Liver
Cancer Treatment in Best Hospitals of India
The liver continuously filters blood
that circulates through the body, converting nutrients and drugs absorbed from
the digestive tract into ready-to-use chemicals. The liver performs many other
important functions, such as removing toxins and other chemical waste products
from the blood and readying them for excretion. Because all the blood in the
body must pass through it, the liver is unusually accessible to cancer cells
traveling in the bloodstream.
What is Liver cancer? WWW.mymedopinion.com
Types of Liver Cancer
There are two broad categories of
liver cancer: Primary and Secondary
Primary Liver Cancer
Primary liver cancer starts in the
cells, bile ducts, blood vessels or connective tissue of the liver . There are
different types of primary liver cancer that include:
· Hepatoma :
This is the most common type. It is sometimes called hepatocellular carcinoma
(HCC). This type of cancer originates from a liver cell (hepatocyte) which
becomes cancerous. The bulk of the liver is made up from hepatocytes. A
hepatoma most commonly develops as a complication of liver diseases such as
cirrhosis or types of hepatitis (liver inflammation).
· Fibrolamellar : This
hepatoma is a rare sub-type of hepatoma. It typically develops in a liver that
was previously healthy.
· Cholangiocarcinoma : This
is uncommon. It develops from cells which line the bile duct.
· Hepatoblastoma : This
is a very rare cancer that occurs in some young children.
· Angiosarcoma : This
is very rare. It develops from cells of blood vessels within the liver.
Secondary Liver Cancer
Secondary liver cancer is a cancer
that first develops elsewhere in the body and then spreads (metastasizes) to
the liver. It is sometimes called metastatic cancer.
When a cancer forms in a part of the
body, a few cancer cells may break off and find their way into the bloodstream.
Because your liver filters your blood, any cancer cells in the bloodstream have
a high chance of settling in the liver to form a cancer nodule (metastasis).
People who are most at risk of
secondary liver cancer are those with cancers of the large bowel (colon),
pancreas, stomach, lung or breast. It is important to know where the cancer
started as this will determine the type of cells which are causing the cancer
and affect which treatment is best suited for you. Secondary cancer diagnosed
in the liver may be a sign of cancer in other organs. Sometimes, secondary
cancer is found in the liver and yet, even with thorough medical tests, it’s
not possible to find out where the cancer started. This is sometimes known as
cancer of unknown primary.
Staging of Liver Cancer
There are a number of different
systems that can be used to stage liver cancer. Many liver cancer specialists
use combination-staging systems that include features of both the cancer and
liver function to stage a person’s condition.
One combination system for staging
liver cancer is known as the Barcelona Clinic Liver Cancer (BCLC) staging
system that consists of the following five stages.
· Stage 0 - The
tumour is less than 2cm (20mm) in diameter and the person is very well and has
normal liver function.
· Stage A - A
single tumour has grown but is less than 5cm (50mm) in diameter, or there are
three or fewer smaller tumours that are less than 3cm (30mm) in diameter and
the person is very well with normal liver function.
· Stage B - There
are multiple tumours in the liver, but the person is well and their liver
function is unaffected.
· Stage C - Any
of the above circumstances, but the person is not so well and their liver
function is not so good; or where the cancer has started to spread into the
main blood vessel of the liver, into nearby lymph nodes or into other parts of
the body.
· Stage D – Where
the liver has lost most of its functioning abilities and the person begins to
have symptoms of end-stage liver disease, such as a build-up of fluid inside
their abdomen.
Diagnosis of Liver Cancer
Physical examination helps in
determining symptoms or lumps that may suspect the presence of liver cancer.
Some of the other tests that are performed for diagnosing liver cancer include
–
· Laparoscopy : A
thin tube is used for observing liver and other organs within the abdominal
cavity. A laparoscope can also be used along with a biopsy. Laparoscopy can
help plan surgery or other treatments, and can help doctors confirm the stage
(extent) of the cancer. If needed, doctors can also insert instruments through
the incisions to remove biopsy samples, which are then looked at under a
microscope to make or confirm the diagnosis of cancer.
· Blood Tests : The
blood tests also include liver enzymes and a serum marker test. The measurement
of some substances associated to cancer can be done by performing serum marker
test. An underlying liver problem is indicated with the help of liver enzymes.
· Angiogram : The
injection of a dye is done into an artery that shows tumors and liver tissues.
· Ultrasound : High-frequency
sound waves from the body are transmitted by this procedure.
