- The liver
- What is liver cancer?
- The risk factors for liver cancer
- Symptoms
- Diagnosis
- Orthodox treatment
The liver
The liver is a large organ located on the right side of
the abdomen and is protected by the rib cage. The liver has
many functions. It plays a role in converting food into energy.
It also filters and stores blood.
What is liver cancer?
Liver cancer is a disease in which liver cells become abnormal,
grow out of control, and form a cancerous tumor. This type
of cancer is called primary liver cancer. Primary liver cancer
is also called malignant hepatoma or hepatocellular carcinoma.
Very young children may develop another form of liver cancer
known as hepatoblastoma.
The risk factors for liver cancer
The development of liver cancer is believed to be related
to infection with the hepatitis-B virus (HBV) and hepatitis-C
virus (HCV). Scientists estimate that 10 to 20 percent of
people infected with HBV will develop cancer of the liver.
Evidence of HBV infection is found in nearly one-fourth of
Americans with liver cancer. The exact relationship between
HCV and cancer of the liver is being studied.
Researchers have found that people with certain other liver
diseases have a higher-than-average chance of developing primary
liver cancer. For example, 5 to 10 percent of people with
cirrhosis of the liver (a progressive disorder that leads
to scarring of the liver) will eventually develop liver cancer.
Some research suggests that lifestyle factors, such as alcohol
consumption and malnutrition, cause both cirrhosis and liver
cancer.
Aflatoxins -- a group of chemicals produced by a mold that
can contaminate certain foods, such as peanuts, corn, grains,
and seeds -- are carcinogens (cancer-causing agents) for liver
cancer.
Symptoms
Primary liver cancer is difficult to detect at an early stage
because its first symptoms are usually vague. As with other
types of cancer, this disease can cause a general feeling
of poor health. Cancer of the liver can lead to loss of appetite,
weight loss, fever, fatigue, and weakness.
As the cancer grows, pain may develop in the upper abdomen
on the right side and may extend into the back and shoulder.
Some people can feel a mass in the upper abdomen. Liver cancer
can also lead to abdominal swelling and a feeling of fullness
or bloating. Some people have episodes of fever and nausea,
or develop jaundice, a condition in which the skin and the
whites of the eyes become yellow and the urine becomes dark.
It is important to note that these symptoms can be caused
by primary or metastatic cancer in the liver, by a benign
(noncancerous) liver tumor, or by other, less serious conditions.
Only a doctor can tell for sure.
Diagnosis
To make a diagnosis of liver cancer, the doctor takes a medical
history, does a careful physical examination, and orders certain
tests.
- Certain blood tests are used to see how well the liver
is functioning. Blood tests can also be used to check for
tumor markers, substances often found in abnormal amounts
in patients with liver cancer. The tumor marker alpha-fetoprotein
(AFP) can be useful to help diagnose liver cancer. About
50 to 70 percent of people who have primary liver cancer
have elevated levels of AFP. However, other cancers such
as germ cell cancer and, in some cases, pancreatic and gastric
cancer, also cause elevated AFP levels.
- X-rays of the chest and abdomen, angiograms (x-rays of
blood vessels), CT scans (x-rays put together by computer),
and MRI's (images created by using a magnetic field) may
all be part of the diagnostic process.
- Liver scans using radioactive materials can help identify
abnormal areas in the liver.
- The presence of liver cancer is confirmed with a biopsy.
Tissue from the liver (biopsy specimen) is removed (through
a needle or during an operation) and checked under a microscope
for the presence of cancer cells. The doctor may also look
at the liver with an instrument called a laparoscope, which
is a small tube-shaped instrument with a light on one end.
For this procedure, a small cut is made in the abdomen so
that the laparoscope can be inserted. The doctor may take
a small piece of tissue during the laparoscopy. A pathologist
then examines the tissue under the microscope to see if
cancer cells are present.
Orthodox treatment
Liver cancer is difficult to control unless the cancer is
found when it is very small. However, treatment can relieve
symptoms and improve the patient's quality of life. Treatment
depends on the stage (extent) of disease, the condition of
liver, and the patient's age and general health. The doctor
may recommend surgery, chemotherapy (treatment with anticancer
drugs), radiation therapy (treatment with high-energy rays),
biological therapy (treatment using substances that help the
body fight the cancer), or a combination of these treatment
methods.
Treatment by stage
Treatments for adult primary liver cancer depend on the stage
of the disease the condition of the liver, and the patient's
age and general health. Standard treatment may be considered,
based on its effectiveness in patients in past studies, or
participation into a clinical trial. Many patients are not
cured with standard therapy, and some standard treatments
may have more side effects than are desired. For these reasons,
clinical trials are designed to find better ways to treat
cancer patients and are based on the most up-to-date information.
Clinical trials are ongoing in most parts of the country for
most stages of adult liver cancer.
Localized Resectable Adult Primary Liver Cancer
Treatment is usually surgery (resection). Liver transplantation
may be done in certain patients. Clinical trials are testing
adjuvant systemic or regional chemotherapy following surgery.
Localized Unresectable Adult Primary Liver Cancer
Treatment may be one of the following:
1. Blocking the hepatic artery and then injecting chemotherapy
drugs into the artery and liver (chemoembolization), surgery
to freeze and kill the tumor (cryosurgery), injection of ethanol
into the tumor, or use of highly focused radio waves designed
to destroy the tumor.
2. Liver transplantation.
3. Regional chemotherapy, including injecting the chemotherapy
directly into the tumor.
4. Systemic chemotherapy.
5. Surgery with or without chemotherapy possibly followed
by radiation therapy.
6. Injection of alcohol directly into the tumor.
7. Radiation therapy plus special drugs that make the tumor
more susceptible to the radiation.
8. Highly focused radio waves designed to destroy the tumor
Advanced Adult Primary Liver Cancer
Treatment of advanced adult primary liver cancer depends on
what treatment a patient has already received, the part of
the body where the cancer has come back, whether the liver
has cirrhosis, and other factors. Patients may wish to consider
taking part in a clinical trial.
Recurrent Adult Primary Liver Cancer
Treatment of recurrent adult primary liver cancer depends
on what treatment a patient has already received, the part
of the body where the cancer has come back, whether the liver
has cirrhosis, and other factors. Patients may wish to consider
taking part in a clinical trial.
|
