Symptoms and treatment of Liver cancer

Hepatocellular carcinoma

Hepatocellular carcinoma is a type of cancer that begins as a growth of the cells in the liver. The liver is an organ that is located just below the rib cage on the right side of the belly. It is necessary to help digest food, rid the body of waste products and substances, among other tasks.

Hepatocellular carcinoma is the most common type of liver cancer. It begins in the liver cells, called hepatocytes. Hepatocellular carcinoma occurs most often in people with chronic liver diseases, such as cirrhosis caused by hepatitis B or hepatitis C infection.

Hepatocellular carcinoma is the treatment may include surgery to remove the cancer or a liver transplant. Other treatments may include ablation, embolization, radiation therapy, immunotherapy, and targeted therapy.

Symptoms

Hepatocellular carcinoma may not cause symptoms that are noticeable immediately. This cancer of the liver that occurs more often in people with scarring of the liver, called cirrhosis caused by hepatitis B or hepatitis C infection. In these people, the symptoms of cancer may be the same as the cirrhosis symptoms.

If signs and symptoms of hepatocellular carcinoma develop, which may include:

Losing weight without trying.
Loss of appetite.
Upper abdominal pain.
A growth in the abdomen.
Yellowing of the skin and the whites of the eyes, known as jaundice.

When to see a doctor

Make an appointment with a doctor or other health care professional if you have any symptoms that worry you.

Causes

It's not always clear what causes hepatocellular carcinoma. This type of cancer begins as a growth of the cells in the liver. Most people with this type of cancer have the condition of the liver, such as cirrhosis caused by hepatitis B or hepatitis C infection.

Hepatocellular carcinoma occurs when the cells in the liver called hepatocytes develop changes in their DNA. A cell's DNA contains the instructions that tell the cell what to do. In healthy cells, the DNA contains the instructions to grow and multiply at a set rate. The instructions that tell cells to die at a set time. In cancer cells, changes in DNA to give different instructions. The changes tell cancer cells to grow and multiply quickly. Cancer cells can continue living when healthy cells would die. This makes too many cells.

The cancer cells form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. At the time, cancer cells can break off and spread to other parts of the body. When cancer spreads, it is called metastatic cancer.

Risk factors

Factors that may increase the risk of hepatocellular carcinoma include:

Advanced age. Hepatocellular carcinoma is more common in older adults.
Infection with the hepatitis B virus or the hepatitis C virus. Ongoing or previous infection with the hepatitis B virus or the hepatitis C virus increases the risk of hepatocellular carcinoma.
Cirrhosis. Cirrhosis is a progressive and irreversible condition that causes the formation of scar tissue in the liver. Increases the chances of developing hepatocellular carcinoma.
Certain inherited diseases of the liver. Some diseases of the liver that can run in families may increase the risk of hepatocellular carcinoma. Examples include hemochromatosis and Wilson's disease.
The excess fat in the liver. Non-alcoholic fatty liver, also called metabolic dysfunction associated with the steatotic liver disease, which occurs when fat accumulates in the liver. People with this disease have an increased risk of hepatocellular carcinoma.
Diabetes. People with this blood sugar condition have an increased risk of hepatocellular carcinoma than those who do not have diabetes.
Obesity. People with obesity have a higher risk of cirrhosis and the excess of fat in the liver. These conditions may increase the risk of hepatocellular carcinoma.
Exposure to aflatoxins. Aflatoxins are poisons produced by molds that grow on crops that are stored wrong. Crops, such as grains and nuts, can be contaminated with aflatoxins, which can end up in the food of these products.
The excessive consumption of alcohol. The consumption of more than moderate amounts of alcohol per day over many years can lead to irreversible liver damage and increase the risk of hepatocellular carcinoma.
Smoking cigarettes. People who smoke cigarettes have a higher risk of hepatocellular carcinoma.

