Lu liver dawn! New therapies enemy from the inside out

Trojan remember is the history of ancient Greece a famous battle, and now the treatment of liver cancer, there have been similar to the Trojan horse of new technologies. Taipei Veterans General Hospital introduced radiotherapy in vivo, will have millions of radioactive yttrium 90 microspheres directly to the liver itself, from the inside out to release a high radiation dose to kill cancer cells. 

 Taipei Veterans General Hospital last year, the introduction of the "Y-90 microspheres - selective body radiotherapy," admitted a total of 41 liver cancer and other terminal cancer patients with metastasis to the liver, a good therapeutic effect. "This from the inside out of the end of radiotherapy in patients with liver cancer has provided the last chance of survival!" Taipei Veterans General Hospital Department of Radiology, said Dr. Rheun-Chuan Lee, in accordance with the present treatment, in patients with terminal liver cancer is no cure, and the radioactive element yttrium 90 microspheres provide a new hope. 

 However, this new medication therapy alone have to spend more than 40 million, pre-and postoperative examination of the patient have at their own expense, all medical expenses more than 600,000 yuan. 

 Rheun-Chuan Lee pointed out that the radioactive element Yttrium-90 containing microspheres, the diameter is very small, only about one-third of the hair, by the way angiography in the liver, from the groin into the hepatic artery within the liver directly to the microspheres blood vessels inside tumors, and then gradually released within two weeks of high-dose radiation, to kill liver tumors. 

 Rheun-Chuan Lee explained that in addition to Y-90 microspheres, the radiation from all the other outside, the radiation from the in vitro into the human body, therefore, can not be too high dose, not to harm normal tissue, and the microspheres is from the inside out , in addition to high accuracy, the radiation dose is also higher, at around the other two to three times the radiation. 

 Trojan horse as the same way the use of angiography, Y-90 microspheres was sent after the hepatic artery, it will take the initiative to look for cancer cells. Tumor blood vessels as a result of the flow near the larger, 90-yttrium microspheres target, you enter the tumor, emit radiation to kill tumor lines. 

 Rheun-Chuan Lee pointed out that the current accepted treatment of patients with Y-90 are mostly due to the failure of multi-line chemotherapy or other treatment of patients with terminal liver cancer invalid, clinical showed that after two months follow-up found that 41 patients, about tumor shrinkage or five well-controlled. 

 As to whether the Y-90 microspheres in the treatment of other cancers do? The answer is no. Linked to other organs because the blood vessels, so can not use this type of radiation "

Examples of advanced liver cancer treatment

Patients with major medical conditions: 

     Liu, male, 5 9-year-old, a worker. 3 years ago in patients with liver conscious pain, fatigue, check liver function: ALT, zinc turbidity are high, albumin 3.5%, globulin 3.7 grams%, for the treatment of chronic hepatitis. Recent exacerbations for alpha-fetoprotein positive Detected by B ultrasound and CT scan diagnosis found that the lower right lobe of liver lesions diagnosed as advanced primary liver cancer. Patient liver pain, intermittent tingling, dark complexion dark, weak body tired, dry mouth would be binding, purple-red tongue without coating, the pulse string Shen. This is the liver and kidney , the fire inside the virtual Chee; governance with Yangyin Rougan, accompanied by stasis of goods, check Fuzheng Xiaozheng Capsule original side addition and subtraction. 

     Treatment modalities: 

     Xiaozheng Fuzheng taking capsules. 

 At the same time, external application of Chinese herbal medicine, medicinal mainly Chinese angelica, safflower, Trigonobalanus, Ezhu, Solanum nigrum, flea break, Notoginseng, Lo vespae, Upper Hill guns. Institute respectively, Autoleveller, when the old mature vinegar plus (moderate) to reconcile, Sticking pain. Application area should be greater than the pain, drugs thickness of 0.5 centimeters, the dressing was changed every 2 day 1 times. 

 The above-mentioned more than 2 0 days after treatment, liver pain significantly reduced, and the spirit of a better, also better looking, but dry mouth interdependence.at a glance. Still used in medicine capsules Xiaozheng Fuzheng original side addition and subtraction. 

     Treatment effect: 

 Xiaozheng Fuzheng taking capsules (including medicine for external application), the condition has always been stable. Zhen Xin satisfied God, his condition gradually improved, medication Shou above, appropriate adjustments, and add Yangwei Shugan of goods, good Subsequently, by the said: "Valley may also prosper." 

