Patients with liver cancer generally are elderly . Primary liver cancer is cancer that starts in the liver and including the potentially fatal type of cancer . In addition to primary liver cancer that arises in the heart , there are also known as secondary liver cancer that originated in other body parts , such as the intestines , before spreading to the liver .
Many occurred in Developing Countries
Liver cancer is the fifth most common type of cancer among men and the seventh among women . About 85% of liver cancer cases in the world occur in countries that are still developing . The cause of high incidence of liver cancer in countries that are still developing is a high incidence of hepatitis B and C in these countries , including Indonesia .
59% of liver cancer cases in developing countries are still caused by hepatitis B and 33% by hepatitis C. While in countries that have been developed such as countries in Europe, the main cause of liver cancer is high alcohol consumption and obesity are increasing ,
In Indonesia, it is estimated there are approximately 33,000 new cases of liver cancer each year. This figure is expected to rise as the number of patients with hepatitis B and C, which currently reaches 30 million people.
Important Organ Liver Function
With hundreds of functions are executed, the liver becomes one of the most complex organ in the human body. Liver cancer is classified as a serious disease caused by obstruction of the functions of the liver, even completely stop it. Here are some of the most important functions of the liver:
Recognizing Symptoms of Liver Cancer
- Eliminate toxins from the body
- Digest proteins and fats
- Producing fat destroyer liquid (bile) that aids digestion
- Helps control blood clotting
Symptoms of the disease usually shaped less common or specific such as fatigue and nausea. Many people who just feel the symptoms are evident after the cancer reaches an advanced stage. Symptoms of liver cancer include:
Cirrhosis: Main Cause of Liver Cancer
- Fatigue
- Weight loss without cause
- Nausea
- Gag
- Jaundice (skin and whites of the eyes turn yellow due to increased levels of bilirubin in the human body)
The exact cause of liver cancer is still unknown, but the disease is estimated to be related to tissue damage cells of the liver, such as cirrhosis of the liver disease. Cirrhosis may be caused by:
Infection with hepatitis B or hepatitis C
Diagnosis of Liver Cancer Early as Possible
- Abuse of alcohol - consuming alcohol more than the recommended amount.
- Obesity is also believed to increase the risk of liver cancer because it is closely related to non-alcoholic fatty liver disease (Non Alcoholic Fatty Liver Disease = NAFLD).
If your GP suspects or diagnoses you have liver cancer, you will be referred to a specialist hospital for further examination. The sooner the disease is diagnosed, the more effective the treatment is given.
In fact, only 1 in 5 people who survive at least one year after being diagnosed with liver cancer. And only 1 out of 20 sufferers were able to survive at least five years. This is because as many as 9 out of 10 new patients are diagnosed when the cancer is already at an advanced stage. In most sufferers, the cancer has grown too severe to be cured.
So to liver cancer can be diagnosed early, people who are at high risk for getting the disease are advised to consult routinely and regularly. Groups of people at high risk are those who are positive are infected with hepatitis C or have ever suffered from cirrhosis. The benefits of routine examinations is to diagnose liver cancer at an early stage, when treatment is more likely to total recovery.
Three Alternative Treatment of Liver Cancer
Stage of cancer determines what type of treatment to be given to patients. If cancer is diagnosed are already at an advanced stage of the condition, the treatment is only intended to reduce pain and discomfort in the patient for the rest of his life. But it is different if the cancer can be diagnosed before they develop more severe, then the condition is more likely to be addressed.
There are at least three ways in treating liver cancer. The first is radiofrequency ablation, the use of an electrical device that is specifically used to destroy cancer cells in the liver. The second is the surgical resection, the process of appointment of certain parts of the organ infected liver. The third is a liver transplant, which is to replace the liver of patients with liver organ donor.
Prevent Liver Cancer with Healthy Living
The risk of liver cancer can be reduced by adopting a healthy lifestyle such as diet and exercise regularly so that the body avoid obesity, as well as avoiding the consumption of liquor and cigarettes.
