Malignant liver damage can be primary, that is, coming from the cells of the liver structures, and secondary - proliferation in the liver of secondary metastatic tumor nodules from cancer cells brought into the liver from other internal organs. Metastatic tumors of the liver are registered 20 times more often than primary tumors, since blood passes from the internal organs through the liver, like through a filter.
Primary liver cancer is a relatively uncommon disease, according to various sources, ranging from 0.2 to 3% of all cancers. Among the patients dominated by males aged 50 to 65 years. There are several forms of liver cancer of various origins.
hepatocellular carcinoma (hepatoma, hepatocellular carcinoma, which occurs, as the name implies, from the liver parenchyma cells);
cholangiocarcinoma (a tumor from epithelial cells of the bile duct, which constitutes 5-30% of all primary malignant tumors of the liver);
liver angiosarcoma (malignant hemangioendothelioma of the liver - one of the most malignant tumors of the liver, growing from the vascular endothelium);
hepatoblastoma (malignant tumor of the liver of childhood).
1. The development of liver cancer contributes to chronic viral hepatitis (hepatitis B, hepatitis C). The risk of hepatocellular carcinoma in carriers of the virus increases 200 times.
2. Cirrhosis of the liver.
3. Hemochromatosis (excessive content of iron in the body).
4. Parasitic diseases (opisthorchiasis, schistosomiasis and others).
6. Chronic alcoholism.
7. Exposure to carcinogens (polychlorinated biphenyls, chlorinated hydrocarbon solvents, for example, carbon tetrachloride, nitrosamines, organic chlorine-containing pesticides, aflatoxins contained in food products).
In the initial stages of cancer, there is general malaise, all sorts of dyspeptic disorders (loss of appetite, nausea, and sometimes vomiting), a feeling of heaviness in the right hypochondrium, dull aching pains, and an increase in temperature. General weakness, weight loss, anemia (anemia) appear.
With the development of the disease, an increase in the liver can be detected, the liver can protrude from under the costal arch, it can acquire ligneous density, tuberosity. When probing the area of the liver, a tumor-like formation can be detected.Gradually increasing jaundice.
Initially, the assumption of liver damage occurs on the basis of complaints and the appearance of the patient.
Ultrasound (ultrasound) is of great importance in the diagnosis of a tumor in the liver due to its wide availability and sufficient accuracy. With the help of ultrasound, it is possible to identify nodules in the liver, according to special characteristics to differentiate their benign and malignant character.
CT (X-ray computed tomography), MRI (magnetic resonance imaging, nuclear magnetic resonance imaging) are used to diagnose liver cancer if the diagnosis cannot be made using simpler methods or to clarify the extent of the process.
Additional data can be obtained from radioisotope scanning of the liver.
Determination of blood indices indirectly in favor of liver damage.
biochemical blood test, in which an increase in the level of bilirubin, a decrease in the level of protein, an increase in the content of liver enzymes can be detected;
blood test for tumor markers (indicators, the increase in the level of which in the blood indicates the presence in the body of a particular tumor).
It should be remembered that identifying any, even malignant disease at an early stage improves the prognosis of the forthcoming treatment.
The main treatment for liver cancer is surgery.
In the case of hepatocellular carcinoma, a segment of the liver with a tumor or liver lobe is removed (hemihepatectomy).
In case of cholangiocarcinoma, in some cases, removal of the duct with a tumor is possible, with subsequent anastomosis (fistula).
With single nodes, their ablation is possible (radiofrequency ablation, chemoablation, cryoablation) - a method of treatment, when a special needle is inserted into the liver node and under the influence of various mechanisms the node is destroyed.
Intravascular chemotherapy is also performed, and a thin catheter is fed through the blood vessel to the tumor site, into which the chemoproduct is inserted, thus the effect on the tumor is more intense and the negative effect of the chemoproduct on the body is less.
The choice of treatment method depends on the type of tumor, the state of the body and other parameters, which are likely to be determined only by careful examination of the patient.
Local invasive growth is characteristic of primary liver tumors, most often the tumor grows into the diaphragm. Distant metastases are most often found in the lungs (up to 45% of cases).
The course of liver cancer depends on the type of tumor, but usually rapid and without treatment after a few months leads to the death of the patient. With operable tumors, the average life expectancy of patients after surgery is 3 years. 5-year survival rate - within 20%.
Since the development of liver cancer is promoted by chronic viral hepatitis B and the virus carrier, some parasitic diseases, a carcinogenic effect on the liver of industrial poisons, the prevention of these diseases and environmental protection are the basis of primary prevention. Secondary prevention is the early detection and timely treatment of chronic liver disease.
Of particular importance is the fight against alcoholism, since cirrhosis of the liver (especially large-node form) is found in about 60-90% of patients with hepatoma.