LIVER CANCER

What Is Liver Cancer ?

There are two main kinds of liver cancer. Heptoma and cholangiocarcinoma. Heptoma is cancer of the hepatocytes. (The main functioning liver cell). Hepatoma is primary liver cancer. Hepatoma usually grows in the liver as a ball-like tumor, invading the normal tissue surrounding it. A history of infection with the hepatitis B virus puts individuals at risk of developing heptoma.

Cancer of the bile duct cells is called cholangiocarcinoma. Cholangiocarcinoma originates in the bile ducts and is often caused by infestation with the liver fluke Clonorchis (a parasite). The cancer grows along the bile ducts in sheets or lines, and is hard to find on X-ray studies.

Most cases of liver cancer are actually cancers that started in another organ. This is called metastases. Because of its very high blood flow and many biological functions, the liver is one of the most common places for metastases to grow. Tumors that originally arise in the colon, pancreas, stomach, lung or breast can spread to the liver.

Liver cancer is much more prevalent in many of the developing countries than in the industrialized world. Its incidence is highest in sub Saharan Africa, China, southern Asia, and Japan. Japan is the exception of the industrialized countries. China accounts for about 45% of the world’s cases.

What Causes or Increases Risk for Liver Cancer?

Once cause of liver cancer is exposure to vinyl chloride. Other causes of liver cancer are unknown. However certain risk factors have been identified. The risk factors are: Chronic Hepatitis, Cirrhosis of the liver and liver flukes (parasites). What are the symptoms of Liver Cancer?A very early cancer will have little or no symptoms. It will have little or no symptoms because it is too small to cause any. As the cancer enlarges, it will have symptoms.

The common symptoms are:

• Pain in the right upper abdominal area. Stretching of the liver’s capsule causes pain.
  
  
• Weight Loss and loss of appetite.
  
  
• Breast swelling in males
  
  
• Blood clotting problems leading to intestinal bleeding and bruises on the skin.
  
  
• Jaundice

How will my doctor know if I have liver cancer?

A. If liver cancer is suspected, the doctor will conduct a physical examination and a medical history. During a medical history, the patient will be asked questions about incidence of cancer in his/her family and other possible risk factors. Further tests help a doctor determine if cancer is causing symptoms. Some tests may include alpha-fetoprotein (AFP) blood test, ultrasonography (ultrasound), computed tomography (CT), magnetic resonance imaging (MRI), angiography’s, laparoscope’s and biopsy. 

What are the side effects of treatment?

It is hard to limit the effects of therapy so that only cancer cells are destroyed. Because treatment often damages healthy cells and tissues, it can cause unpleasant side effects. The side effects of cancer treatment vary, depending on the type of treatment. Also, each patient reacts differently.

The side effects of surgery depend on the extent of the operation, the patient’s general health and other factors. Pain for the first few days after surgery is to be expected, but it can be controlled with medicine. People should feel free to discuss pain relief with the doctor or nurse.

Because it affects the whole body, chemotherapy is useful for treating liver metastases from other tumors. Chemotherapy damages rapidly dividing cells, like cancer cells. Unfortunately, other cells in the body, like hair follicle cells, cells lining the digestive tract, and blood-producing cells of bone marrow are also affected by chemotherapy, causing hair loss, nausea and vomiting, mouth sores, bruising and bleeding, increased chance of infection, and fatigue. Doctors can alleviate some of these symptoms with medication, so patients with side effects should inform their cancer care team. Recently, hepatic artery infusion has been studied as a treatment for HCC. This is a type of regional chemotherapy in which drugs are injected directly into the artery that supplies blood to the liver.

Radiation therapy is not often used because the entire liver, not just the tumor, is negatively affected by the radiation, and no real effect on survival has been shown.