Additionally, you can also avoid the risk of infection with hepatitis B and C with vaccination and have sex safely. If you want a body piercing or tattooing, make sure to do it in a place that has the tools with a guaranteed level of sterility.
Symptoms of Liver Cancer
Generally, people with early -stage liver cancer do not have symptoms that means . New symptoms will be seen clearly at an advanced stage . Yet some of the following symptoms may be wary as a symptom of liver cancer :
Consult your doctor if you experience the symptoms above
- Feeling very tired and weak
- Dark urine
- Stomach ache
- Itchy
- Liver swell
- Feeling of nausea and vomiting
- Weight loss for no reason
- The skin and the whites of the eyes turn yellow
Cause of Liver Cancer
The cause and how changes in cells in the liver cancer is still unclear. However, the risk of liver cancer seems to increase with damage to the liver, such as cirrhosis. However, not all cases of cirrhosis will culminate in liver cancer.
Linkages cirrhosis with liver cancer
Liver cancer is closely related to cirrhosis and the formation of scar tissue in the liver. Normal liver tissue formed from cells that software. Cirrhosis is a condition when the normal liver tissue that has been hardened by the process of formation of new tissue from cells are injured. As a result of cirrhosis, liver function starts to decline. Keep in mind that not all people will experience cancer liver cirrhosis.
In a country that is still developing as Indonesia, cirrhosis is commonly caused by:
Infection with hepatitis B virus
- Infection with hepatitis B and C.
- Non-alcoholic fatty liver disease.
- Excessive alcohol consumption.
- Autoimmune disease.
Hepatitis B is a virus that spreads through contaminated blood. In addition, this virus spreads through body fluids such as saliva, semen, and vaginal fluids. Most people with hepatitis B suffer the same symptoms as the pathway to patients with liver cancer and the risk of widespread scarring in the liver. Scarring of the liver tissue that is formed when normal tissue and soft undergo the process of wound.
The ethnic factor thought to influence the risk of potential infection of people with hepatitis B develop into liver cancer. Asians infected with hepatitis B are at higher risk above the average of developing liver cancer, regardless of whether they are also suffering from liver cirrhosis or not. As with the other ethnic hepatitis B patients, their risk for developing liver cancer only increased if they also suffer from cirrhosis or other liver diseases such as hepatitis C.
The combination of smoking and hepatitis B makes the risk of liver cancer is higher.
Infection with hepatitis C
In the long run, people with hepatitis C may experience inflammation and damage to the liver. If you are living with hepatitis C, remove yourself from smoking. People with hepatitis C who smoke are more at risk of developing liver cancer later in life.
Indonesia is one of the countries with the highest rate of hepatitis C in Southeast Asia. One method of spread of hepatitis C in Indonesia is the use of contaminated hypodermic needles.
Non-alcoholic fatty liver disease
The exact cause of nonalcoholic fatty liver disease still can not be explained with certainty. However, this disease is often associated with obesity and type 2 diabetes.
Disease non-alcoholic fatty liver is a common condition and does not cause any obvious symptoms in most sufferers. Fat accumulates in the liver tissue causing the disease.
But in some people, the accumulation of fat in high levels can cause liver inflammation. Over time, this inflammation will cause injury to the liver tissue.
As a result of bad liquor
Another of other organs, the liver is an organ with strong resistance. The liver can handle the level of damage that is much higher than other organs such as the heart and brain. This is because the liver cells were able to regenerate after injury.
Whenever you consume liquor, solid organ and soft this will filter out harmful substances in alcohol from your blood. This filtering makes some heart cells to die.
Indeed capable of regenerating liver cells to make new cells. But how powerful was this organ, excessive alcohol consumption, and in the long term can damage the liver permanently. If you continue to consume excessive booze for years, your heart will lose the ability to regenerate.
Other Risk Factors
Liver cancer is also triggered by other factors following:
autoimmune hepatitis
A rare genetic condition that arises when the immune system or the body's natural resistance that normally fight infection actually attack the liver cells healthy. Risk patients with autoimmune hepatitis to liver cancer smaller than patients with cirrhosis or other liver disorders.
