Liver cancer treatment

Liver cancer treatments necessary to take into account a patient's liver function, because patients with these two diseases will cause death; another tumor size, number and location can also affect treatment planning. Hepatocellular carcinoma on the effects of chemotherapy well, in fact extremely sensitive to radiation therapy, in theory suitable for radiotherapy, but around the same non-cancerous liver cells are extremely sensitive to radiation, unless the location of the tumor proper, otherwise, easy exposure to the surrounding organization caused by liver failure, it is often only used in the transfer of bone lesions such as the exposure. Currently recognized only surgical resection and liver transplantation are the eradication of treatment, liver cancer is still the first choice of treatment. However, because most patients and has cirrhosis, larger tumor resection often restricted in order to avoid postoperative liver failure. And patients seeking medical treatment should have around 50% more than a liver, and distributed in different sections of liver. Such characteristics of lesions caused by many to finish a knife from a different place will grow a new liver, making surgery after a high incidence. For these reasons, really suitable for surgical resection of the cases are rare. Therefore non-surgical local treatment of an extremely high rate of recurrence of liver cancer treatment is very important. Non-surgical treatment, including partial removal of the local (Local ablation), transcatheter arterial chemo-embolization (Transcatheter arterial chemo-embolization, TACE) and so on. Including partial removal of the tumor pure alcohol (PEIT) or acetic acid injection (PAI), burning microwave (Microwave), radio frequency cautery (Radiofrequency), lasers, hot cautery probe (Heater probe) or cold therapy (Cryotherapy) in terms of their common principle for the use of local physical or chemical changes caused by cell necrosis, more will not hurt the other liver function. Application can be transmitted by way of ultrasound-guided percutaneous, CT-guided percutaneous, laparoscopic surgery when puncture or by ultrasound-guided puncture. The most commonly used for tumor ethanol injection. These methods more appropriate to 3-4 cm in diameter tumor, the number should not be too general for use in tumor less than three cases. It should be noted that most side effects of internal bleeding caused by puncture, so the prior determination of a patient's coagulation function, how to avoid the purposes of the volume of ascites in patients. There is still a small number of patients in the treatment of liver function has deteriorated after the emergence of another may also be because the tumor itself is extremely transfers differentiation everywhere a bad liver, has transferred to the needle channels (liver surface or skin) report. 

 Cancer hospital to provide medical digestion with pure ethanol injection (PEIT) or radio frequency cautery (Radiofrequency ablation) to treat patients in the abdominal ultrasound room to implement. Hepatocellular carcinoma with pure ethanol injection (PEIT) is the coagulative necrosis, because of the proliferation of alcohol is limited, so can only be used for small hepatocellular carcinoma. Ethanol injection of liver cancer in the side-effects include: abdominal pain, injection Office have burning sensation, abdominal discomfort, temporary fever, may also be temporary AST / ALT, bilirubin increased, and clotting time prolonged, albumin lower and liver failure. Cancer in the merits of ethanol injection are having surgery, simple, safe, without serious side effects, a small amount of play can be done out-patient clinics do not have to stay home and take a rest. Only disadvantage is the treatment of hepatocellular carcinoma, the distribution of alcohol in the liver and sometimes unpredictable, treatment must be repeated, for example, twice a week a total of four to six range. 

 Radio frequency cautery (Radiofrequency ablation) the use of coarse needles, in both sides of the thigh after shaving paste electrodes after chip implementation, the use of current flows through the organization have a thermal resistance of tumor cell degeneration. Single Cancer therapy single time a long time, side-effects within the same tumor but pure ethanol injection may be more serious and must be hospitalized for observation. The advantages of radio frequency cautery are having surgery, very few serious side effects, reduce treatment frequency, not only the treatment of primary liver cancer, but also the treatment of secondary liver cancer. Disadvantage are expensive, have vascular tumor next to easily flow away from hot to be a result of residual tumor, tumor location is too easy to work together next to the adjacent organ spread, the use of coarse needles easier to bleeding and may lead to transfer to the next pin way, although when times reusable needles buy the caliber of the next may not be able to apply to health insurance only paid a fixed-diameter needle (LeVeen needle), and since the approval of the use of invasive diagnostic to around one-month time-consuming, so most patients are still choose, at their own expense and paid by insurance companies. 

 Transcatheter arterial chemo-embolization (Transcatheter arterial chemo-embolization, TACE) implemented by the radiologist, there are different embolization materials, including soluble, absorbable embolic material and can not be dissolved, will not be absorbed by embolization material. Larger than 250μm embolization material can be stuffed larger hepatic artery, proximal embolization is a kind of objects smaller than 250μm embolization embolization were compared with surrounding structures. Surrounding material to do with embolization TACE, can lead to tumor necrosis, but it also makes a larger non-tumor destruction, resulting in such as liver failure, liver abscess, gallbladder gangrene and other complications. On the other hand, objects to do with proximal embolization TACE, tumor necrosis less completely, but its complications are also less. Does the timing of TACE for the (1) liver cancer patients not suitable for larger or refuse surgery, but its also a good liver function, (2) no major hepatic portal vein tumor thrombus, (3) of the patients have symptoms and have serious movement shunt, (4) rupture of hepatocellular carcinoma. TACE of the side effects include: fever, abdominal pain, loss of appetite, nausea, vomiting, gastrointestinal bleeding, liver failure, acute cholecystitis, bile duct necrosis and acute pancreatitis go far.