Prevention

To reduce the risk of cirrhosis

Cirrhosis is scarring of the liver, and increases the risk of hepatocellular carcinoma. You can reduce your risk of cirrhosis if:

Drink alcohol only in moderation, if at all. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink per day for women and up to two drinks per day for men.
Maintain a healthy weight. If your weight is healthy, work to maintain that weight. If you need to lose weight, consult with a health care professional about the healthy ways to lose your weight. Eating fewer calories, and gradually increase the amount of exercise.

Get vaccinated against hepatitis B

Infection with the hepatitis B virus increases the risk of hepatocellular carcinoma. You can reduce your risk of getting hepatitis B by means of the receipt of the vaccine against hepatitis B. The vaccine can be applied to almost any person, including infants, children, adults, and older adults.

Take measures to prevent hepatitis C

Infection with the hepatitis C virus increases the risk of hepatocellular carcinoma. There is No vaccine for hepatitis C exists, but you can reduce your risk of infection.

Know the health status of any sexual partner. Do not engage in unprotected sex unless you are sure that your partner is not infected with hepatitis B, hepatitis C or any other sexually transmitted infection. If you do not know the health status of your partner, use a condom every time you have sex.
Do not use intravenous drugs, but if choose to do so, use a clean needle. To reduce the risk of hepatitis C by the non-injection drugs, legal or illegal, may be sold on the streets. But if that is not an option for you, make sure that the needle you use is sterile and don't share it. The needles are a common cause of hepatitis C infection. Take advantage of needle-exchange programs in your community and consider seeking help for your drug use.
Search for safe, clean stores to get a piercing or a tattoo. The needles that can not be properly sterilized can spread the hepatitis C virus. Before getting a piercing or a tattoo, take a look at the shops in your area and ask the staff members about their security practices. If the employees of a store, do not respond to your questions or do not respond to their questions seriously, take that as a sign that the establishment is not suitable for you.

Seek treatment for hepatitis B or C infection

Treatments are available for hepatitis B and hepatitis C infections. The research shows that treatment can reduce the risk of hepatocellular carcinoma.

Ask about the detection of liver cancer

For most people, the screening of liver cancer has not been shown to reduce the risk of dying from cancer of the liver, and is not recommended in general. People with conditions that increase the risk of liver cancer could be considered research. People with a higher risk are those who have:

Hepatitis B infection.
Hepatitis C infection.
Cirrhosis of the liver.

Talk about the pros and cons of screening with their health care team. Together you can decide whether screening is appropriate for you in light of your risk. Hepatocellular carcinoma detection typically involves a blood test and an abdominal ultrasound every six months.

Diagnosis

To diagnose hepatocellular carcinoma, a healthcare provider may do a physical exam and ask you questions about your health history. Other tests and procedures may include imaging tests, blood tests and the removal of some cells for analysis.

Imaging tests

Imaging tests create pictures of the body. You can show the location and size of a hepatocellular carcinoma. Tests may include:

Ultrasound.
Computerized axial tomography scan, also called a CT or cat scan.
Magnetic resonance imaging, also called magnetic resonance imaging.
The positron emission tomography scan, also called a PET.

Blood tests

Blood tests can give to your health care team clues about what is causing your symptoms. These tests can include blood tests that measure the function of your liver. Blood tests can also search for proteins produced by cancer cells. These tests are referred to as tumor marker tests.

Biopsy

A biopsy is a procedure to remove a sample of tissue for testing in a lab. For hepatocellular carcinoma, biopsy, a needle is used to obtain the tissue sample. During a liver biopsy, a health care professional inserts a needle through the skin and the cancer. The health care provider uses a needle to remove a sample of cells from the liver.

The sample is analyzed in a laboratory to see if it is cancer. Other special tests to give more details on the cancer cells. Your health care team uses this information to make a treatment plan.

Not everyone will need a biopsy to diagnose hepatocellular carcinoma. Sometimes the professional teams to make the diagnosis with the results of other tests.

Staging of hepatocellular carcinoma

If you are diagnosed with hepatocellular carcinoma, the next step is to determine the cancer of the measure, called the stage. Your healthcare team uses the stage of the cancer to help create your treatment plan.

The stages of hepatocellular carcinoma (hcc) use the number 0 and the letters a to D. A stage 0 hcc is small and confined to the liver. As the cancer grows or spreads beyond the area began in the stages ranging from a to D.

