Malignant lesions of the liver can be primary, that is, coming from the cells of the liver structures, and secondary – the growth in the liver of secondary metastatic tumor nodes from cancer cells brought into the liver from other internal organs. Metastatic tumors of the liver are registered 20 times more often than primary ones, since blood coming from the internal organs passes through the liver, as through a filter.
Primary liver cancer is a relatively rare disease, accounting for, according to various sources, from 0.2 to 3% of all cancer cases. Among the diseased, males aged 50 to 65 years predominate. There are several forms of liver cancer, different in origin.
- hepatocellular carcinoma (hepatoma, hepatocellular carcinoma, occurring, as the name implies, from the cells of the liver parenchyma);
- cholangiocarcinoma (tumor from epithelial cells of the bile ducts, accounting for 5-30% of all primary malignant liver tumors);
- angiosarcoma of the liver (malignant hemangioendothelioma of the liver – one of the most malignant tumors of the liver, growing from the vascular endothelium);
- hepatoblastoma (malignant liver tumor of childhood).
1. Chronic viral hepatitis (hepatitis B, hepatitis C) contributes to the development of liver cancer. The risk of developing hepatocellular cancer 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, schistosomtosis and others).
6. Chronic alcoholism.
7. Exposure to carcinogens (polychlorinated biphenyls, chlorinated hydrocarbon solvents such as carbon tetrachloride, nitrosamines, organic chlorine pesticides, aflatoxins found in foods).
In the initial stages of cancer, there are general malaise, all kinds of dyspeptic disorders (loss of appetite, nausea, sometimes vomiting), a feeling of heaviness in the right hypochondrium, dull aching pains, fever. There are general weakness, weight loss, anemia (anemia).
With the development of the disease, an increase in the liver may be detected, the liver may protrude from under the costal arch, may acquire a woody density, tuberosity. When probing the area of the liver, a tumor-like formation can be detected. Gradually jaundice increases.
Initially, the assumption of liver damage arises on the basis of complaints and the appearance of the diseased.
Ultrasound (ultrasound) is of great importance in the diagnosis of tumor lesions of the liver due to its wide availability and sufficient accuracy. With the help of ultrasound, it is possible to identify nodular formations in the liver, by special characteristics to differentiate their benign and malignant nature.
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 by simpler methods or to clarify the prevalence of the process.
Additional data can be obtained from radioisotope scanning of the liver.
Determination of blood parameters that indirectly testify in favor of liver damage.
- a biochemical blood test, which can detect an increase in bilirubin levels, a decrease in protein levels, an increase in liver enzymes;
- a blood test for tumor markers (indicators, an increase in the level of which in the blood indicates the presence of a particular tumor in the body).
It should be remembered that the detection of any, even a malignant disease at an early stage improves the prognosis of the upcoming treatment.
The main treatment for liver cancer is surgery.
In the case of hepatocellular carcinoma, a segment of the liver with a tumor or a lobe of the liver (hemihepatectomy) is removed.
With cholangiocarcinoma, in some cases, removal of the duct with the tumor is likely, followed by the imposition of an anastomosis (fistula).
With single nodes, their ablation is possible (radiofrequency ablation, chemoablation, cryoablation) – a treatment method 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, while a thin catheter is inserted through the blood vessel to the tumor node, into which the chemical product is injected, thus the effect directly on the tumor is more intense, and the negative effect of the chemical product 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 can only be determined with a thorough examination of the patient.
Primary liver tumors are characterized by local invasive growth, especially 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 violent and without treatment in 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 – within 20%.
Since the development of liver cancer is promoted by chronic viral hepatitis B and virus carriers, some parasitic diseases, carcinogenic effects on the liver of industrial poisons, the basis of primary prevention is the prevention of these diseases and environmental protection. Secondary prevention is the early detection and timely treatment of chronic liver diseases.
Of particular importance is the fight against alcoholism, since cirrhosis of the liver (especially large-nodular form) is found in approximately 60-90% of patients with hepatoma.