Liver cancer refers to the disease, the proportion of which among oncological lesions of the body is steadily increasing.
And this is connected, first of all, with the increase in the number of patients with chronic form of viral hepatitis of different species, as well as with a number of other disease-provoking factors.
Cancerous liver damage is difficult to tolerate, revealing the disease at the initial stage of its development greatly facilitates the treatment and can result in complete recovery.
The concept and statistics of the disease
Under the hepatic malignant formation is implied the development of cancer cells in this organ. The disease can be primary, or secondary.
In the first case, the tumor directly begins to grow from hepatocytes, that is, the cells of this organ or from the bile ducts.
Secondary form of hepatic cancer is detected approximately 30 times more often and it arises because of metastasis, that is, under the influence of cancer cells from other organs with malignant neoplasm.
Photo of liver cancer - angiosarcoma
Every year, malignant liver damage occurs in almost 700,000 people around the world. But the share of primary malignant lesion among the identified patients is only 0.2%.
The use of thermally untreated fish results in infection with parasites that damage liver cells.
Those who are over 40 years old and men among them are almost 4 times more likely to suffer from cancer.
This pattern is revealed - if a man has any tumor, the probability that it will turn out to be malignant is close to 90%.The detection of hepatic formations in women in 60% of cases establishes a benign process and in 40% malignant.
Classification of
In medicine, several classifications of liver cancer are used. In its origin, malignant neoplasm is divided into:
- Primary.
- Secondary. More often the primary tumor leading to organ damage is localized in the large intestine, lungs, breast, ovaries, stomach.
Liver cancer is divided and depending on what cells of the body it develops:
- Epithelial. This group includes cholangiocellular, hepatocellular and hepato-cholangiocellular. Epithelial cancer of the liver can be of undifferentiated type.
- Non-epithelial. This group includes hemangiendothelioma.
- Mixed are carcinosarcomas and hepatoblastomas.
Video on volumetric liver formations:
Species:
- Cholangiocellular - tumor growth starts from the epithelial cells of the bile ducts. At the onset of malignant disease, there are practically no symptoms of the disease.
- Hepatocellular begins to form from hepatocytes, according to the frequency of spreading it is practically the very first place. This type of cancer can be either as a single tumor or as a set of small nodules. The subtype of this malignant lesion is fibrolamellar carcinoma, it is characterized by the defeat of small areas of the liver, which improves the prognosis of the course of pathology.
- Angiosarcoma is a malignant formation, formed from endothelial cells of blood vessels. It is characterized by extremely aggressive development, rapid appearance of metastases and significant destruction of the parenchyma of the organ.
- Carcinosarcoma is a mixed type of tumor, consisting of atypical cells of cholangiocellular or hepatocellular carcinoma and from cells formed in sarcoma. This type of cancer is rare.
- Hepatoblastoma. This type of malignant neoplasm develops from cells that are similar in structure to the embryonic cells of the organ. Children under the age of 4 are subjected to this pathology. Is manifested by a rapid increase in the abdomen, fever, decreased activity.
Primary
Primary liver cancer is a neoplasm that begins its formation directly in the organ itself.
In most cases, the formation of this malignant tumor is caused by chronic inflammatory processes in the organ and cirrhosis.
To the developmental reasons, the primary cancer is:
- Opisthorchiasis - a helminthic invasion of , which develops when eating poorly fried or raw fish. Such a disease is more often found in the Irtysh and Ob rivers living in the basins and leads to the growth of tumors with a cholangiocellular structure.
- Effects on the body aflatoxin , a product of a fungus, affecting cereals, nuts.
- Viral hepatitis. Hepatitis B antigen is detected in blood in more than half of patients with primary liver cancer.
There is a carcinogenic effect on liver cells of tobacco tar, alcohol, components of oral contraceptives and drugs used by athletes to build muscle mass.
By its anatomical structure is divided into:
- Massive. Neophyte in size reaches the fist, and from the healthy tissues of the body is limited to a capsule.
- Nodal. Tumors can be more than a dozen, their sizes can reach the size of a walnut.
- Diffuse. With this form of malignant damage, cancer cells permeate the whole organ.
In most cases, primary cancer is hepatocellular carcinoma. The disease is more susceptible to men after 50 years.
The first symptoms of pathology include the appearance of pain in the upper half of the abdomen, the identification of compaction, weight loss. The first manifestations of hepatocellular carcinoma often become febrile syndrome, ascites or peritonitis.
Secondary
Secondary, i.e., metastatic liver cancer, occurs almost 30 times more often than in its primary form.