 Overall: hepatocellular carcinoma are the king, the disease incidence level and the rate of deterioration is very, more rapid development of advanced liver cancer, but the adoption of advanced primary liver cancer in patients with Chinese medicine treatment, can survive more than 1 year , and its induction has: ① cure for this: the main disease in patients with liver cancer, but the righteous have been true, obviously body fluid, so the Chinese medicine treatment, differentiation to be made, in order to Yangyin Fuzheng-based governance must not only attack cancer; If only attack cancer, neglect footer frail, cancer is likely to deteriorate. ② "All internal and external governance, of the justifications phase one" principle, external application of anti-HCC lesions scattered on the surface, so that the drug permeability through the skin pores to Tatsu, the direct effect on the lesion to reduce the symptoms of cancer attacking evil. ③ Shou-side: the treatment of chronic diseases, we must have attack Shou has not often change in order to receive the reservoir effect. ④ attention to the Wei Qi, treatment of chronic diseases, must pay attention to the Wei Qi. Health because it has the Wei Qi, Wei Qi is no defeat. 

 For patients with early liver cancer at the same time, if traditional Chinese and western medicine treatment, patients would be better in the survival, quality of life will have greater improvement.

Liver cancer prevention

Because of the occurrence of liver cancer and chronic B, C hepatitis and cirrhosis are closely related to the prevention of liver cancer is necessary to proceed from this aspect. In patients with chronic hepatitis B, to the best vaccination. There is no hepatitis C vaccine, to avoid non-essential injection, careful pre-transfusion screening of blood products and dialysis equipment disinfection, such as isolation precautions. Chronic B, C hepatitis B carriers should be regularly track blood plus abdominal ultrasonography with a view to identifying small liver cancer early. Should avoid eating aflatoxin, such as known carcinogens.

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.

Diagnostic indicators of liver cancer

Basically, through the serum liver tests, imaging and histopathological examination to diagnose the three aspects: 

 First, serum tests: blood tests the diagnosis of liver cancer are the most simple and convenient methods. Among them, serum "A Fetal protein" (Alpha-fetoprotein, AFP) The most common, can be used as an important indicator of liver tests. A normal fetal protein has an upper limit value, as a general rule in many below 20ng/ml. If more than this ceiling, it is necessary to pay attention to whether there is any possibility of the occurrence of liver cancer. However, inflammation of the liver cell necrosis in the liver cell regeneration, during pregnancy and certain testicular tumor protein when AFP values are likely to go up. Therefore found a species of clinical fetoprotein values have increased, consideration should be given these circumstances. Therefore, if the blood found on the AFP to determine any unusual increase in liver cancer long are incorrect, it should be combined with imaging examinations before they can make accurate judgments. A fetal protein in the value of the normal does not mean that there is no liver cancer, in general, about 85 percent of large hepatocellular carcinoma A-fetoprotein values will rise, but the following three centimeters of small liver cancer, only about two-thirds of patients with AFP higher protein value. So, A normal-fetoprotein value and should not be completely ruled out and will not be the liver, the liver should still refer to abdominal ultrasound to be determined. 

 Second, imaging examination: liver imaging, including abdominal ultrasound, abdominal CT scan, angiography, and MRI. For the diagnosis of liver cancer is very valuable and can make up for inadequate serum test. 

 1. Ultrasound scan: ultrasound scan diagnosis of liver cancer in recent years are the most frequently used imaging tool, it is the biggest advantage of convenience and not invasive, the patient will not be painful. For intrahepatic tumors, even as small as 1 cm, as long as the physician or technician has enough experience, can be detected; Therefore, ultrasound scan screening for liver cancer has become the main tool. Ultrasound can detect liver cancer, apart from size, location, but also can assess whether the liver cancer has invaded blood vessels or bile duct of the phenomenon, in addition to assessing whether patients have cirrhosis of the phenomenon, whether there is ascites, the understanding of the situation for liver cancer patients in the choice of treatment modalities with a very important reference value. However, the accuracy of ultrasound scanning and inspection of those who have considerable experience in the relationship between technology, sometimes a simple ultrasound scan can not correctly distinguish the nature of Cancer, they are often still required further examination to be determined. 

