What is Liver Cancer? Symptoms and Treatment Methods

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1 What is Liver Cancer? Symptoms and Treatment Methods
2 İmages

Symptoms of Liver Cancer

There are many different functions of the liver, such as removing harmful substances from the body, storing energy, and digesting food. One of the most common types of cancer worldwide, liver cancer occurs in liver cells.

It is also possible for other cancerous cells in the body to spread to the liver. Among the risk factors for liver cancer are excessive alcohol and smoking, fatty liver disease, cirrhosis, certain inherited liver diseases, and chronic infection with hepatitis B and hepatitis C viruses. Liver cancer has very few symptoms. Generally, patients can see the effects of this disease at an advanced stage.

Factors That Trigger Liver Cancer

Hemangioma and Focal nodular hyperplasia are benign liver tumors that do not transform into cancer. However, they still need to be monitored as they may increase in size and cause pain. Liver adenoma or hepatic adenoma, as for that, has the potential to develop into liver cancer and bleed. Liver cancer is a common disease in our country. With an average age at diagnosis of 62 years, there are many different risk factors for liver cancer.

Hepatitis can be prevented by avoiding hepatitis infection, stopping alcohol and smoking, and eating a healthy diet. Risk factors include obesity, type two diabetes, inherited metabolic diseases, and cirrhosis.

How does liver cancer manifest itself?

Among the symptoms of liver cancer are jaundice, vomiting, nausea, persistent weakness and fatigue, weakness and unexplained weight loss, tenderness, pain, and abdominal discomfort. You should inform your doctor if you have a family history of hepatitis. Before a cancer diagnosis, your doctor will listen to you and look for signs of liver cancer. To determine the degree of health, various liver function tests are performed.

CT or MRI scans of the abdomen are performed to look at detailed images of the liver and other organs. Treatment of liver cancer usually involves removing the tumor from the organ. It can be performed in cases where it is confined within the liver and if the cancer is accompanied by cirrhosis. Other treatment methods that can be used include chemotherapy, radiation therapy, ablation methods (tumor-burning procedures in the liver), radioembolization, and chemoembolization.

Diagnosing Liver Cancer

Treatment of the disease is often diagnosed incidentally. A physical examination of the patient may reveal a larger painful liver. Some blood tests also provide important information about the disease. Besides, various radiology modalities such as computed tomography, magnetic resonance imaging, and ultrasound can help detect liver cancer.

It is not always necessary to have a biopsy to diagnose liver cancer. Liver masses with a typical radiologic appearance can almost certainly be diagnosed. A biopsy is possible if there is any doubt about the diagnosis. The biopsy is performed under local anesthesia.

Diagnosis of Liver Tumor

For diagnosis and treatment of liver tumors, you should consult your doctor. The liver is located below the diaphragm and above the stomach. In the liver, which is located in the upper right part of the abdomen, tumors can cause abdominal pain in the final stages. People with a family history of liver cancer, people with chronic liver disease, people with hepatitis B and hepatitis C, and people who drink alcohol are most at risk of developing liver cancer.

While the diagnosis of liver cancer can occur during periodic controls of high-risk patients, it can also occur as a result of the symptoms of the disease itself. Methods such as measurement of alpha-fetoprotein (AFP) and CA 19-9 levels, magnetic resonance, computed tomography, ultrasonography, and blood tests can be used to diagnose the disease. Surgical intervention is the most effective method, although many different methods are preferred for the treatment of the patient. Thanks to today’s technology and increased patient care facilities, it is now possible for most patients to be discharged in a few days after surgical interventions on the liver.

In the case of hepatitis B, hepatitis C, fatty liver disease (hepatosteatosis), and associated inflammation of the liver (steatohepatitis) or chronic liver disease due to other causes, hepatocellular cancer (HCC) is the most common type of liver tumor. In this disease, since the liver tissue is diseased, surgery must be decided after careful calculations. In other words, some hepatocellular carcinoma patients benefit from surgery, while others do not, and it is necessary to plan treatment with the right strategy. Biliary tract and gallbladder cancers are also common diseases encountered by liver surgeons. Surgical treatment is effective for cancers of the biliary tract (cholangiocarcinoma).

Cholangiocarcinoma involving the common biliary tract is called Klatskin’s tumor. This is a highly complex and sophisticated procedure that requires careful calculations and good planning. If successfully operated with good planning, however, a significant advantage can be achieved in the patient’s life expectancy. This surgery can only be successful if it is performed by well-trained and experienced surgeons who are experts in their field.

Nowadays, surgical methods applied to liver tumors have come a long way and almost any tumor can be removed wherever it is located in the liver, as long as the remaining liver tissue is not diseased (cirrhosis) and has sufficient volume. If the tumors are removed with some surrounding intact liver tissue, the risk of recurrence is significantly reduced. The liver consists of eight segments and two halves. Most commonly, tumors require resection of one or more of these segments or resection of the right or left half of the liver (right hepatectomy, left hepatectomy). Removing tumors, especially those located in the middle of the liver, requires the use of special techniques such as central hepatectomy.