In this type of disease, the primary focus is most often located in a number of located organs - the stomach, pancreas, kidneys, mammary glands. More rarely, the root cause of the disease is found in women in the uterus and ovaries, in men in the prostate gland.
Cancer cells enter the liver through a portal vein with blood or lymph flow. Secondary cancer is more often its nodular form, in which the nodes can be located both on the surface of the organ and be in the center of it.
Symptoms in a secondary tumor are practically the same as the primary type of malignant lesion.
Epithelioid hemangiendothelioma
Epithelioid hemangiendothelioma develops from the endothelium lining the capillaries of the liver. The spread of malignant neoplasm occurs along the vessels and also covers the branches of the portal vein.
Epithelioid hemangiendothelioma should be differentiated with angiosarcoma and cholangiocarcinoma.
Causes of
The main cause of liver damage to cancer cells, as well as other types of cancer, has not yet been established.
But examination of patients with this type of malignant formation made it possible to find out that it occurs in most people if one or several of the following provoking causes on their organism:
- Chronic course of viral hepatitis , most often it is hepatitis B, although there are many cases in which cancer occurs in people with hepatitis C. The virus is capable of mutation, which predetermines changes in the structure of cells.
- Cirrhosis. In turn, cirrhosis often develops in people with viral diseases, as well as those who suffer from alcoholism. The cause of the disease may be long-term use of certain groups of medications. In cirrhosis, normal liver tissue is replaced by a connective tissue, and this leads to a disruption of its functions.
- Effects on the body of aflatoxin. This substance is a product of the disintegration of fungi, localized on products whose storage conditions are disturbed. More often the toxin reproduces on peanuts, wheat, rice, soybeans, corn.
- Increased iron content in the body. This pathology is designated by the term hemochromatosis.
- Gallstone disease and diabetes mellitus.
- Infection with helminths.
- Syphilis. With this venereal disease, the structure of the liver tissue is steadily changing.
- The use of steroids - drugs used to set muscle by some athletes.
Malignant tumor is more often detected in people who smoke, carcinogenic effect on hepatocytes is provided by alcohol. The likelihood of getting sick is increased in people working in harmful industries, as well as in those who have close relatives in the heredity with this pathology.
Symptoms of liver cancer in women, men and children
At the initial stages of education, the tumor does not show a pronounced clinical picture. And it is this that affects the fact that the disease is sometimes found too late.
In liver cancer, specific and non-specific symptoms develop. The latter include signs of cancer intoxication, general deterioration of well-being, weight loss.
To specific manifestations of the disease include the development of jaundice, hepatomegaly, ascites, internal bleeding. These manifestations of cancer occur already in the third-fourth stage.
Symptoms at an early stage
The liver is the digestive organ, with which food digestion and neutralization of harmful substances occurs. A growing tumor disrupts the functions of the organ and, accordingly, the character of digestion also changes.
Therefore, at an early stage of the disease, the pathology may manifest itself:
- Nausea, decreased appetite, constipation or diarrhea.
- Increased fatigue and drowsiness.
- Discomforting sensations and a feeling of heaviness under the right hypochondrium.
- Pain. They often give in the back and shoulder blade.
- Seal formation under the ribs. Jaundice sclera of eyes, skin.
Often a sick person records a fever and febrile syndrome. The development of these changes is related to the work of the immune system, which independently begins to fight with cancer cells.
Another manifestation of the neoplasm is Cushing's syndrome, related to endocrine disorders and in advanced cases is the cause of steroid diabetes. In some patients, weight begins to decrease in the initial stages of the disease.
Late symptoms of
The last stage of liver cancer is exhibited when the tumor spreads to most of the organ and metastasizes to other parts of the body.
In this regard, not only the functioning of the organ is almost completely destroyed, but pathological disorders throughout the body develop.
In neoplasm, blood circulation also changes, which also causes a number of symptoms.
The last symptoms of liver cancer include:
- The appearance of almost constant pain.
- Sharp weight reduction. On its background, exhaustion of the body and anemia develops, fatigue and drowsiness increase, periodic dizziness occurs, often ending with fainting.
- Nervous system disorders, apathy, depression.
- The appearance of edema on the legs, this is due to a violation of blood circulation. Edema is detected in more than half of patients, and especially in the elderly. Puffiness can be so severe that it disrupts the walking process.
- Ascites. A pathological accumulation of fluid is associated with a violation of its circulation.
