Hepatoma is the one of the most common cancer in the world with 1 Million new cases diagnosed every year. Roughly 20,000 new cases are diagnosed every year in United states. It is more frequent in men and Oriental-Americans. The average age at the time of diagnosis if 60 years. Unfortunately, most patients are diagnosed in advanced stages when cure is not possible. The liver is a gland which is located in the upper part of the abdomen, laying almost on the spine. The liver is a common site for metastasis from other cancers. Hepatoma has to be distinguished from other cancers that spread to liver.
CAUSES OF LIVER CANCER
Many viruses and chemical agents seem to be involved in causation of this cancer.
• Hepatitis B and C viruses are the most important causes worldwide. Hopefully, vaccination with hepatitis vaccine will reduce the frequency of this illness in the next century.
• Alcohol-induced liver damage
• Aflatoxin is a toxin which is produced by fungus that grows in peanuts, corn, etc.
• Throrotrast, which was used decades ago in radiology studies
• PVC-exposure among factory workers. PVC is used in plastic pipes, etc.
• Iron overload and Arsenic poisoning
SIGNS AND SYMPTOMS
Cancer of the liver can grow for a long time without causing any problems. Most patients are diagnosed in advanced stages and present with any of the following signs:
• Abdominal pain
• Weight loss
• Nausea, vomiting
• Jaundice, as a result of obstruction of bile ducts
• Anemia
STAGING
A CT Scan of the abdomen can easily determine the extent of this illness. The disease can be limited to one site in the liver or spread to multiple sites. Hepatoma is a very malignant disease that can be fatal even before spreading to other areas outside the liver.
TREATMENT
Surgery: Management of this disease relies on surgery in an attempt to remove most or all of the liver and reconstruct the continuity of the bile ducts. This is a rather very difficult procedure which, even in best hands, carries a very high risk. Indications for surgery are limited to younger patients with very small size tumors. Liver transplant is another option which may be considered in certain patients.
Chemotherapy is appropriate for patients in whom the disease is not curable with surgery. Adriamycin, VP-16, Cisplatinum, Mitomycin, 5-FU and Leucovorin are among the most commonly used drugs for liver cancer. These drugs are used in combination and can have moderate to severe toxic effects. This condition is rather difficult to manage with chemotherapy. Attempts at infusion of chemotherapy directly into the liver vessels have not proven to be very effective.
Radiation is rarely used to treat this illness.
