Liver Cancer Introduction

The location and function of liver cancer 

 Liver is the body's largest organ, is located in the body cavity of the right upper abdomen, protected by the ribs. 

 Liver has many functions, including: 

 Manufacture of anticoagulant substances and the majority of plasma proteins. 

 Engulfed damaged red blood cells and white blood cells, and certain bacteria. 

 Detoxification. 

 Food into energy. 

 Manufacture of bile. 

 Glucose uptake and storage. 

 What is liver cancer? 

 Hepatocellular carcinoma liver cells are abnormal changes in a disease, it is not unusual to split the control and the formation of cancerous tumors. This type of cancer known as primary liver cancer. Also known as primary liver cancer or hepatocellular carcinoma malignant liver tumor. Many young children may produce another type of liver cancer called germ cell tumor of the liver. 

 Other organs from the body of cancer spread to the liver (metastatic carcinoma) and primary hepatocellular carcinoma is not the same. Described below are mainly based on adult primary liver cancer 

 A risk factor for liver cancer 

 Formation and infection of hepatitis B-and C-related hepatitis. Scientists estimate 10 ~ 20% infected with hepatitis B will develop liver cancer. In Taiwan has 80 ~ 90% of liver cancer patients have been infected with hepatitis B. And hepatitis C and liver cancer is still the precise relationship between studies. 

 The study found those with certain liver diseases, people have a higher chance of suffering from primary liver cancer. For example, 5 ~ 10% of liver cirrhosis (a progressive disease leading to liver damage) of patients will eventually develop liver cancer. Some studies also showed that life style, such as excessive drinking and malnutrition, will lead to cirrhosis and liver cancer. 

 Aflatoxin - a group of things by the moldy arising from chemical substances, will pollute the certain foods such as: peanuts, corn, grains and seeds, is a carcinogenic factor. 

 Liver cancer symptoms 

 Early primary liver cancer because early symptoms are usually not obvious, it is very difficult to detect. Like other cancers, liver cancer and also have a common physical symptoms of discomfort. Liver may lead to loss of appetite, weight loss, fever, fatigue and weakness. 

 When the cancer grew, the Department may have right upper quadrant pain phenomenon and may extend to the back and shoulders. Some people may have touched on the abdominal mass. Liver can also lead to abdominal swelling and have a sense of satiety. Some patients may have fever, nausea or jaundice phenomena, jaundice is a yellowing of the skin and the white of the eye and have dark brown urine phenomenon. 

 It should be noted that the primary or metastatic liver cancer, other benign liver tumor or some less serious illnesses, will cause the above-mentioned symptoms. Only a professional physician and the diagnosis can be established, it has similar symptoms, do not need to panic, but medical treatment as soon as possible. 

 Liver Cancer Diagnosis 

 Doctors will carry out the inquiry history, detailed physical examination and the use of other special inspection to determine the diagnosis. 

 Some hematology tests can be used to test liver function. Blood test can also be used to check the tumor marker, the material index in liver cancer patients are usually abnormal rise. Fetal protein can be used to help diagnose liver cancer. About 50 ~ 70% of liver cancer patients fetoprotein (α-fetoprotein; AFP) index will rise. However, other cancers such as germ cell tumors, pancreatic cancer or gastric cancer patients, may also have fetal globulin rose. 

 Chest and abdominal X-rays, computed tomography and magnetic resonance imaging can also be used to do is to diagnose. 

 

 Angiography in the examination process, the catheter will be placed in the transport of blood to the liver's main blood vessels inside. Reagent will be injected through this catheter into the blood vessels so the liver can be demonstrated X-ray. Angiography can help physicians determine the primary liver cancer or are other parts of the body to the spread of metastatic cancer. This inspection usually need to be implemented in the hospital. 

 Liver scan is the use of radioactive material to help determine the site of the liver abnormalities. 

 

 To establish the diagnosis of liver cancer, the most reliable biopsy are accepted. If the X-ray inspection (such as computer tomography) have found the existence of mass, physicians may be through the X-ray guidance to insert intra-abdominal use of fine needle aspiration from the liver to obtain a small number of organizations under the microscope to observe whether there is the existence of cancer cells, that is, known as fine needle aspiration biopsy. Physicians will be in check before the injection of local anesthetic in the scope of sections, so that patients feel no pain. Physicians may also use a laparoscopic instruments, a small light source end of the pipe has to observe the liver. The process of cutting in the abdomen on a small incision in laparoscopic implantation. In the course of laparoscopy to remove a small piece of Chinese medicine practitioners will be organization. Pathologists will be placed on the microscope under the organization in order to observe whether there is the existence of cancer cells.

Liver cancer treatment 

 Except in the very hour Cancer was found, otherwise it is difficult to control liver. However, treatment can reduce symptoms and improve quality of life of patients. Treatment according to disease stage, liver function, the patient's age and general condition of the body. Doctors may recommend surgery, chemotherapy, radiation therapy, biological agents or combined therapy using the above treatment. 

 Surgical treatment 

 The purpose of surgical treatment to remove the tumor or part of liver replacement: 

 Liver resection liver resection lesions are part of. 

 Liver transplant is to remove the entire liver and replacement from the donor onto a healthy liver. Only a very small number of patients suitable for liver transplant. 

 Frozen by frozen resection is a surgical method to kill cancer cells. 

 Hepatic artery embolization (Transcatheter Arterial Embolization referred to as TAE) 

 Normal liver has 70-75% of the total blood is supplied by the portal vein, which has 20-30% are from the hepatic artery, while patients suffering from hepatocellular carcinoma, the cancerous growth of 90-95% of blood required for hepatic artery . Hepatic artery embolization is the use of catheter embolization substances or anticancer substances into the hepatic artery so that hepatic artery occlusion, and hepatoma cells due to lack of nutrients will supply and necrosis. Normal liver cells from portal vein blood supply, can still maintain its function. 