· Surgical biopsy: In
some cases, a biopsy sample may not be obtained until surgery that is meant to
treat the tumor. An incisional biopsy (removing a piece of the tumor) or an
excisional biopsy (removing the entire tumor and some surrounding normal liver
tissue) can be done during an operation. But since doctors often prefer to know
the exact type of tumor before surgery, other types of biopsy methods may be
used.
· Magnetic Resonance Imaging (MRI): A computer, large magnet and radio waves are produced in
this test that provides clear images of the human body.
· Computed Tomography (CT scan) : This test also provides detailed images of the organs.
Liver Cancer Treatment at Best
Cancer Hospitals in India
The treatment options are dictated
by the stage of Liver Cancer and the overall condition of the patient. The
treatment to be given depends mainly on the size, number, and site of tumors in
the liver. Before planning the appropriate treatment the functioning of the
Liver is checked as also the spread of the cancer within and outside the liver
is to be tested. The Various treatment options available are as follows :
· Surgery : Surgery
is the removal of the tumor and surrounding tissue during an operation. It is
likely to be the most successful disease-directed treatment, particularly for
patients with small tumors (smaller than 5 cm). A surgical oncologist is a
doctor who specializes in treating cancer using surgery. In some cases, a
biopsy sample may not be obtained until surgery that is meant to treat the
tumor. An incisional biopsy (removing a piece of the tumor) or an excisional
biopsy (removing the entire tumor and some surrounding normal liver tissue) can
be done during an operation. But since doctors often prefer to know the exact
type of tumor before surgery, other types of biopsy methods may be used.
· Liver Transplant : When
it is available, a liver transplant may be the best option for some people with
small liver cancers. At this time, liver transplants are reserved for those
with small tumors (either 1 tumor smaller than 5 cm across or 2 to 3 tumors no
larger than 3 cm) that have not invaded nearby blood vessels. In most cases,
transplant is used for tumors that cannot be totally removed, either because of
the location of the tumors or because the liver is too diseased for the patient
to withstand removing part of it.
· Radiation therapy : Another
potential method of treating liver cancer is radiation therapy . The radiation
comes in the form of high energy x-rays that are delivered to the patient only
in the areas at highest risk for cancer. These x-rays are similar to those used
for diagnostic x-rays, only of a much high energy. The high energy of x-rays in
radiation therapy results in damage to the DNA of cells. Because cancer cells
are not as good as normal, healthy cell at repairing DNA damage, radiation
results in relatively more damage to the cancer cells than to normal
cells.consists of a specific number of treatments given over a set period of
time.
· External-beam radiation therapy is radiation given from a
machine outside the body. External-beam radiation therapy is not often used for
HCC.
· Targeted Therapy : Targeted
therapy is a treatment that targets the cancer’s specific genes, proteins, or
the tissue environment that contributes to cancer growth and survival. This
type of treatment blocks the growth and spread of cancer cells while limiting
damage to normal cells. Recent studies show that not all tumors have the same targets.
To find the most effective treatment, your doctor may run tests to identify the
genes, proteins, and other factors in your tumor.
Nonsurgical Treatments for Liver
Cancer in Best Cancer Hospitals in India
Chemoembolization
: Before Insertion of the tiny
particles that block the blood flow an anticancer drug is injected into the
artery. The drug stays in the liver for longer without blood flow, and thus the
impact is more.
- Radiofrequency Ablation : For inoperable liver tumors, radiofrequency ablation (RFA) offers a nonsurgical, localized treatment that kills the tumor cells with heat, while sparing the healthy liver tissue. Thus, this treatment is much easier on the patient than systemic therapy.
- Cryosurgery : It is a treatment that uses an instrument to freeze and destroy abnormal tissue, such as cancerous cells. This type of treatment is also called Cryotherapy. The doctor may use ultrasound to guide the instrument.
- Percutaneous Ethanol Injection : Percutaneous ethanol injection is a cancer treatment in which a small needle is used to inject alcohol directly into a tumor to kill cancer cells. The procedure may be done once or twice a week. Usually local anesthesia is used, but if the patient has many tumors in the liver, general anesthesia may be needed.
- Hyperthermia Therapy : Hyperthermia therapy is a type of treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells or to make cancer cells more sensitive to the effects of radiation and certain anticancer drugs. Because some cancer cells are more sensitive to heat than normal cells are, the cancer cells die and the tumor shrinks.
- Biologic Therapy : Biologic therapy is a treatment that uses the patient’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
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