 FU). Systemic chemotherapy does not, however, significantly lengthen the patient\'s survival time.
Radiation Therapy: Radiation therapy is the use of high-energy rays or x-rays to kill cancer cells or to shrink tumors. Its use in liver cancer, however, is only to give short-term relief from some of the symptoms.
Liver Transplant: Most liver cancer patients have liver cirrhosis also and would not tolerate surgery. Liver transplant is the removal of the patient�s diseased liver and transplanting a donor liver instead.
Percutaneous Ethanol (Alcohol) Injection: In this technique, pure alcohol is injected into the tumor through a very thin needle with the help of ultrasound or CT visual guidance. Alcohol destroys the tumor by dehydrating its cells.
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