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  1. The liver
  2. What is liver cancer?
  3. The risk factors for liver cancer
  4. Symptoms
  5. Diagnosis
  6. Orthodox treatment

The liver

The liver is a large organ located on the right side of the abdomen and is protected by the rib cage. The liver has many functions. It plays a role in converting food into energy. It also filters and stores blood.

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What is liver cancer?

Liver cancer is a disease in which liver cells become abnormal, grow out of control, and form a cancerous tumor. This type of cancer is called primary liver cancer. Primary liver cancer is also called malignant hepatoma or hepatocellular carcinoma. Very young children may develop another form of liver cancer known as hepatoblastoma.

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The risk factors for liver cancer

The development of liver cancer is believed to be related to infection with the hepatitis-B virus (HBV) and hepatitis-C virus (HCV). Scientists estimate that 10 to 20 percent of people infected with HBV will develop cancer of the liver. Evidence of HBV infection is found in nearly one-fourth of Americans with liver cancer. The exact relationship between HCV and cancer of the liver is being studied.
Researchers have found that people with certain other liver diseases have a higher-than-average chance of developing primary liver cancer. For example, 5 to 10 percent of people with cirrhosis of the liver (a progressive disorder that leads to scarring of the liver) will eventually develop liver cancer. Some research suggests that lifestyle factors, such as alcohol consumption and malnutrition, cause both cirrhosis and liver cancer.
Aflatoxins -- a group of chemicals produced by a mold that can contaminate certain foods, such as peanuts, corn, grains, and seeds -- are carcinogens (cancer-causing agents) for liver cancer.

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Symptoms

Primary liver cancer is difficult to detect at an early stage because its first symptoms are usually vague. As with other types of cancer, this disease can cause a general feeling of poor health. Cancer of the liver can lead to loss of appetite, weight loss, fever, fatigue, and weakness.
As the cancer grows, pain may develop in the upper abdomen on the right side and may extend into the back and shoulder. Some people can feel a mass in the upper abdomen. Liver cancer can also lead to abdominal swelling and a feeling of fullness or bloating. Some people have episodes of fever and nausea, or develop jaundice, a condition in which the skin and the whites of the eyes become yellow and the urine becomes dark.
It is important to note that these symptoms can be caused by primary or metastatic cancer in the liver, by a benign (noncancerous) liver tumor, or by other, less serious conditions. Only a doctor can tell for sure.

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Diagnosis

To make a diagnosis of liver cancer, the doctor takes a medical history, does a careful physical examination, and orders certain tests.

  • Certain blood tests are used to see how well the liver is functioning. Blood tests can also be used to check for tumor markers, substances often found in abnormal amounts in patients with liver cancer. The tumor marker alpha-fetoprotein (AFP) can be useful to help diagnose liver cancer. About 50 to 70 percent of people who have primary liver cancer have elevated levels of AFP. However, other cancers such as germ cell cancer and, in some cases, pancreatic and gastric cancer, also cause elevated AFP levels.
  • X-rays of the chest and abdomen, angiograms (x-rays of blood vessels), CT scans (x-rays put together by computer), and MRI's (images created by using a magnetic field) may all be part of the diagnostic process.
  • Liver scans using radioactive materials can help identify abnormal areas in the liver.
  • The presence of liver cancer is confirmed with a biopsy. Tissue from the liver (biopsy specimen) is removed (through a needle or during an operation) and checked under a microscope for the presence of cancer cells. The doctor may also look at the liver with an instrument called a laparoscope, which is a small tube-shaped instrument with a light on one end. For this procedure, a small cut is made in the abdomen so that the laparoscope can be inserted. The doctor may take a small piece of tissue during the laparoscopy. A pathologist then examines the tissue under the microscope to see if cancer cells are present.
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Orthodox treatment

Liver cancer is difficult to control unless the cancer is found when it is very small. However, treatment can relieve symptoms and improve the patient's quality of life. Treatment depends on the stage (extent) of disease, the condition of liver, and the patient's age and general health. The doctor may recommend surgery, chemotherapy (treatment with anticancer drugs), radiation therapy (treatment with high-energy rays), biological therapy (treatment using substances that help the body fight the cancer), or a combination of these treatment methods.

Treatment by stage

Treatments for adult primary liver cancer depend on the stage of the disease the condition of the liver, and the patient's age and general health. Standard treatment may be considered, based on its effectiveness in patients in past studies, or participation into a clinical trial. Many patients are not cured with standard therapy, and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in most parts of the country for most stages of adult liver cancer.
Localized Resectable Adult Primary Liver Cancer
Treatment is usually surgery (resection). Liver transplantation may be done in certain patients. Clinical trials are testing adjuvant systemic or regional chemotherapy following surgery.
Localized Unresectable Adult Primary Liver Cancer
Treatment may be one of the following:
1. Blocking the hepatic artery and then injecting chemotherapy drugs into the artery and liver (chemoembolization), surgery to freeze and kill the tumor (cryosurgery), injection of ethanol into the tumor, or use of highly focused radio waves designed to destroy the tumor.
2. Liver transplantation.
3. Regional chemotherapy, including injecting the chemotherapy directly into the tumor.
4. Systemic chemotherapy.
5. Surgery with or without chemotherapy possibly followed by radiation therapy.
6. Injection of alcohol directly into the tumor.
7. Radiation therapy plus special drugs that make the tumor more susceptible to the radiation.
8. Highly focused radio waves designed to destroy the tumor

Advanced Adult Primary Liver Cancer

Treatment of advanced adult primary liver cancer depends on what treatment a patient has already received, the part of the body where the cancer has come back, whether the liver has cirrhosis, and other factors. Patients may wish to consider taking part in a clinical trial.

Recurrent Adult Primary Liver Cancer

Treatment of recurrent adult primary liver cancer depends on what treatment a patient has already received, the part of the body where the cancer has come back, whether the liver has cirrhosis, and other factors. Patients may wish to consider taking part in a clinical trial.

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