- Internal bleeding. Growing a tumor leads to vascular damage and to their rupture. Bleeding is determined by increasing pallor, falling blood pressure, shock state of the patient. Often, patients with liver cancer and bleeding from the nose.
- Enlargement of lymph nodes of different groups.
- Education on the skin of oblong dark spots.
The listed signs develop and with other pathologies, therefore it is possible to establish the diagnosis accurately after a comprehensive examination.
The stages of the development of the disease
The stage of cancer of the liver is set up in a system that takes into account the size of the tumor( T), the degree of pathological involvement of the lymph nodes( N), and the presence of metastases( M).
- The first stage is T1, N0, M0. Neoplasm is one, there is no germination in the vessels, as there is no lesion of lymph nodes and metastases.
- The second stage is T2, N0, M0. Several small neoplasms or one large, sprouting into the walls of blood vessels are detected. But there are no metastases and lesions of lymph nodes.
- The third stage is T3, N0, M0. Neoplasm of large size, but beyond the body does not come out. Sometimes it is germinated in the portal vein. T4, N0, M0 - the neoplasm begins to germinate into the peritoneum and the outer wall of the organs adjacent to the liver. T4, N1, M0 - there is a germination of the tumor in a number of located organs and lymph nodes.
- The fourth stage is T1-4, N1-4, M1. There is a cancerous tumor in the liver, lesion of several groups of lymph nodes and metastasis of at least one remotely located organ.
What is different from cirrhosis and hemangioma?
Cirrhosis, a disease characterized by a gradual replacement of the normal connective tissue. As a result, the body wrinkles and can no longer perform all its functions.
The pathological process can be suspended if the main cause of cirrhosis is eliminated.
In cancerous lesions, a further change in the structure of the organ depends on which type of malignant lesion has arisen and at what stage the treatment is started.
Liver cancer most often develops against the background of the already existing cirrhosis , and the joint course of these pathologies only increases the symptomatology. Cirrhosis and cancer are two diseases, the outlook for which is unfavorable. Much in prolonging life with cirrhosis depends on the patient himself, and on how much he will listen to the advice of the doctor.
Hemangioma is a benign tumor that develops from the blood vessels. In most cases, it does not cause any symptoms and does not require treatment. But with a large size of hemangioma, the liver increases in size, there is compression of the vessels and a number of organs located.
The growth of hemangiomas, unlike malignant tumors that damage the blood vessels of the liver, is slow, sometimes dozens of years. A large tumor can burst, resulting in internal bleeding.
Metastases
The spread of metastases beyond the liver occurs when the primary form of cancer. Rapid metastasis is explained by the fact that it is abundantly supplied with blood, portal and hepatic veins pass through it, and there is a connection with the aorta.
In addition to blood flow, cancer cells are transferred to the lymphatic system. The nearest secondary foci of primary cancer can be in the lymph nodes located at the gates of the liver, in the head of the pancreas, in the mediastinum. In later stages, lymph nodes of the neck and posterior mediastinum are metastasized.
With the blood flow, the cancer can pass to the vertebrae and ribs, with such a lesion the symptoms resemble the course of osteochondrosis.
Later, cancer cells pass to lung tissue, into the diaphragm, pancreas, stomach, adrenals, into the kidneys, with the right kidney being metastasized several times more often.
How to identify the disease?
If a patient is suspected of having liver cancer, a number of instrumental examinations are assigned to the patient, including:
- of the organ.
- CT or MRI.
- Biopsy.
- General and biochemical blood test.
- Radiography of the lungs, spine.
How to cure a malignant tumor?
In the event that liver cancer is represented by a single and small in size formation, then surgical treatment is prescribed. After successful removal of the organ can be restored and then a favorable outcome of the disease is noted.
Chemotherapy is used if surgery can not be performed or as an additional method of treatment. Greater efficacy of the drugs is observed if they are injected directly into the tumor-bearing artery.
In some cases, the tumor shows the administration of trichloroacetic acid or alcohol, these substances have a destructive effect. In the advanced stages of cancer, we select palliative treatment.
How many patients live?
The prognosis for malignant liver damage is affected by the size of the tumor, the number of neoplasms, the presence of metastases in the organ itself. Survival of patients is higher if the performed operation is the least traumatic.
Patients with a single node survive in no more than half the cases, with two nodes marked a favorable outcome for approximately 30%. The most unfavorable prognosis, if there are several sites - with this defeat within five years only 12 to 18% of people survive.
At 3-4 stages of liver cancer there is a rapid metastasis and therefore a fatal outcome is possible in a few months.
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