Treatment

The treatment for hepatocellular carcinoma is dependent on the location and the extent of the cancer. The treatment may also depend on the condition of the liver. You can use the surgery to remove the cancer. In some people, a liver transplant may be an option. Other treatments may include ablation, embolization, radiation therapy, immunotherapy, and targeted therapy.

Surgery

The treatment for hepatocellular carcinoma can begin with the surgery to remove part of the liver, including cancer, or liver transplant. Surgical options include:

The surgery to remove the cancer. Partial hepatectomy is used for people whose cancer is in a part of the liver. This surgery removes the cancer and some healthy tissue around it. If this is an option for you depends on the location of the cancer in the liver, as well your liver function and your overall health.
Liver transplant surgery. Sometimes, surgery to remove the cancer is combined with a liver transplant. A surgeon removes the cancer and all of the liver. Then, the surgeon puts a healthy liver from a donor into the body. A liver transplant may be an option in otherwise healthy people whose cancer has not spread beyond the liver. Other treatments may be used to treat the cancer, while waiting for a transplant.

Other procedures of liver

Other procedures in the liver can assist in the treatment of hepatocellular carcinoma. These treatments may be used in people who cannot have surgery to remove the cancer. These other liver procedures for hepatocellular carcinoma include:

Radiofrequency ablation. Radiofrequency ablation is used, the electric current and the heat of the damage to the cancer cells. During this procedure, a health care professional places small needles in cancer. Needles to deliver high temperatures that damage to the cancer cells.
The cryoablation. Cryoablation uses cold water to hurt the cancer cells. During the procedure, a healthcare professional placing small needles in cancer. Needles to deliver the low temperatures that damage to the cancer cells.
Chemoembolization. Chemoembolization gives the chemotherapy drugs directly to the cancer. Also used a drug that blocks the blood flow to the cancer. Blocking the flow of blood to the cancer can cause the cancer to reduce the size, grow more slowly or do not grow at all.
Radioembolization. Radioembolization using tiny drops that keep the radiation. The health team puts the ball into a blood vessel that goes to the liver. The beads emit radiation directly to the cancer.
The radiation therapy. Radiation therapy treats cancer with powerful rays of energy. The energy can come from X-rays, protons or other sources. The beams can be directed at the cancer in the liver.

Immunotherapy

Immunotherapy for cancer is a treatment with a medication that helps the body's immune system destroys the cancer cells. The immune system fights diseases by attacking the germs and other cells that should not be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the cells of the immune system find and kill cancer cells.

Immunotherapy may be used after surgery to destroy any remaining cancer cells. For those with advanced hepatocellular carcinoma that cannot be removed with surgery, immunotherapy may be an option.

Targeted therapy

Targeted therapy for cancer is a treatment that uses drugs that attack specific chemicals in cancer cells. By blocking these chemicals, specific treatments can cause cancer cells to die.

Targeted therapy may be used after surgery to destroy any remaining cancer cells. For those with advanced hepatocellular carcinoma that cannot be removed with surgery, targeted therapy may be an option.

Palliative care

Palliative care is a special type of health care that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve the pain and other symptoms. A health care team that may include doctors, nurses and other specially trained health professionals providing palliative care. The care team's goal is to improve the quality of life for you and your family.

Palliative care specialists work with you, your family and your care team. They provide an extra layer of support, while you have cancer treatment. You can have palliative care at the same time that you are getting strong cancer treatments, such as surgery, chemotherapy, immunotherapy, targeted therapy or radiation therapy.

The use of palliative care with other treatments can help people with cancer feel better and live longer.

Coping and support

With time, you will find ways to cope with the feelings that occur after a diagnosis of cancer. Until then, here are some ideas for coping with hepatocellular carcinoma.

Learn enough about cancer to make decisions about your care

Ask your health care team about your cancer, including your test results, treatment options, and, if you like, your prognosis. As you learn more about hepatocellular carcinoma, may be more confident in making treatment decisions.

