What is Liver Cancer and Hepatocellular Carcinoma Treatment Methods?
Liver tumors are malignant tumors that originate from organ tissue. The most common of these types of tumors is hepatocellular carcinoma. It accounts for about 90 percent of primary liver cancer cases. Cholangiocarcinoma, which originates in the bile ducts, is a common subtype among the remaining cases. The liver is a large organ located in the upper right abdomen, above the stomach and below the diaphragm.
Metastatic cancers are cancers that originate in other organs of the body and spread to the liver. Cancers that start in areas such as the colon, lung or breast account for most cancers in the liver. The liver is like a factory that processes blood, and cancer cells from other organs in the body can metastasize here through blood vessels.
Liver Cancer Symptoms
Cancer is a disease that can occur in many different organs in the body and the symptoms seen in each organ may differ. Early diagnosis is therefore of great importance for definitive treatment.
Especially liver cancer is one of the most dangerous and rapidly progressing types of cancer. For this reason, immediate intervention may be required when the first symptoms appear.
Symptoms of liver cancer are usually as follows:
Severe pain in the upper abdomen: This can be caused by enlargement or pressure in the liver.
A feeling of bloating in the abdomen: There may be a feeling of discomfort in the abdomen as a result of enlargement of the liver.
Back pain in the upper right side of the abdomen: Problems with the liver can cause back pain.
Unexplained weight loss: Loss of appetite and a marked decrease in body weight may be observed.
Loss of appetite and fatigue: A general feeling of low energy and lack of desire.
Yellowing of the skin and eyes: Jaundice may indicate impaired liver function.
Persistent nausea: May occur due to digestive system problems.
Taking these symptoms into consideration, detecting liver cancer at an early stage and starting treatment is critical to prevent the progression of the disease.
Table of Contents
Liver cancer does not develop suddenly, as is the case with other types of cancer. There are factors that trigger the development of primary liver cancer. Cirrhosis is one of these factors and the risk of liver cancer in cirrhotic patients is 300 times higher than in those without cirrhosis.
Liver Cancer Treatment Methods
There are various methods for the treatment of liver cancer. One of the most effective and prioritized methods is surgery. In this method, the part of the liver where the cancer has formed is surgically removed. In some cases, liver transplantation may also be considered.
In cases where surgery is not feasible, alternative methods such as chemotherapy, radiotherapy, ablation therapy (burning of the tumor) or nuclear medicine treatments with microspheres can be used.
Surgical and Interventional Methods in Liver Cancer
Surgical treatments for liver cancer are mostly determined depending on the size of the tumor, its spread and the general health of the patient. Here are brief explanations of liver cancer surgical treatment methods:
1-What is Metastasectomy?
Metastasectomy is a surgical procedure used in cases where the cancer has spread outside the liver. It is performed in two main ways: local metastasectomy and segmental metastasectomy. The surgical team first uses imaging methods to determine the location of the tumor and the extent of spread. Then, the areas or segments containing these metastases are surgically removed.
Local Metastasectomy: Refers to the surgical removal of metastases in a specific area.
Segmental Metastasectomy: It is the removal of one or several liver segments.
2-What is Hepatectomy Surgery?
Hepatectomy is the surgical removal of part or all of the liver. There are different types such as right lobectomy, left lobectomy, bi-segmentectomy or trisector hepatectomy. This procedure involves removing a specific part of the liver, usually through a large incision. Special devices and techniques are used to minimize blood loss.
Right Lobectomy: Refers to the removal of the right lobe.
Left Lobectomy: Refers to the removal of the left lobe.
BiSegmentectomy: It is the removal of two segments.
Trisector Hepatectomy: It means removal of three segments.
3-What is Extended Hepatectomy?
Procedures such as extended right or left lobectomy are used in advanced cancer cases. These procedures are usually more extensive than standard hepatectomy procedures. Cutting and rearranging tissues may require more care and surgical skill.
Extended Right Lobectomy: An extended removal of the right lobe.
Extended Left Lobectomy: This is an extended removal of the left lobe.
4-ALPPS Procedure: Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy
ALPPS surgery involves temporarily closing part of the liver and then removing the remaining part. This is a two-stage surgical procedure in which the liver is allowed to grow and the remaining part is removed in the second stage.
5-Liver Transplantation
Liver transplantation is usually considered for advanced liver cancer or liver failure. In deceased donor liver transplantation, a liver from a deceased donor is transplanted, while in living donor liver transplantation, a part of a person is transplanted.
Deceased Donor Liver Transplantation: The liver from a deceased donor is transplanted.
Living Donor Liver Transplantation: A part taken from a living person is transplanted.
6-Laparoscopic Liver Surgery
Laparoscopic hepatectomy is a minimally invasive surgical technique. Small incisions are made and special instruments are used to remove the liver laparoscopically. This method can offer less blood loss and faster recovery compared to traditional open surgery.
7-Liver Cancer Embolization (Vascular Occlusion) Methods
Embolization methods such as TARE, TACE and LIOX are usually performed by radiologists. During these procedures, a thin catheter is used to access the vessels supplying the tumor and special substances are injected to control or shrink the growth of the tumor.
TARE (Transarterial Radioembolization):
Radioembolization is a method that targets the tumor by introducing radioactive particles into the tumor.
TACE (Transarterial Chemoembolization):
Chemoembolization is the control of tumor growth by injecting chemical substances into the blood vessels that feed the tumor.
LIOX (Lipiodol-based Intra-arterial Infusion Chemotherapy with Oxygen Microbubbles):
Lipiodol-based intra-arterial injection aims to inject chemicals into the vessels supplying the tumor and increase their effect on the tumor.
Detailed descriptions of each method and decisions about its use are determined by surgical oncologists, depending on the patient's condition and the characteristics of the cancer.
Local Treatments for Liver Cancer
Local therapies are treatment methods that focus only on a certain area of the cancer, such as liver cancer. The aim of these methods is to control or shrink the cancer. Now let's move on to detailed explanations about the methods you have given:
1- Liver Radiofrequency Ablation (RFA) or Microwave Ablation
Thermal ablation techniques, such as radiofrequency ablation or microwave ablation, are minimally invasive procedures that use high-energy waves to kill cancer cells. These methods cause the death of cells by exposing cancerous tissue to high temperatures.
2- Liver Embolization Treatments
(TAKE Treatment) Transarterial Embolization:
In this method, fusible or hardenable substances are injected into the blood vessels feeding the tumor to block them. This prevents the tumor from feeding and aims to shrink or control it.
(TACE Treatment) Transarterial Chemoembolization:
In this method, in addition to embolization, chemical substances are injected into the tumor to kill cancer cells. In this way, tumor nutrition is stopped and cancer cells are damaged.
3- Percutaneous Ablation Methods
Percutaneous Ethanol Injection (PEI):
In this method, alcohol is injected into the cancerous tumor to kill the cells.
Percutaneous Thermal Ablation (e.g. Microwave or Laser Ablation):
High-energy beams or microwaves are used to heat and kill cancerous cells. These techniques are usually directed to the cancerous area with a needle or probe.
4- Liver Cancer and Atomic Therapy (Liver Cancer Radiotherapy)
What is Internal Radiotherapy?
A source of radiation is provided from inside the tumor by placing radioactive materials inside the tumor.
What is External Radiotherapy?
It is a form of radiotherapy that uses high-energy beams from the outside. With the help of a machine, intense rays are sent to the tumor to kill or control cancer cells. These local treatment methods are used in cases such as liver cancer and are preferred to control the cancer, shrink it or relieve symptoms. Which treatment option is used depends on the patient's condition and the characteristics of the cancer.
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