 2. Computed tomography or magnetic resonance imaging: CT or MRI to check for the nature of liver tumors can provide further information. Sometimes the patient's A-fetoprotein value continues to rise, but in the ultrasound scan can not find suspicious lesions, if still a high degree of clinical suspicion Cancer has existed, often required the use of CT or MRI to look for the possibility of liver cancer, especially in the ultrasound scan of the corner location. In addition sometimes liver cancer are invasive, and not obvious mass at the ultrasound scan is not easy and cirrhosis distinction, at this time necessary to rely on other imaging to be determined. CT or MRI scan can also check other than the liver or intra-abdominal intra-abdominal lymph nodes of the great vessels whether liver cancer has been violated, this treatment option for liver cancer have a significant impact. 

 3. Angiography: because with invasive angiography, usually in the final inspection, the patient to accept the inspection process a bit complicated, but if you encounter the following situation, or required by angiography to determine: 

 (1) A fetal protein value continued to rise, but other items can not be found when the liver. 

 (2) ultrasound, computer tomography and magnetic resonance imaging scans have no way to determine the characteristics of liver tumors. 

 (3) by angiography to determine the number of liver tumors, because the number of tumors often affect the liver cancer therapy. 

 Third, histopathological examination: serum tests and imaging studies can only be treated as indirect evidence, still unable to see 100% to determine liver tumor is not liver cancer, liver cancer diagnosis should be the most direct way is the histopathological diagnosis, At this point it needs to be done to check liver tumor puncture, liver tumor puncture aim of the inspection is to obtain a definite diagnosis, in order to determine the treatment method. Occasionally will hear patients say that the liver tumor puncture condition deteriorated would definitely not make the liver tumor puncture 

 This is a wrong concept. Liver Cancer in general will not puncture to check the progress of tumor and treatment has adverse effects, often can help clinicians make the correct diagnosis and decide on the most appropriate treatment. Histopathological examination is to take patients directly suspicious liver tissue to be tested. Organizations in two ways: puncture or surgery. Puncture are used in ultrasound-guided fine needle directly piercing the patient's liver tumor biopsy taken. Surgery to be carried out after the cut section of liver tumor tissue. In general, the clinical use of percutaneous methods are often made organization, but the patients clinically to determine if surgery must accept, it is not necessarily required to puncture in the preoperative examination, you can track receive surgery to cut inspection organizations. If the blood test A value of abnormal fetal protein increased (greater than 400ng/ml), in conjunction with other imaging studies have also showed that liver cancer, we can consider direct treatment. However, if the clinical diagnosis have doubts, we must take into needle biopsy to confirm the diagnosis. If patients have ascites, or abnormal clotting function due to the risk of bleeding has not suitable for on biopsy.

Symptoms and signs of liver cancer

Symptoms of liver cancer at an early hour the volume has not been any special symptoms such as anorexia if burnout is often hepatitis, cirrhosis symptoms. Large tumor, will have weight loss, right upper quadrant pain, hepatomegaly and other phenomena, a small number of patients with internal bleeding due to liver rupture shock treatment. Patients are often mistaken for blood on behalf of the normal liver all normal, which in high-risk group of patients are not applicable. The so-called high-risk groups include: (1) has a family history of liver disease, especially mothers with chronic hepatitis carriers; (2) liver cirrhosis patients, particularly over 40-year-old male. Only regular screening in order to early detection of liver cancer, and get good treatment. Screening methods generally include a species of blood-fetoprotein (alpha-fetoprotein, AFP) measurement and abdominal ultrasound scan. However, only about 20-30% of small hepatocellular carcinoma will increase its AFP and therefore useful for early diagnosis is not very big, but a large number of high-risk patients are still screening the blood of its practicality. Abdominal sonography for the diagnostic accuracy of small liver cancer is very high, up to 95%, but the scans are required a considerable degree of training to identify small hepatocellular carcinoma, and double-check is the amount of time spent in general only for high-risk group of patients. Use a combination of two methods, you can improve the diagnosis rate. For those who have abnormal conduct further abdominal CT scan or angiography, if there is still doubt as further consideration should be given the liver tumor puncture histopathological examination to determine the diagnosis. For patients with cirrhosis should be every three to six months periodic inspection time, asymptomatic chronic hepatitis carriers, currently every 6-10 months once appropriate periodic inspection.

What is Liver Cancer

The definition

 Liver cell mutations and become non-stop fragmentation, gradual destruction of normal liver tissue, and even transferred to other body organs, and thus the destruction of the final life-threatening. 