Keep friends and family close

Keep your close relationships strong can help you deal with hepatocellular carcinoma. Friends and family can provide the practical support that you may need, such as help to take care of your house if you're in the hospital. And that you can serve as emotional support when you feel overwhelmed by the fact of having cancer.

Find someone to talk to

Find someone who is willing to listen to you talk about your hopes and concerns. This can be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group may also be useful.

Ask your health care team about support groups in your area. Other sources of information include the U.S. National Cancer Institute and the American Cancer Society.

Preparing for your appointment

Make an appointment with a doctor or other health care professional if you have any symptoms that worry you.

If your healthcare provider thinks you might have to hepatocellular carcinoma, you may be referred to a doctor who specializes in diseases of the liver, called a hepatologist. If a diagnosis of cancer, you may also be referred to a doctor who specializes in the treatment of cancer is called an oncologist.

Because appointments can be brief, it is a good idea to be prepared. Here's some information to help you prepare.

What you can do

Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there is anything that you need to do in advance, such as restrict your diet.
Write down any symptoms you have, including those that do not seem to be related to the reason for which you scheduled the appointment.
Write important personal information, including major stresses or recent life changes.
Make a list of all medications, vitamins or supplements you are taking and the dose.
Have a family member or friend. Sometimes it can be very difficult to remember all the information provided during an appointment. Someone who goes with you may remember something that you missed or forgot.
Write questions to ask their health care team.

Your time with your health care team is limited, so preparing a list of questions can help you make the most of their time together. A list of questions from most important to least important in case time runs out. For hepatocellular carcinoma, some basic questions to ask include:

Do I have hepatocellular carcinoma?
What is the stage of my hepatocellular carcinoma?
Has my hepatocellular carcinoma spread to other parts of my body?
More evidence is needed?
What are the treatment options?
How much does it cost each treatment to increase my chances of a cure or to prolong my life?
What are the possible side effects of each treatment?
How will each treatment affect my daily life?
There is a treatment option which you think is the best?
What would you recommend to a friend or family member in my situation?
You should see a specialist?
Are there brochures or other printed material that I can take with me? What sites do you recommend?
What is going to determine whether I should plan for a follow-up visit?

Do not hesitate to ask other questions.

What to expect from your doctor

Be prepared to answer questions, such as:

When did your symptoms begin?
The symptoms been continuous or occasional?
How severe are the symptoms?
What, if anything, seems to improve your symptoms?
What, if anything, appears to worsen your symptoms?

Diagnosis

Diagnosis of liver cancer

Tests and procedures used to diagnose liver cancer include:

Blood tests. Blood tests may reveal liver function abnormalities.
Imaging tests. Your doctor may recommend imaging tests, such as ultrasound, CT and MRI .
Removing a sample of liver tissue for analysis.It is sometimes necessary to remove a piece of liver tissue for laboratory testing in order to make a definitive diagnosis of liver cancer. During a liver biopsy, your doctor inserts a thin needle through the skin and into the liver to obtain a tissue sample. In the lab, the doctors examine the tissue under a microscope to look for cancer cells. Liver biopsy carries a risk of bleeding, bruising and infection.

Removing a sample of liver tissue for analysis. It is sometimes necessary to remove a piece of liver tissue for laboratory testing in order to make a definitive diagnosis of liver cancer.

During a liver biopsy, your doctor inserts a thin needle through the skin and into the liver to obtain a tissue sample. In the lab, the doctors examine the tissue under a microscope to look for cancer cells. Liver biopsy carries a risk of bleeding, bruising and infection.

Determining the extent of liver cancer

Once the diagnosis of liver cancer, your doctor will work to determine the extent (stage) of the cancer. Essay tests help to determine the size and location of the cancer and whether it has spread. The test image is used for the stage of liver cancer include CTs , mri and bone scan.

There are different methods of staging of liver cancer. For example, a method that uses Roman numerals from I to IV, and the other uses the letters a to D. the doctor uses his or her stage of cancer to determine your treatment options and your outlook.

Treatment

Treatments for primary liver cancer depends on the extent (stage) of the disease as well as your age, overall health and personal preferences.