Primary biliary cirrhosis
The basic cause of primary biliary cirrhosis is still not known with certainty. The disease attacks the bile ducts, the pipeline that serves to drain bile into the digestive system. Bile duct damage then caused a buildup of bile in the liver. This buildup damage such organs and lead to cirrhosis. About 5% of people with advanced stage biliary cirrhosis is expected to suffer from liver cancer in the future.
haemochromatosisDiagnosis of Liver Cancer
Approximately ten percent of patients with cirrhosis due to hemochromatosis suffering from liver cancer. Haemochromatosis is a genetic condition when the body stores too much iron is absorbed from food. Iron piled eventually reach toxic levels and liver damage.
People who are more at risk of developing liver cancer need to undergo periodic examination. Generally you will undergo the examination as follows:
Monitoring for Detection of Liver Cancer Intensive
If you belong to a group of people at high risk of liver cancer as patients with cirrhosis, it is advisable to perform periodic checks every six months.
Examination usually through two stages, namely blood tests and ultrasonography (USG). The blood test used to detect the presence or absence of a protein in the blood called alpha fitoprotein (AFP). In addition, ultrasound or ultrasound done to determine abnormalities in the liver.
Tests Confirm Diagnosis
There are several tests that can be used to confirm the diagnosis of liver cancer, namely:
However, you do not need to use all kinds of tests to make the diagnosis.
- MRI scan
- CT scan
- Biopsy
- laparoscopy
Stages of Development of Liver Cancer
Ranking System Barcelona Clinic Liver Cancer (BCLC) divides the five stages of development of liver cancer as follows:
Treatment of liver cancer
- Stadium o: the patient is still in a healthy condition and heart function well, but there are tumors less than 2 cm in diameter.
- Stage A: The patient is in good health and his heart is functioning normally. But it has grown a tumor diameter of less than 5 cm, or there are three or more tumor with a diameter less than 3 cm.
- Stage B: there are multiple tumors in the liver, but it has not affected his liver function.
- Stage C: the cancer has begun to spread into the blood vessels, into the surrounding lymph nodes or other parts of the body. The body of people with not so healthy and his liver function does not work so well.
- Stage D: si sufferers begin to show symptoms of the final stages of liver disease, such as a buildup of fluid in the abdomen. Heart has lost most of its functional capabilities.
People with liver cancer will be dealt with in accordance with the type of treatment that each stage of the cancer. There are three major ways that can be done to treat liver cancer:
Patients can be cured if the cancer when it is diagnosed, the cancer she suffered were in stage A. However, total healing can not be done if the cancer is detected at stage B or C. While at stage D, the only treatment will focus on relieving pain and discomfort.
- Resection: take a piece of liver is affected.
- Liver transplantation: surgery to replace the organ with a new liver.
- Radiofrequency ablation / RFA (removal with radio frequency): uses heat to kill the cancerous cells.
Appointment of liver cancer surgically
Surgical resection is done by lifting the cancerous cells through surgery. In general it takes 3-4 months to recover your organs after surgery. But you are allowed to leave the hospital within 6-12 days after surgery.
However, like all medical procedures, surgical resection is also at risk. About 25 percent of liver resection surgery cause complications such as infection, bleeding or deep vein thrombosis. An estimated 30 people who underwent liver resection surgery, there is one person who died after or during surgery. This is because the liver resection can sometimes cause deadly complications such as heart attack.
With donor liver transplantation
Transplant can be performed using organs from the dead and living donors. Each method has advantages and disadvantages:
Transplantation of the deceased:
- Can take a long time to wait for a suitable donor.
- The result is better than the donor is still alive.
Transplantation of a donor who is still alive:
In addition, liver transplants performed only appropriate for certain cases. This procedure is usually suitable if the tumor diameter of less than 5 cm. But will not be helpful if you suffer from some of the tumor or the tumor is more than 5 cm in diameter. Liver transplantation may be recommended for:
- No need to wait too long.
- This procedure complication rate is higher.
- Results tend to be not as good when using the liver of a deceased person.
People with three or more tumor with a diameter less than 3 cm
People with tumors that are highly responsive to treatment to show no signs of tumor development until six months later.