 Hepatic artery embolization is a radiation specialist from the Executive. Patients should be lying on the platform of vascular cameras by local disinfection and local anesthesia, the doctor will use a needle puncture from the groin into the femoral artery to determine the needle into the femoral artery after the catheter insertion, along the femoral artery, abdominal main artery and depth within the hepatic artery. Physicians will be in these blood vessels branch into the reagent for angiography in order to understand the distribution of hepatic artery, hepatic portal vein smooth degree and tumor location, size and number. If the patients were assessed for hepatic artery embolization to do, then doctors will try to catheter to place close to liver cancer, and then injected into the oily iodine embolization material (Lipiodol) and the mixture of anti-cancer drugs, blocking its blood flow, and so that liver cell necrosis. 

 After treatment of cancer patients may be due to necrosis or the role of anti-cancer drugs caused by upper abdominal pain, fever, vomiting and even the phenomenon, and its will subside in a week or so. But other complications have gastrointestinal bleeding, gallbladder necrosis, splenic abscess, liver abscess, acute pancreatitis, obstructive jaundice and so on, the frequency of these complications was not high. 

 Hepatic artery embolization for the implementation of treatment, liver cancer patients to choose, if cirrhosis, portal vein obstruction, jaundice, low blood pressure would be extra cautious. In general, hepatic artery embolization for large hepatocellular carcinoma, decompensated liver function in patients with good results, but it may result in non-hepatocellular carcinoma part of the liver cell necrosis, so as decompensated liver function of liver cancer patients, make End of postoperative hepatic artery embolization may cause further liver failure and death, and there are still, after hepatic artery embolization syndrome. And hepatic artery embolization of the technically more difficult, especially in elderly patients with atherosclerosis have, therefore not suitable for hepatic artery embolization, and small hepatocellular carcinoma (less than 5 or 3 cm), liver cancer is less than the number of three From the form of percutaneous ethanol injection method is more suitable.

Percutaneous ethanol injection (Percutaneous Ethanol Injection) 

 Suited to make percutaneous ethanol injection therapy in patients with conditions including: À largest tumor diameter less than 3 cm; Á Cancer of less than 3; Â without ascites without bleeding tendency. Percutaneous transhepatic ethanol injection therapy of high concentration in the abdominal ultrasound under the guidance of local anesthesia through long needles to insert accurate tumor, and then high concentrations of alcohol (99.5%) slowly into the liver after dehydration caused by cancer cells, coagulation necrosis and vascular thrombosis, necrosis of obstruction caused by cancer cells. Percutaneous ethanol injection in a single injection is usually not completely successful, generally about 2-3 times a week, each tumor in accordance with the injection of the total tumor size, the effect of tumor necrosis and the patients to determine the degree of acceptance. 

 As for complications, most are percutaneous ethanol injection treatment of local pain, chills, shivering, fever of the phenomenon, but most of these symptoms after taking a small amount of painkillers, it can alleviate. 

 Radiation Therapy 

 Radiation therapy is the use of X-ray or other high-energy rays to kill cancer cells or tumor shrinkage. Radiation may come from machines, in vitro irradiation (radiation therapy or in vitro). Or direct the placement of a radioactive material with a thin plastic tubes in the tumor site (ie, in vivo radiation therapy). Radiotherapy can be given by certain drugs to increase the sensitivity of cancer cells to radiation (ie radiation sensitization). 

 Radiation can also be given by the antibodies attached to radioactive substances (ie, radioisotope tracking antibodies) to identify the particular liver cells. Antibodies are manufactured by the body to fight germs and other harmful substances, usually of different antibodies against different cells. 

 Chemical treatment 

 Chemical treatment is the use of drugs to kill cancer cells. Liver cancer chemotherapy are usually fine needle inserted into the body of the vein or artery. Because the drug will enter body, killing cancer cells outside the liver, and they are systemic chemotherapy treatment. Another chemical treatment known as localized chemotherapy, a continuous drug injection pump will be placed in the body. This pump drugs directly into the Department of Vascular Get Cancer. 

 If the physician through surgery to remove the tumor, the patient may be in the postoperative chemotherapy to kill remaining cancer cells. Postoperative chemotherapy to eliminate residual cancer cells is called adjuvant chemotherapy. 

 Heat therapy 

 High-temperature treatment is still in clinical trials is the use of a special machine to heat a part of the body some time to kill cancer treatment. Than normal cells because cancer cells more sensitive to heat, so as to enable the cancer cells die, the tumor will shrink. 

 Biological agents therapy 

 Therapy and biological agents are still in pre-clinical testing stage, is to use a physical approach to fight against cancer. Certain substances from the body or in the laboratory, manufacturing, had been used to enhance, command or restore the body's natural defense mechanisms to combat the disease, therapy of biological agents, also known as biological response modifier therapy or immunotherapy. 

 Clinical trials 

 Clinical trials are designed to discover more effective treatment method or a better use of existing methods. Participation in clinical trials in patients with liver cancer are a lot of choice. In some studies, all patients received the new treatment. While in other studies, patients with a group of physicians will accept the new treatment and another group of patients receiving standard treatment. Nevertheless, doctors can compare different treatment modalities. At present, liver cancer clinical trials, most physicians in the study of new anti-cancer drugs and drug combinations. They also are studying new methods of chemotherapy given, such as direct placement of drug to the liver. Other studies include cryotherapy (via surgery, the use of a refrigeration equipment and methods of destruction of cancer cells) and combined a variety of standard treatment.