Surgery

Operations used to treat cancer of the liver include:

The surgery to remove the tumor.In some situations, your doctor may recommend an operation to remove the cancer of the liver and a small portion of healthy liver tissue surrounding it if the tumor is small and the function of your liver is good. If this is an option for you also depends on the location of the cancer in the liver, as well your liver function and your overall health.
Liver transplant surgery. During liver transplant surgery, the diseased liver is removed and replaced with a healthy liver from a donor. Liver transplant surgery is an option for only a small percentage of people with early-stage liver cancer.

The surgery to remove the tumor. In some situations, your doctor may recommend an operation to remove the cancer of the liver and a small portion of healthy liver tissue surrounding it if the tumor is small and the function of your liver is good.

If this is an option for you also depends on the location of the cancer in the liver, as well your liver function and your overall health.

Treatments

Localized treatments for liver cancer are those that are administered directly to the cancer cells or the area surrounding the cancer cells. Localized treatment options for liver cancer include:

The heating of cancer cells. Radiofrequency ablation uses electric current to heat and destroy cancer cells. The use of a test image as a guide, as the ultrasound, the doctor inserts one or more thin needles into small incisions in the abdomen. When the needles reach the tumor, they're heated with an electric current, the destruction of cancer cells. Other procedures to heat the cancer cells can use a microwave or a laser beam.
The freezing of the cancer cells. Cryoablation uses extreme cold to destroy cancer cells. During the procedure, the doctor places an instrument (cryoprobe) that contains liquid nitrogen directly into the tumors of the liver. Ultrasound imaging is used to guide the cryoprobe and monitor the freezing of the cells.
The injection of alcohol into the tumor. During the injection of alcohol, pure alcohol is injected directly into the tumors, either through the skin or during an operation. The Alcohol causes the tumor cells to die.
The injection of chemotherapy drugs in the liver. Chemoembolization is a type of chemotherapy treatment that supplies strong anti-cancer drugs directly to the liver.
The placement of accounts full of radiation in the liver. Small spheres that contain the radiation can be placed directly into the liver, where they can deliver radiation directly to the tumor.

Radiation therapy

This treatment uses high-powered energy from sources such as X-rays and protons, to kill cancer cells and shrink tumors. Physicians with direct care of the energy of the liver, without affecting the surrounding healthy tissue.

Radiation therapy may be an option if other treatments are not possible, or if not have helped. For advanced liver cancer, radiation therapy may help control symptoms.

During external beam radiation therapy treatment, you will lie on a table and a machine that directs the energy beams at a precise point on your body.

A specialized type of radiation therapy called stereotactic body radiation therapy, is the focus of many of the radiation beams simultaneously at a point of your body.

Targeted drug therapy

Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die.

Many specific drugs are available for the treatment of advanced liver cancer.

Some targeted therapies only work in the people that the cancer cells have certain gene mutations. Cancer cells can be analyzed in a laboratory to see if these medications can help.

Immunotherapy

Immunotherapy uses your immune system to fight cancer. From your body to fight off diseases immune system will not attack the cancer because the cancer cells produce proteins that blind the immune system cells. Immunotherapy works by interfering with that process.

Immunotherapy treatments are generally reserved for people with advanced liver cancer.

Chemotherapy

Chemotherapy uses drugs to kill fast-growing cells, including cancer cells. Chemotherapy can be administered through a vein in your arm, in the form of a pill, or both.

Chemotherapy is sometimes used to treat advanced liver cancer.

Supportive (palliative) care

Palliative care is specialized medical care that focuses on the relief of pain and other symptoms of a serious disease. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing other aggressive treatments, such as surgery, chemotherapy, or radiation therapy.

When palliative care is used along with all other appropriate treatments, people with cancer may feel better and live longer.

Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life of people with cancer and their families. This form of care that is offered alongside curative or other treatments you may be receiving.

Alternative medicine

Alternative treatments can help to control pain in people with advanced liver cancer. Your doctor will work to control the pain with treatments and medications. But sometimes the pain can persist or you may want to avoid the side effects of pain medications.

