Liver cancer: How common he is and where he is due

The liver, or , is a large compact organ located on the upper right part of the abdomen, just below the diaphragm and to the right of the stomach, and plays many and important functions. Our liver weighs about 3 kg in adults and its function is to store nutrients from food, turning them into energy when needed. CORVERSE In addition, it produces bile, a liquid that helps digest food, while breaking down harmful substances, allowing the body to secrete them through urine or faeces. What is hepatocellular carcinoma? Hepatocellular carcinoma, or hepatom, is the most common primary malignant liver tumor in adults. This tumor consists of hepatocytes and very often patients suffering from it already have cirrhosis or hepatitis B. Other rarest types of cancer include: ADVERSE Fibrophylactic carcinoma: A rare type of HCC usually developed in young people Holangiocarcinoma: Cancer starting in the bile ducts of the liver Angiosarcoma: Cancer developing in the blood vessels within the liver Hepatoblastoma: A very rare liver cancer that usually affects young children How common is liver cancer and what is it? “Hepatic cancer is the fifth most common cancer in men and the seventh most common cancer in women. According to the World Health Organization, it is also the second main cause of cancer death after lung cancer. Its incidence is increasing, in Europe and America, with a possible link between this increase and hepatitis C (HCV) and migration. The condition occurs more frequently in men, 4/1 versus women. 95% of patients with liver cancer are between 45 and 60 years old, but there is also a tendency to increase cases to younger ages, mainly between 30 and 35 years old,” points out Demetrius David Director of Surgeon at Metropolitan Hospital. What are the symptoms of hepatocellular carcinoma? In early stages, hepatocellular carcinoma shows no symptoms, and often, during diagnosis, it has already reached an advanced stage. Some of the symptoms that may occur include: Weight loss Payment Local pain Tiniest Cirosis symptoms Weight feeling Fever Askite What are the risk factors for hepatocellular carcinoma? “The data that increase the risk of developing hepatocellular cancer include factors such as alcohol consumption, hepatitis B and others. A high proportion of patients with hepatocellular cancer experience cirrhosis (70%), which may be associated with various risk factors such as: Infection with hepatitis viruses, especially hepatitis B and C, as hepatitis B patients have a rate of 25% of liver cancer, while hepatitis B carriers have 10%. In Europe, 80% of hepatocellular neoplasms are associated with hepatitis C. Excessive alcohol consumption (alcoholism), which causes chronic inflammation in the liver and eventually liver cirrhosis. Carcinogenic substances such as aflatoxins, produced from fungi and related to the consumption of nuts, nuts, spices, cereals and others. Anabolic hormones, aimed at increasing muscle mass. In addition, factors related to liver cancer include fatty filtration of the liver, morbid obesity, type II diabetes mellitus, as well as certain hereditary metabolic diseases such as haemochromatosis, Wilson’s disease, and alpha-1 antithrombin deficiency. It is important to note that, unlike other neoplastic diseases, such as breast cancer, there is no hereditary predisposition to the occurrence of liver cancer,” he points out. Are there any preventive tests I can run? Any person belonging to the high risk group, presenting chronic or active hepatitis B and C, cirrhosis of the liver or making unreasonable alcohol abuse (even if he does not suffer from alcoholism), must undergo regular preventive controls. These checks shall include: Clinical examination by a specialist. General haematologic examination. Cancer index AFP (alpha embryonic protein). Liver imaging: The liver ultrasound, especially when combined with Doppler, is the preferred method of depicting the liver. This check assesses the presence of tumours, while allowing for the monitoring of benign liver diseases such as hemangiomas, cysts, fatty filtration etc. Biopsy: Your liver may require a biopsy. In this process, tissue samples will be taken from the liver in order to detect cancer cells. However, it is usually not necessary to biopsy, as doctors can often diagnose hepatocellular carcinoma only on the basis of imaging tests. If a biopsy is required, this can be performed either with a transdermal biopsy or with minimal invasive surgery (laparoscopy). How is liver cancer treated? The doctor may request a biopsy from your liver, as previously mentioned, during which liver tissue samples will be collected to detect possible cancer cells. Once diagnosis is made, treatment is individualized, taking into account the characteristics of each patient, such as liver function, tumour stagnation, and age and clinical condition. Can liver surgery be performed? “The procedure of hepatectomy is recognised as the best treatment for liver cancer, provided that patients meet the appropriate criteria for surgery. The size and location of the tumor determine the type of hepatectomy to be applied, in order to achieve histologically negative limits. Hepatectomy aims to remove the liver tumor, as well as surrounding areas that may experience intrahepatic metastases through the portal vein. In cases where this is not possible (due to the removal of a large hepatic parexus), a resection of the tumor is preferred within healthy limits, at least 1 cm. Each hepatectomy approach should be carefully designed, so that the exemplar remaining is sufficient. It is important to note that the majority of post-operative complications, especially in patients with cirrhosis, are associated with post-operative hepatic impairment. During the process of segmentectomy, approximately 10% – 15% of the liver