Treatment of disorder
There are Metastatic Liver Cancer, which Bowel Cancer or Stomach Cancer advanced then transferred to Liver, and Primary Liver Cancer which is developed from Liver itself. They are completely different diseases so that their characteristics and treatment methods are also different. Primary Liver Cancer is then grouped into several groups such as Hepatocellular Cancer or Hepatic Duct Cellular Cancer. About 95% of Primary Liver Cancer is Hepatocellular Cancer. Here we will explain about hepatocellular cancer which constitute nearly all primary liver cancer developed from Liver.
Hepatocellular cancer has a unique characteristic for which other cancer does not have. They are;
There are other characteristics like high risk group of cancer development is clear and distinctive so that test objective person is easy to squeeze down. Also, as several treatments are necessary so that liver function is the concerned point regarding the selection of treatment.
Symptoms are stomach pain and/or jaundice, but they do not appear until disease advances much deeper then it becomes the late stage. On relatively early stage, no symptoms appeared, so that it is necessary to have periodical medical test mentioned as below. Also, Hepatocellular Tumor suddenly develops much bleeding on or inside of abdomen, if it grows rapidly (Liver Cancer Rapture). In this case, sudden acute abdominal pain appears.
Almost all hepatocellular cancer is developed on chronic hepatitis or cirrhosis of liver. So that person who has high risk of developing hepatocellular cancer is the person in chronic hepatitis or cirrhosis of liver. Whatever the cause is, it is requested to have image test for persons having chronic hepatitis or cirrhosis of liver, in more than few times a year. Image Tests are, abdominal ultrasonography, CT exam and MRI exam are the mains. Each of these tests has merit and demerit, so that it is considered as desirable to combine these test.
In addition to these image test, measurement of AFP, AFP Lectin (L3) Cutoff, RIVKA II are conducted. However, tumor marker does not necessarily give abnormal value all the time, comprehensive diagnosis for image test and tumor marker is needed. With these test, as almost all hepatocellular cancer can be diagnosed unlike other cancers, histopathological work-up, to pick up tissue directly and observe it using microscope which is different from other cancer, will not conducted in general. But when it is unable to diagnose, histopathological work-up may conducted.
When treatment is performed to hepatocellular cancer, not only spreading of the cancer but also liver function is the main issue. Spreading of disease focus is diagnosed by image test, but liver function will be comprehensively diagnosed by the existence of ascites fluid and with or without the symptom of liver encephalopathy
Treatment methods are, surgery, Ablation Coagulation Therapy, transcatheter arterial chemoembolization/ hepatic arterial infusion, Radiation Therapy, molecularly-target drug. Outlines of selection criteria for the treatment are listed as below.
|Treatment Method||Expansion of focus||Liver Function|
|Surgery||Max. diameter less 3 cm plus less 3 pieces, or Diameter 5cm plus one piece||Limited to goodness sample for liver function *Stipulate cut off area by liver function|
|Ablation Coagulation Therapy||Max. diameter less 3 cm plus less 3 pieces, or Diameter 5cm plus one piece||Possible to Liver Function moderately poor case|
|Transcatheter Arterial Chemoembolization / Hepatic Arterial Infusion|
|molecular target drug|