Month: December 2020

What is Liver Cancer?

What is Liver Cancer?

Patient Education: Hepatocellular Carcinoma (Liver Cancer):

What is liver cancer?

Liver cancer happens when normal cells in the liver change into abnormal cells and grow out of control. The liver is a big organ in the upper right side of the belly.

Most people who get liver cancer have long-term liver disease (also called chronic liver disease). Having long-term liver disease increases a person’s chances of getting liver cancer. The most common and most serious form of long-term liver disease is a condition called “cirrhosis,” which scars the liver.

What are the symptoms of liver cancer?

Liver cancer does not usually cause any symptoms of its own. A few patients might have a lump or mild pain in the upper belly, feel full early on when they try to eat, or lose weight.

Others might have symptoms that are caused by the liver disease they had before they got cancer. Those symptoms can get worse or come back because of the cancer. They include:

  • Swelling of the belly or legs
  • The skin or white part of the eyes turning yellow

If you have these symptoms, tell your doctor or nurse.

Is there a test for liver cancer?

Yes. If your doctor suspects you have liver cancer, they will do 1 or more of the following tests:

  • Blood tests
  • Imaging tests: An MRI scan, CT scan, ultrasound, or other imaging test. Imaging tests create pictures of the inside of the body and can show abnormal growths.
  • Biopsy – For this test, a doctor will remove a small sample of tissue from the liver. Another doctor will look at the sample under a microscope to see if it has cancer.

What is liver cancer staging?:

Cancer staging is a way in which doctors find out if a cancer has spread past the layer of tissue where it began and, if so, how far.

How is liver cancer treated?

Liver cancer can be treated in different ways. Treatment depends on the stage of your cancer. It also depends on how healthy your liver is (in other words, how serious your liver disease was before you got cancer). The different treatments include:

  • Surgery – Liver cancer can sometimes be treated with surgery to remove the part of the liver with the cancer.
  • Liver transplant – A liver transplant is a type of surgery in which a doctor replaces a diseased liver with a healthy liver from another person.
  • Ablation therapy – Ablation therapy is a procedure that can kill cancer cells in the liver. It does not involve surgery. Doctors can do ablation therapy in different ways. They can kill the cancer cells using heat, microwaves, a laser, or radiation therapy.
  • Blocking the cancer’s blood supply – Doctors can do a procedure called “embolization” to block off the blood vessel that sends blood to the cancer. This keeps the cancer from growing by “starving” it of its blood supply. Sometimes, the embolization procedure is combined with chemotherapy (“chemoembolization”) or radiation (“radioembolization”).
  • Immunotherapy – This is the term doctors use for medicines that work with the body’s infection-fighting system (the “immune system”) to stop cancer growth.
  • Chemotherapy – Chemotherapy is the medical term for medicines that kill cancer cells or stop them from growing.

What happens after treatment?

After treatment, you will be checked every so often to see if the cancer comes back. Regular follow up tests usually include exams, blood tests, and imaging tests.

You should also watch for the symptoms listed above. Having those symptoms could mean the cancer has come back. Tell your doctor or nurse if you have any symptoms.

If you had a liver transplant, you will need to take medicines called “anti-rejection medicines” for the rest of your life. These medicines help keep your body from reacting badly to your new liver.

What happens if the cancer comes back or spreads?

If the cancer comes back or spreads, your doctor will talk with you about possible treatment choices. These might include the treatments listed above.

What else should I do?

It is important to follow all your doctor’s instructions about visits and tests. It’s also important to talk to your doctor about any side effects or problems you have during treatment. People who have liver cancer, especially if they have long-term liver disease, should avoid alcohol and any drugs that could be harmful to the liver.

Getting treated for liver cancer involves making many choices, such as what treatment to have.

Always let your doctors and nurses know how you feel about a treatment. Any time you are offered a treatment, ask:

  • What are the benefits of this treatment? Is it likely to help me live longer? Will it reduce or prevent symptoms?
  • What are the downsides to this treatment?
  • Are there other options besides this treatment?
  • What happens if I do not have this treatment?

Compiled from UpToDate.

What is Cirrhosis of Liver?

What is Cirrhosis of Liver?

Patient education: Cirrhosis

Cirrhosis is a disease that scars the liver. The liver is a big organ in the upper right side of the belly. Damage to the liver can cause heavy bleeding, swelling, and breathing problems.