During surgery for this type of centrally located tumor, a mistake can lead to the unnecessary removal of some of the intact liver tissue. If the tumor is very widespread in the liver and the remaining liver after removal is very small, the ALPPS (Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy) procedure or two-stage surgery techniques may need to be used to prevent the patient from going into liver failure after surgery. Such procedures are more complex than normal liver operations and are performed only by surgeons with a special interest in the subject. In recent years, liver surgeries can also be performed laparoscopically and robotically.

Knowledge of liver anatomy, experience, and training play a major role in this, and in appropriate cases, laparoscopic surgery shortens hospitalization, reduces the amount of blood used, and allows for treatment with a smaller surgical scar and less postoperative pain.

Among the symptoms of liver cancer may be vomiting and nausea, yellowing of the eyes in more advanced stages, a general feeling of weakness and fatigue, abdominal swelling, and involuntary weight loss. If the tumor does not initially cause any complaints, it may cause a person to neglect their health. Therefore, you should definitely undergo a doctor’s check-up at regular intervals.

Karaciğer kanseri belirtileri arasında kusma ve mide bulantısı, daha ileri evrelerde gözde sararma, genel bir halsizlik ve yorgunluk hissi, karında şişlik, istem dışı kilo kaybı olabilir. Tümörün başlangıçta herhangi bir şikayete sebep olmaması, kişinin sağlığını ihmal etmesine sebep olabilir. Bu nedenle mutlaka belirli periyotlarda doktor kontrolünden geçmeniz gereklidir.

Yüksek riskli hastaların periyodik kontrollerinde ortaya çıkabilen karaciğer kanseri tanısı, kişinin kendisinde meydana gelen hastalık belirtileri sonucunda da ortaya çıkabilir. Hastalığın teşhis edilebilmesi için için alfa fetoprotein (AFP) ve CA 19-9 düzeyi ölçümü, manyetik rezonans, bilgisayarlı tomografi, ultrasonografi, kan testleri gibi yöntemler kullanılabilir. Hastanın tedavisi için birçok farklı yöntem tercih edilse de en etkili yöntem cerrahi müdahaledir. Günümüz teknolojisi ve hasta bakım imkanlarının artmasıyla günümüzde karaciğere yapılan cerrahi müdahaleler sonrası hastaların çoğunun birkaç günde taburcu edilmesi mümkün olmaktadır.

Measures Against Liver Cancer

You can take measures to prevent liver cancer yourself. You can protect your health by controlling risk factors and taking measures on your own. Even though there is no protective vaccine for hepatitis C, you can take measures against hepatitis C. It would be advantageous for you to use condoms during sexual intercourse and to get information about the health status of your sexual partner. It would be advantageous for you to choose safe centers that comply with hygiene rules if you are considering piercing or tattooing. Another way to prevent liver cancer is to get the hepatitis B vaccine.

The hepatitis B vaccine, which can be given at any age, reduces the risk of liver cancer. You can limit alcohol consumption to reduce the risk of cirrhosis. Exercise and getting rid of excess weight will also help you to prevent liver cancer. Remember to have regular health check-ups if you are in a risk group. You should consult your doctor immediately if you have problems such as dark urine, a light-colored large toilet, yellowing of the whites of the eyes, yellowing of the skin, bloating in the upper right part of the abdomen, or abdominal pain.

Vomiting, nausea, decreased appetite, fatigue, weakness, and involuntary weight loss are among the symptoms of liver cancer. You should take action to diagnose the disease at an early stage if you are suffering from such problems. This allows you to detect cancer before it has spread throughout the body.

Treatment of Liver Cancer

Liver cancer is a treatable disease. It may vary according to the treatment method, which is usually performed with surgical procedures. Hepatocellular carcinoma is a malignant tumor that occurs in the liver located below the diaphragm and above the stomach. Cancer of other organs, such as the large intestine, stomach, breast, and pancreas, spreads to the liver in the majority of cases, resulting in a tumor in the liver. Then hepatocellular carcinoma is the most common and the remaining cases are called cholangiocellular carcinoma. These tumors, called cholangiocellular cancer or cholangiocarcinoma, are tumors that originate in the bile ducts, usually located in the liver.

Cancer types like these are called metastatic cancers. Risk factors for liver cancer include excessive alcohol consumption over many years, fatty liver disease independent of alcohol, hereditary liver diseases, chronic liver infections such as hepatitis B and hepatitis C, and cirrhosis. Vomiting and nausea, yellowing of the eyes, fatigue and weakness, abdominal swelling, and involuntary weight loss are among the symptoms of liver cancer. Liver cancer is usually treated with surgery.

This surgical intervention, in which the tumorous part of the liver is surgically removed, also includes liver transplantation. Depending on the patient’s condition, other treatment modalities such as nuclear medicine, microsphere, ablation therapy, and radiotherapy can also be applied. Caused by the deterioration of the cells in the liver, liver cancer manifests itself with different factors such as my mother, back pain, itching, fever, and white coloration of the stool.

Yellowing under the eyes, yellowing of the skin and involuntary weight loss are also among the symptoms of liver cancer. To be protected from this disease, which does not give symptoms in the early period, and to make an early diagnosis, you should definitely have your doctor’s check-up regularly.