parectomy is lost, while in the left hepatectomy approximately 65% is lost and in the right hepatectomy approximately 80% – 85% is lost,” explains the expert. For patients who cannot perform hepatectomy, are there any other methods of treatment? In cases where surgical export of liver tumor is not possible, alternative, less invasive methods are used, such as: Radio-wave thermal disaster (RF Ablation): The RFA method is based on the use of radio waves, with which it focuses high thermal energy directly on the liver tumor. It is suitable for tumors < 3 cm, especially in high risk patients for hepatectomy, and can also be used for larger tumors (5-7 cm). Application of the RFA method is avoided near vascular structures and large cholanges to avoid complications such as biliary fistulas and abscess. In addition, it can be used additionally during hepatectomy to reduce the extensive hepatic parectomy to be removed. While through this the result is checked with a liver CT scan about a month after treatment. Transdermal infusion of alcohol or acetic acid This technique is based on the application of a controlled transdermal solution of ethyl alcohol directly to the liver volume, under the guidance of a axial tomograph or ultrasound. Alcohol solution (95-97%) causes immediate chemical destruction of cancer cells. As an alternative method it is more recent, but it gains popularity thanks to its effectiveness. Transcatheter arterial chemoembolization (TACE) The procedure involves percutaneous catheterization of the femoral artery, using a special catheter promoted under radioscopic control within the hepatic artery. When the catheter reaches the hepatic artery or even higher, near the feeding point of the tumor, an infusion of a solution involving a chemotherapeutic agent (such as adriamycin, cisplatin) and a lipophilic preparation (Lipiodol) is activated. Lipiodol is trapped in the abnormal vascular microcirculation of the tumor, while binding the chemotherapeutic agent. In this way, chemotherapeutic activity concentrates exclusively on the tumor, without significant systemic effects on healthy tissues. In addition, microvaccination of tumour neovasculars is induced and cancer cell necrosis. Systemic chemotherapy Systemic chemotherapy has not achieved significant therapeutic results, as only about 15% to 20% of patients with primary liver volume respond positively. In addition, this response is usually limited in duration. Nevertheless, there are work on research and development of new chemotherapeutic medicinal products that are under assessment in the early stages of clinical trials. What is fatty liver filtration? "The accumulation of excessive fat in the liver creates fatty filtration of the liver, a frequent pathological condition. Most people who face this problem do not consume alcohol, show no symptoms and suffer from serious health problems. This condition is known as Non Alcoholic Fat Liver Disease (NAFLD). However, in some cases, fatty filtration may cause liver damage. Fat liver disease, or steatosis, is a common condition caused by excessive accumulation of fat in the liver, affecting its normal function. In this case, it is called Non Alcoholic Steatohepatitis," says Mr. David. What causes the disease and why is it harmful? The origin of non-alcoholic fatty liver disease (NAFLD) remains unknown. It seems that the amount of fat accumulated in the liver is related to the calories we consume. Researchers are aware that fatty filtration of the liver occurs more frequently in people who: They experience type 2 diabetes or prediabetes They suffer from polycystic ovarian syndrome with insulin resistance They are obese They are middle-aged or advanced (although they can also occur in children) They have high blood fat levels, such as cholesterol and triglycerides They face high blood pressure They take certain medicines, such as corticosteroids and certain anticancer drugs They experience certain metabolic disorders. They are exposed to certain infections such as hepatitis C They have been exposed to certain toxins They face obstructive sleep apnea "NAFLD affects about 25% of world population. As obesity, type 2 diabetes and high cholesterol rates increase, the NAFLD rate increases. This is the most common chronic liver disorder. Usually, fatty liver disease does not cause serious problems and does not affect normal liver function in the majority of cases. However, for 7% to 30% of people suffering from this disease, fatty filtration of the liver develops adversely over time and can affect liver function. During this development, the liver swells and cells may suffer destruction. In these areas, scar tissue begins to gradually replace healthy tissue. When this process develops heavily in the liver, cirrhosis of the liver may occur. Hard scar tissue that replaces healthy liver tissue significantly slows liver function and may result in complete limitation of liver function. Cirrhosis can lead to liver failure and even liver cancer," he notes. What are the symptoms and how are they treated? Both NAFLD and alcoholic fatty liver disease usually develop without obvious symptoms or with little, such as fatigue or discomfort on the upper right side of the abdomen due to the enlarged liver condition. Doctors advocate weight loss as a measure for non-alcoholic fatty liver disease. If the doctor suspects that a particular medicine causes NAFLD, it may advise you to discontinue its use. However, before taking this action, it is important to consult the doctor who has given you treatment, as stopping a drug may require a gradual approach and perhaps replacing it with another. It is noted that there are no authorised drugs for the treatment of NAFLD, while studies consider the potential usefulness of certain medicines for diabetes or vitamin E. However, these require further research," concludes Mr. David.