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What are the symptoms of Cirrhosis?

Some people with cirrhosis have no symptoms. When symptoms do occur, they can include:

  • Swelling in the belly and legs, and fluid buildup in the lungs
  • Heavy bleeding from blood vessels in the esophagus, the tube that connects the mouth to the stomach
  • Bruising or bleeding easily
  • Trouble breathing
  • Feeling full
  • Feeling tired
  • Trouble getting enough sleep or sleeping too much
  • Yellowing of the skin or whites of the eyes, called jaundice
  • Confusion that can come on suddenly
  • Coma

Cirrhosis also makes it more likely that you will get infections, and it can increase your risk of liver cancer.

What causes cirrhosis?

When something harms the liver, the organ tries to fix itself. In the process, scars form. Causes of liver damage include:

  • Heavy alcohol use – People who abuse alcohol or who are addicted to it are most at risk for cirrhosis.
  • Hepatitis B or hepatitis C – Viruses cause these liver diseases. People can catch the viruses by sharing needles or having sex with people who are infected.
  • Nonalcoholic steatohepatitis (NASH) – People with this condition often don’t drink alcohol. Doctors aren’t sure what causes NASH, but many people who have it are overweight and have diabetes.

Is there a test for cirrhosis?
Yes. Tests include:

  • Biopsy – In this test, a doctor puts a needle into your liver and takes out a small sample of tissue. The sample will show how severe the damage is.
  • Blood tests – Results can show what is causing the disease.
  • Imaging – Your doctor might take pictures of your liver with an ultrasound machine or with a MRI.

Is there anything I can do to prevent further liver damage?

Yes. To help protect your liver:

  • Avoid alcohol
  • Talk to your doctor before you start taking any new medicines, including pain killers such as ibuprofen (sample brand names: Advil, Motrin), naproxen (sample brand name: Aleve), or acetaminophen (sample brand name: Tylenol). Also talk to your doctor before taking any herbs, vitamins, or supplements. Some medicines and supplements can damage the liver.
  • Get vaccinated against hepatitis A and B if you have not had the infections before.

How is cirrhosis treated?:

Treatments depend on the cause of cirrhosis, how severe it is, and what symptoms you have. Treatments fall into a few main categories, including those that:

  • Treat the cause of the disease – Some causes of cirrhosis can be treated. For example, people with cirrhosis caused by alcohol abuse can try to stop drinking. People with chronic hepatitis C or B can take medicines.
  • Lower the risk of bleeding – Cirrhosis can cause the blood vessels around the esophagus to swell or even burst and bleed. To prevent that from happening, doctors can:
  • Prescribe medicines called “beta blockers.” These medicines reduce blood pressure in the liver and help reduce the chance of bleeding.
  • Place tiny bands around the swollen blood vessels (this procedure is called “variceal band ligation”)
  • Decrease fluid buildup in the belly – In people with cirrhosis, the belly sometimes fills with fluid. To decrease fluid buildup, doctors can:
  • Prescribe medicines called “diuretics.” These medicines make you urinate a lot. People who take diuretic medicines often must also reduce the amount of salt they eat.
  • Drain the fluid from your belly using a needle (this procedure is called a “paracentesis”)
  • Implant a device in the liver that reduces fluid buildup in the belly (this procedure is called “TIPS”)
  • Treat or prevent infection – People with cirrhosis have a higher than normal chance of getting infections. When they get an infection, they can also get much sicker than people without cirrhosis. As a result, people with cirrhosis sometimes need antibiotics to either treat or prevent infection. Most people with cirrhosis should also get the flu vaccine and other vaccines to prevent common infections.
  • Treat confusion – Advanced cirrhosis can lead to confusion. Doctors usually use lactulose (a medicine that softens stool) or certain antibiotics to treat the confusion.

Will I need a new liver?

People with severe cirrhosis need a new liver. Talk to your doctor about the surgery before you get too sick, to find out if a liver transplant might be an option for you. People often have to wait for up to 2 years to get a new liver.
Can cirrhosis be prevented?

You can reduce your chances of getting cirrhosis by:

  • Getting help if you have an alcohol problem
  • Getting the vaccines for hepatitis B and hepatitis A, if you haven’t already
  • Using condoms when having sex
  • Not sharing drug needles

Compiled from UpToDate.