 

 Prevalence 

 

 Liver cancer mortality in Taiwan are the highest. B-induced liver cancer liver men accounted for about 40-60 years old up to, but also has less than 10 years of age. C liver caused by liver cancer for men and women is similar to many over the age of 50. 

 The cause of liver cancer 

 

 B-type hepatitis, C-type hepatitis, cirrhosis, alcohol, Huang Ju toxins, such as hemoglobin deposition, can cause liver cancer. Which is the largest number of B and C hepatic liver. Deposition, iron deposition, autoimmune, drugs and chronic heart failure and so on. 

 

 The growth rate of liver cancer 

 

 Varies from person to person, the fastest month doubled, the slowest year it doubled. 

 

 Liver cancer symptoms 

 1. The initial no symptoms, it is necessary to open the outer membrane of liver pain before. Sometimes to the end of pain, but can be controlled drugs. 

 2. Sometimes long to jaundice caused by bile duct. 

 3. Sometimes up to Endovascular re-grow to the heart caused by heart failure. 

 4. Sometimes with a fever of unknown causes. 

 5. Sometimes suddenly rupture, causing acute abdominal pain, abdominal bleeding, shock. 

 6. Sometimes just keep up the liver, palpable mass in the upper abdomen. 

 7. Will add to the performance of liver cirrhosis, resulting in liver failure. 

 8. Sometimes asymptomatic liver itself, it is transferred to the brain caused by brain tumor or stroke of similar symptoms, transferred to the bones, causing fractures or pain, transferred to the chest caused by coughing or wheezing. 

 The cause of death of liver cancer 

 

 1. Hepatoma growing, oppression gastrointestinal, eat, malnutrition, debilitating death. 

 2. A sudden rupture of hepatocellular carcinoma, died of shock. 

 3. Hepatocellular carcinoma or liver cirrhosis caused by rupture of esophageal varices, hematemesis. 

 4. Ascites is difficult to control, resulting in infection, sepsis, renal failure. 

 5. Hepatic coma. 

 6. Be transferred organ failure, such as brain metastases, heart failure, respiratory failure,. 

 7. Other complications. 

 The degree of liver cancer 

 Early hepatocellular carcinoma refers to 3-5 cm below the small tumor, usually asymptomatic, surgery or other treatment can. Have symptoms of liver cancer is usually larger or infringe upon the bile duct, blood vessels, or other organs, the majority of late surgery, but may still have to relieve pain or prolong life treatment. Also often associated with liver cirrhosis of liver cancer, cirrhosis of liver cancer will also affect the extent of the prognosis. 

 

 Liver Cancer Treatment 

 

 1. Surgery to remove: must not be transferred, there is no violation of the great vessels, there is no liver failure, the remaining liver enough. 

 2. Ethanol injection: must be less than 3 cm, up to 3, there is not much ascites, there is no transfer, there is no violation of major blood vessels, normal blood coagulation. 

 3. Hepatic artery tied Cypriot: must not infringe upon the great vessels, there is no liver failure, normal blood coagulation. 

 4. Others: acetic acid injection, microwave, freezer, radiotherapy ... not yet universal. 

 

 The prevention of liver cancer 

 B and C Prevention of hepatic liver. Drink less.

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.

Liver puncture examination may lead to the proliferation of liver tumor

This is a big problem controversy, liver tumor biopsy to be done either in the end, because it was suspected in the biopsy, the cancer may spread with the pinhole. 

Recently, University Hospital Birmingham Mirza physicians in addition to their own studies, and reference documents published so far, including seven retrospective and a forward-looking study, a total of 1340 cases collected for the study found that patients If the patients of liver cancer caused by liver biopsy to accept the proliferation of 2.7 percent, the annual incidence of 0.9 percent, in his analysis of the literature, liver cancer undergo invasive inspection caused the proliferation of liver cancer in accordance with the literature and different, which is about 4 percent, about 1.3 percent each year around. But he also pointed out that even if there is no impact on the spread of a patient's survival, because they can be removed or partially processed. 

We frequently encountered in clinical practice refused to accept the lymph node biopsy or liver, lung puncture examination of view, but the liver tumor may be the primary liver cell itself, but also may be caused by the gastrointestinal tract, transferred from the lungs, causes may be dozens above, due to different pathological affect treatment, it can not be solely with the CT or PET found that patients given mass, we found that the tumor or in a variety of methods can be used to do when pathological confirmation organizations to determine the diagnosis in order to further treatment.