Killing Cancer Cells with Radio Frequency
Radiofrequency Ablation RFA or kill cancer cells and shrink the tumor size with a heating process that uses electricity.
Ablation / removal with radio frequency step can be recommended as alternatives to surgery to deal with cases with one or several tumor diameter of less than 5 cm.
After undergoing the procedure, you may feel uncomfortable and experience flu-like symptoms, such as chills or muscle aches for several days. Although rare, complications that may occur are bleeding, infections, minor burns, or damage to surrounding organs.
Chemotherapy treatment
Type of chemotherapy is recommended to handle the liver cancer stage B and C are called kemoembolisasi (Transcatheter arterial chemoembolization / TACE). This treatment does not cure, but only relieve pain and prolong life expectancy. But this procedure is not recommended to handle the liver cancer Stage D because it can worsen the condition.
Kemoembolisasi can be executed when sufferers are waiting for a liver transplant organ. This procedure helps prevent the spread of cancer to the liver when the patient about waiting for liver cangkok.Kemoembolisasi undertaken with a combination of two techniques:
Helps slow the growth of tumors by injecting gel or small plastic granules into the blood vessels draining the tumor
The chemotherapy drugs are injected directly into your heart. This process avoids the patients from the side effects often associated with 'traditional chemotherapy' such as hair loss and fatigue.
About a month after undergoing kemoembolisasi, the body's response to it will be evaluated with a CT scan.
Approximately 30% of patients who undergo kemoembolisasi experience side effects known as post-kemoembolisasi syndrome with symptoms of nausea, vomiting, abdominal pain, fever, and loss of appetite. These side effects can disappear 1-2 weeks thereafter.
In addition, there are also some complications kemoembolisasi rarer:
Alcohol ablation options
- Inflammation of the liver.
- Worsening of liver function. Usually temporary.
- Abdominal swelling caused by water retention.
- Damage to the duct or gallbladder.
Alcohol ablation aims to make cancer cells become dehydrated and stop the flow of blood to the tumor. This treatment can only be done if you just suffer from a few small tumors.
sorafenib
Sorafenib is a tablet used to treat liver cancer in certain cases. Not all cases of liver cancer can be treated with sorafenib. In cases of advanced liver cancer, the use of sorafenib may not be advisable because the benefits are limited. The medical team will check whether the drug is likely to bring benefits or losses, and right or not if used to you.
Prevention of Liver Cancer
The growth of liver cancer can be prevented. The key is a healthy lifestyle and discipline in maintaining health. Such measures include:
Hepatitis B vaccine
- Healthy eating.
- Avoiding away from obesity with regular exercise.
- Avoid themselves from the risk factors for liver cancer such as hepatitis C and hepatitis B.
- Limiting consumption of liquor.
You can avoid the risk of hepatitis B vaccine. In Indonesia, the hepatitis B vaccine has been part immunizations must be taken at birth and at two, four and six months. However, adults of any age should receive this vaccine.
Hepatitis B vaccine is also recommended for people at high risk groups as follows:
The risk of transmitting hepatitis C
- People with chronic renal failure and chronic liver disease.
- People who frequently change sexual partners.
- Medics and patients injecting drug users.
- Close relatives of people with chronic hepatitis B.
- People who receive regular blood donor.
- Inmates and prison staff.
Often infected with hepatitis C virus through the blood of an infected person to another. This causes hepatitis C generally occurs among drug users, especially those who share drug use tools such as needles carelessly. Here are some things you can do to minimize risk:
- Avoiding the use of personal items together. Avoid exchange of contaminated blood of others such as earrings, razors or toothbrushes.
- It is advised to use contraceptive condom during sex, because hepatitis C can also be transmitted through body fluids such as semen.
Limit or avoid consumption of liquor
If you consume alcohol, you should not exceed the limit of consumption per day. The recommended limit is about 2.5 cans of beer for men and up to 2 cans of beer per day for women. Even so, the decision to stop consuming alcohol is the recommended steps are most effective in reducing the risk of developing liver cancer.
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