Ask your doctor about alternative treatments that can help deal with the pain, such as:

Acupressure
Acupuncture
Hypnosis
Massage
Relaxation techniques

Coping and support

Learning is a life-threatening illness can be devastating. Each person finds their own way to cope with a diagnosis of liver cancer. Although there are no easy answers for people dealing with cancer of the liver, the following suggestions may be of assistance:

Learn enough about the liver cancer to make decisions about your care. Ask your doctor about your cancer of the liver, including the stage of your cancer, your treatment options and, if you like, your prognosis. As you learn more about liver cancer, you can be more confident in making treatment choices.
Keep friends and family close. Keep your close relationships strong will help you deal with your cancer of the liver. Friends and family can provide the practical support you need, such as help to take care of your house if you're in the hospital. And that you can serve as emotional support when you feel overwhelmed by the cancer.
Find someone to talk to.Find a good listener, you can talk about your hopes and fears. This can be a friend or family member. The support of a counselor, medical social worker, a member of the clergy or of the cancer survivors group can also be useful. Ask your doctor about support groups in your area. Or look in your telephone directory, or the library of a cancer of the organization, such as the National Cancer Institute or the American Cancer Society.
Make plans for the unknown.Have a life-threatening illness, such as cancer, requires you to prepare for the possibility that you could die. For some people, having a strong faith or a sense of something greater than themselves makes it easier to come to terms with a life-threatening illness. Ask your doctor about advance directives and living wills to help you plan for the end-of-life, if necessary.

Find someone to talk to. Find a good listener, you can talk about your hopes and fears. This can be a friend or family member. The support of a counselor, medical social worker, a member of the clergy or of the cancer survivors group can also be useful.

Ask your doctor about support groups in your area. Or look in your telephone directory, or the library of a cancer of the organization, such as the National Cancer Institute or the American Cancer Society.

Make plans for the unknown. Have a life-threatening illness, such as cancer, requires you to prepare for the possibility that you could die. For some people, having a strong faith or a sense of something greater than themselves makes it easier to come to terms with a life-threatening illness.

Ask your doctor about advance directives and living wills to help you plan for the end-of-life, if necessary.

Preparing for your appointment

If you think you may have cancer of the liver, which is likely to start by seeing your family doctor. If your doctor thinks you may have liver cancer, you may be referred to a doctor who specializes in diseases of the liver (hepatologist) or a doctor who specializes in the treatment of cancer (oncologist).

Because appointments can be brief, and because there is often a lot of ground to cover, it is a good idea to be well prepared. Here's some information to help you prepare and what to expect from your doctor.

What you can do

Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there is anything that you need to do in advance, such as restrict your diet.
Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
Write down key personal information, including any major stresses or recent life changes.
Make a list of all the medicines, as well as any vitamins or supplements you are taking.
Consider the possibility of a family member or friend. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.
Write questions to ask their doctor.

Your time with your doctor is limited, so preparing a list of questions will help you to make the most of your time together. A list of questions from most important to least important in case time runs out. For liver cancer, some basic questions to ask your doctor include:

What type of liver cancer do I have?
What is the stage of my cancer of the liver?
What does my pathology report say? I have a copy of the pathology report?
More evidence is needed?
What are my treatment options?
What are the possible side effects of each treatment option?
There is a treatment that we recommend over the others?
How will my treatment affect my daily life?
How long can I take to make my decision on treatment of liver cancer?
Should I seek a second opinion?
I need to see a liver cancer specialist? What will that cost, and will my insurance cover it?
Are there brochures or other printed material that I can take with me? What sites do you recommend?

In addition to the questions that you've prepared to ask your doctor, do not hesitate to ask questions during your appointment.

What to expect from your doctor

Your doctor may ask you a series of questions. Be ready to answer them may allow more time later to cover other points you want to address. Your doctor may ask:

When did you first begin experiencing symptoms?
The symptoms been continuous or occasional?
How severe are the symptoms?
What, if anything, seems to improve your symptoms?
What, if anything, appears to worsen your symptoms?