Saturday, August 20, 2011

Liver Cancer

Cancer of the liver is known as Hepatocellular Carcinoma. When patients or physicians speak of liver cancer, however, they are often referring to cancer that has spread to the liver, having originated in other organs (such as the colon, stomach, pancreas, breast, and lung). More specifically, this type of liver cancer is called metastatic liver disease (cancer) or secondary liver cancer. This i common compared to primary liver cancer and frequently leads to confusion, because the term liver cancer actually can refer to either metastatic liver cancer or hepatocellular cancer. Liver cancer is the third most common cancer in the world, and the majority of patients with liver cancer will die within one year as a result of the cancer.
Causes, incidence, and risk factors
Hepatocellular carcinoma accounts for most liver cancers. This type of cancer occurs more often in men than women. It is usually seen in people ages 50 - 60. Hepatocellular carcinoma is not the same as metastatic liver cancer, which starts in another organ (such as the breast or colon) and spreads to the liver.
In most cases, the cause of liver cancer is usually scarring of the liver (cirrhosis). Cirrhosis may be caused due to alcohol abuse (the most common cause), certain autoimmune diseases of the liver, diseases that cause long-term inflammation of the liver, hepatitis B or C virus infection or too much iron in the body (hemochromatosis). Patients with hepatitis B or C are at risk for liver cancer, even if they do not have cirrhosis
Diabetes, obesity, anabolic steroids and tobacco use can also cause liver cancer.
Symptoms
·    Abdominal pain or tenderness, especially in the upper-right part
·    Easy bruising or bleeding
·    Enlarged abdomen
·    Weight-loss and lack of apetite
·    Yellow skin or eyes (jaundice)
Signs and tests
Physical examination may show an enlarged, tender liver.  The combination of an imaging study (ultrasound, CT, or MRI scans) and an elevated blood level of alpha-fetoprotein most effectively diagnoses liver cancer. A liver biopsy can make a definitive diagnosis of liver cancer, but the procedure requires an expert liver pathologist and is not necessary for all patients.
Treatment
Aggressive surgery or a liver transplant can successfully treat small or slow-growing tumors if they are diagnosed early. However, few patients are diagnosed early. Chemotherapy and radiation treatments are not usually effective. However, they may be used to shrink large tumors so that surgery has a greater chance of success.
Ablative and local techniques such as chemoembolization, radioembolization, radiofrequency or cryoablation, and stereotactic radiosurgery can by very useful in controlling individual cancers for an extended time. Surgical resection (removal) of the tumor may be curative for a select group of individuals with liver cancer, specifically for those with small tumors and healthy liver function.
Sorafenib tosylate (Nexavar), an oral medicine that blocks tumor growth, is now approved for patients with advanced hepatocellular carcinoma. However please seek advice from a reputed doctor before taking any medication.
Prognosis
The usual outcome is poor, because only 10 - 20% of hepatocellular carcinomas can be removed completely using surgery. If the cancer cannot be completely removed, the disease is usually fatal within 3 - 6 months. However, survival can vary, and occasionally people will survive much longer than 6 months.
Complications include gastrointestinal bleeding, liver failure and spread (metastasis) of the carcinoma. Call your health care provider if you develop persistent abdominal pain, especially if you have a history of any liver disease.
Prevention
Preventing and treating viral hepatitis may help reduce your risk. Childhood vaccination against hepatitis B may reduce the risk of liver cancer in the future. Avoid drinking excessive amounts of alcohol. Certain patients may benefit from screening for hemochromatosis.
If you have chronic hepatitis or known cirrhosis, periodic screening with liver ultrasound or measurement of blood alpha fetoprotein levels may help detect this cancer early.

1 comment:

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