Melo, Monica Tan

BSN IV-1
LIVER
The liver continuously
filters blood that
circulates
through
the
body,
converting nutrients and drugs absorbed from the digestive tract into ready-to-use
chemicals. The liver performs many other important functions, such as removing toxins
and other chemical waste products from the blood and readying them for excretion.
Because all the blood in the body must pass through it, the liver is unusually accessible
to cancer cells traveling in the bloodstream.
Cancer of the LIVER

Hepatic tumors may be malignant or benign. Most liver cancer is secondary or

metastatic, meaning it started elsewhere in the body.
Because the liver is made up of several different types of cells, several types of tumors
can form there. Some of these are benign (noncancerous), and some are cancerous and
can spread to other parts of the body (metastasize).

What Causes Liver Cancer?

Primary liver cancer (hepatocellular carcinoma) tends to occur in livers damaged by:

Birth defects

Alcohol abuse

Chronic infection with diseases such as hepatitis B and C,

Hemochromatosis (a hereditary disease associated with too much iron in the liver)

Cirrhosis

Herbicides

Smoking

Liver cancer may also be linked to obesity and fatty liver disease.

Liver Metastases
Metastases from other primary sites, particularly the;

Digestive System

Breast

Lung

Clinical Manifestation

Continuous dull ache in right upper quadrant, epigastrium or back.

Weight loss

Loss of strength

Anorexia

Anemia

Jaundice (When large bile ducts are occluded)

How is liver cancer diagnosed?

The diagnosis of liver cancer is based on clinical signs and symptoms, the history
and physical examination, and the results of laboratory and x-ray studies.

Melo, Monica Tan

BSN IV-1
Increase of
Serum levels

Leukocytosis

Bilirubin

Erythrocytosis

Alkaline phosphatase

Hypercalcemia

AST and GGT

Hypoglycemia

Lactic dehydrogenase

hypocholesterolemia

The best way to detect liver cancer is through surveillance ultrasound of the liver done
every 6 months in a patient with a diagnosis of cirrhosis. As with most forms of cancer, it is best
to treat the liver cancer as soon as it is detected.
Once a suspicion of liver cancer arises, a physician will order one the following to confirm a
diagnosis:
1. Blood tests: alfa-fetoprotein (AFP), which may be elevated in 70% of patients with liver
cancer. AFP levels could be normal in liver cancer. A rising level of AFP is suspicious
for liver cancer. Other labs tests include des-gamma-carboxy prothrombin, which can be
elevated in most patients with liver cancer.
2. Imaging studies: Multiphasic helical CT scan and MRI with contrast of the liver are the
preferred imaging for detecting the location and extent of blood supply to the cancer.
3. Liver biopsy is performed to sample tissue from the lesion in the liver, which is analyzed
by a pathologist to confirm the suspected diagnosis of liver cancer.
Medical Management

Surgical resection is possible in some patients.

The underlying cirrhosis is so prevalent in cancer of the liver that increases the risks
associated with surgery.

Radiation Therapy

Chemotherapy

Percutaneous Biliary Drainage (Bypass biliary ducts)

Non-surgical treatment; Laser hyperthermia, Immunotherapy, Transcatheter and

injection of alcohol

Surgical Management

Lobectomy

Melo, Monica Tan

BSN IV-1
Local Ablation
Liver Transplantation

Complications
Rejection

Bleeding

Infection