Liver Cancer Surgery

Because of its location and structure in the abdomen, the liver is one of the most difficult organs to operate on. This is partly because it rests against and is adherent in places to the diaphragm, the membrane that separates the chest and abdominal cavities, and partly because of the variations in the vessels that supply and drain it, that is, the variations from person to person. Against this background, thanks to developments in medicine, the variety of liver surgeries have increased in the last 20 years, and today, highly complex and serious resections can be performed both open and closed with laparoscopic and robotic surgery.

Liver cancer, medically known as hepatocellular carcinoma (HCC), is a disease that usually occurs in older people. In the liver, spontaneous malignant tumors can hurt a person’s life. This condition can be triggered by metabolic diseases, certain carcinogenic substances, liver adenine, alcohol-related liver cirrhosis, hepatitis B, and hepatitis C virus. Liver cancer is a symptomless disease in the early stages. In patients with liver cancer, which manifests itself with easy bleeding from the skin and other tissues, yellowing of the skin, abdominal swelling, and mild pain in the right side of the abdomen, patients may not have any complaints.

The most common disease of the liver requiring surgery in our country is a hydatid cyst (canine worm/cyst). There are two types of hydatid cyst disease: good prognosis and poor prognosis. In our country, the good prognosis variety is more common, while the bad prognosis variety is also frequently encountered, especially in Eastern Anatolia. In hydatid cysts with a good prognosis, the intracyst parasite is deactivated with medication during surgery and the cyst is drained. It is also often necessary to remove part of the cyst shell.

Rarely, part of the liver also needs to be removed (resection). However, a bad prognosis requires liver resection just like a tumor. With the use of preoperative medication, properly performed surgery, and postoperative medication, successful treatment is possible with very low recurrence rates after hydatid cyst disease. Today, treatment of some patients with hydatid cysts has become possible with special drugs administered through a needle under local/general anesthesia without surgery. The choice of treatment method depends on the patient and the condition of the disease.

How is liver cancer surgery performed?

The most commonly used method in the treatment of liver cancer is surgery. During the surgical treatment process, which continues with the removal of the tumor or tumors, a part of the liver must be removed or a liver transplant must be performed. After liver surgery, even if 75% of the healthy liver is removed, the remaining liver will rapidly regenerate itself and regain its function. Both open and closed methods can be used for liver surgery.

Surgery on the closed liver requires considerable experience and skill. In every surgery, whether open or closed, there are certain common points from the process of being taken to the operating room to the process of performing surgical procedures. There are two different incisions in open liver surgery. There is one horizontal and one vertical incision in the upper part of the abdomen. The surgery can also be performed by making a vertical incision in the upper abdomen and on the midline.

As a team, in the last 12 years, we have performed hundreds of liver surgeries to date. We performed 130 of these operations in the form of closed, laparoscopic liver surgery. These numbers make us the first in the country in closed laparoscopic technique. In more than half of the patients, we perform liver resections laparoscopically. Similarly, laparoscopic surgery has been used for almost all types of large and small liver resections, including right hepatectomies in which about 70% of the liver is removed. The average hospital stay of these patients is usually 2-7 days.

Mass in the Liver

A mass in the liver is called a tumor. Masses in the liver area usually arise from the liver’s own tissue. These malignant masses can also spread to the liver from different organs. Even though most of the masses found in the liver are benign, there may also be malignant tumors that invite liver cancer.

These masses can be detected after special tests and examinations. However, you can also get to know your body and suspect whether there is a mass in the liver. Symptoms of a liver tumor include vomiting, jaundice, high fever, persistent weakness, and severe abdominal pain. Symptoms of liver cancer include excessive yellowing of the skin and yellowing of the whites of the eyes, significantly reduced desire to eat and loss of appetite, nausea, and weight loss.

If a benign mass is detected, the patient should undergo periodic medical check-ups. The treatment for malignant masses will be decided by your doctor. If necessary, the mass can be removed from the liver or a liver transplant can be performed.

Treatment of a Mass in the Liver

Other treatments used in the liver include smart drug applications, immunotherapy, chemotherapy, and radiotherapy. Different applications such as a radioactive sphere, chemotherapy, cold, or heat can also be performed to destroy the mass. Liver tumors usually occur in patients with cirrhosis, chronic hepatitis B and C, and advanced fatty liver disease.

A mass in the liver usually does not show any symptoms. They can therefore be detected incidentally on imaging examinations. Cancer patients have symptoms such as fever, jaundice, weakness, abdominal pain, weight loss, vomiting, and nausea. After the mass is detected, a biopsy is performed to confirm the diagnosis.

Treatment Methods for a Mass in the Liver

By far the most common types of liver cancer include cholangiocarcinoma and hepatocellular carcinoma (HCC). The most frequent cancers that metastasize to the liver are prostate, kidney, lung, breast, stomach, and colon cancer. Chemotherapy and surgery can help you fight liver cancer.

It is also possible to cure cancer with new treatment methods. These methods include radioembolization, chemoembolization, and percutaneous ablation. Which of these procedures will be appropriate for the patient will be decided by the physician.