Liver cancerLiver cancer Liver cancerLiver cancer

Sef lucrari Dr. Carmen AntonSef lucrari Dr. Carmen Anton

Definition

• Liver cancer is malignancy that begins in the cells of liver

• Liver cancer is one of the most common forms of cancer in the world

Symptoms

• Most people don't have signs and symptoms in the early stages of primary liver cancer. When symptoms do appear, they may include:

Symptoms

• Losing weight without trying • Loss of appetite • Upper abdominal pain • Nausea and vomiting

Symptoms

• General weakness and fatigue • An enlarged liver• Abdominal swelling • Yellow discoloration of the skin

and the whites of eyes (jaundice)

Causes

• It's not clear what causes most cases of liver cancer.

• In some cases, the cause is known, for instance, chronic infection with certain hepatitis viruses can cause liver cancer.

Causes

• Liver cancer occurs when liver cells develop changes (mutations) in their DNA — the material that provides instructions for every chemical process in the body.

Causes

• DNA mutations cause changes in these instructions. One result is that cells may begin to grow out of control and eventually form a tumor — a mass of malignant cells.

Types of liver cancer

• Primary liver cancer, which begins in the cells of the liver, is divided into different types based on the kind of cells that become cancerous. Types include:

Types of liver cancer Hepatocellular carcinoma

(HCC). ▪ This is the most common form of

primary liver cancer in both children and adults.

▪ It starts in the hepatocytes, the main type of liver cell.

Types of liver cancer Cholangiocarcinoma ▪This type of cancer begins in the

small tube-like bile ducts within the liver

▪This type of cancer is sometimes called bile duct cancer.

Types of liver cancer Hepatoblastoma ▪This rare type of liver cancer

affects children younger than 4 years of age

▪ Most children with hepatoblastoma can be successfully treated.

Types of liver cancer Angiosarcoma or

hemangiosarcoma ▪These rare cancers begin in the

blood vessels of the liver and grow very quickly.

Risk factors

• Sex - Men are more likely to develop liver cancer than are women.

• Age - In North America, Europe and Australia, liver cancer most commonly affects older adults. In developing countries of Asia and Africa, liver cancer diagnosis tends to occur at a younger age — between 20 and 50.

Risk factors• Chronic infection with HBV or

HCV Chronic infection with hepatitis B

virus (HBV) or hepatitis C virus (HCV) increases the risk of liver cancer.

Risk factors• Cirrhosis ▪This progressive and irreversible

condition causes scar tissue that is form in the liver and increases chances of developing liver cancer

Risk factors• Certain inherited liver

diseases ▪Liver diseases that can increase

the risk of liver cancer include hemochromatosis, autoimmune hepatitis and Wilson's disease.

Risk factors• Diabetes ▪People with this blood sugar

disorder have a greater risk of liver cancer than do people who don't have diabetes.

Risk factors• Nonalcoholic fatty liver

disease

▪An accumulation of fat in the liver increases the risk of liver cancer.

Risk factors• Exposure to aflatoxins ▪Consuming foods contaminated

with fungi that produce aflatoxins greatly increases the risk of liver cancer. Crops such as corn and peanuts can become contaminated with aflatoxins. 

Risk factors• Excessive alcohol consumption ▪Consuming more than a

moderate amount of alcohol can lead to irreversible liver damage and increase the risk of liver cancer.

Risk factors• Obesity Having an unhealthy body mass

index increases the risk of liver cancer.

Tests and diagnosis

• Blood tests - blood tests may reveal liver function

abnormalities + alfa feto protein (AFP) + CA 19-9

•Imaging tests - ultrasound - computerized tomography (CT) scan - magnetic resonance imaging (MRI)

•Liver biopsy

The stages of liver cancer

Stage I

At this stage, liver cancer is a single tumor confined to the liver that hasn't grown to invade any blood vessels.

Stage II Liver cancer at this stage can be a single tumor that has grown to invade nearby blood vessels, or it can be multiple small tumors in

the liver.

The stages of liver cancer

Stage III This stage may indicate that the cancer is composed of several larger tumors. Or cancer may be one large tumor that has grown to invade the liver's main veins or to invade nearby structures, such as the

gallbladder.

Stage IV At this stage, liver cancer has spread beyond the liver to other areas of the body.

Treatments and drugs

•The goal of any treatment is to eliminate the cancer completely

Treatments and drugs

• Surgery to remove a portion of the liver

- recommend partial hepatectomy to remove the liver cancer and a small portion of healthy tissue that surrounds it if the tumor is small and the liver function is good

Treatments and drugs

• Liver transplant surgery - liver transplant surgery may be an

option for people with early-stage liver cancer who also have cirrhosis

Treatments and drugs

• Freezing cancer cells - Cryoablation uses extreme cold to destroy cancer cells- During the procedure,it is placed an instrument

(cryoprobe) containing liquid nitrogen directly onto liver tumors

- Ultrasound images are used to guide the cryoprobe and monitor the freezing of the cells.

- Cryoablation can be the only liver cancer treatment, or it can be used along with surgery, chemotherapy or other standard treatments.

Treatments and drugs

• Heating cancer cells- In a procedure called radiofrequency ablation, electric

current is used to heat and destroy cancer cells

• Injecting alcohol into the tumor•Injecting chemotherapy drugs into the

liver- Chemoembolization is a type of chemotherapy

treatment that supplies strong anti-cancer drugs directly to the liver

Treatments and drugs

• Radiation therapy - this treatment uses high-powered energy beams to

destroy cancer cells and shrink tumors

- radiation side effects may include fatigue, nausea and vomiting

Treatments and drugs

• Targeted drug therapy - Sorafenib (Nexavar) is a targeted drug

designed to interfere with a tumor's ability to generate new blood vessels

- Sorafenib has been shown to slow or stop advanced liver cancer from progressing for a few months longer than with no treatment

- More studies are needed to understand how this and other targeted therapies may be used to control advanced liver cancer

Prevention• Get vaccinated against hepatitis B

• Take measures to prevent hepatitis C - Know the health status of any sexual

partner - Don't use IV drugs, but if you do, use a clean needle - Seek safe, clean shops when getting a piercing or tattoo