Multaq Liver : Only about five percent of hepatocellular carcinoma patients are good candidates for surgical resection. For the others, an increasingly successful choice is liver transplantation, a good option for HCC patients who have developed cirrhosis. For these patients, the five-year survival rate is 75 percent, though the waiting period can be an obstacle. In those instances, a living-donor transplantation—a procedure in which part of a liver is donated by a compatible donor and transplanted into the HCC patient—can be a lifesaver.
Because liver tumors grow so gradually and imperceptibly, many are inoperable by the time they are diagnosed. For those patients, one option is a percutaneous alcohol injection (PEI), in which alcohol is injected by needle into the tumor—a procedure that destroys up to 90 percent of small tumors (of less than five centimeters) in patients who have fewer than three liver tumors and who have not developed advanced cirrhosis.
For individuals with a larger tumor, doctors may try tumor embolization and chemoembolization. During these procedures, chemotherapy drugs are selectively introduced into a branch of the hepatic artery supplying the HCC. Gelfoam gelatin sponges containing the drugs are often used to offer the best chance of killing the cancer cells.
Another popular treatment for liver tumors is radio frequency ablation (RFA), which uses heat caused by electrical energy to kill the cancerous tissue. During the procedure, a special probe is inserted into the tumor. When it is positioned correctly, several electrodes protruding from the tip of the probe send a predetermined amount of radiofrequency, or heat energy, into the tissue. Tiny diermometers in the device measure the heat, which is applied until the cancerous tissue is dead. It is a relatively quick procedure, usually lasting less than 15 minutes, and is done with appropriate anesthesia.
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Of che liver cancers that can be mistaken for another disorder, a metastatic liver tumor, a cancer that began in some other organ and spread to the liver, is the most serious. Metastatic liver tumors often begin in the colon, kidney, uterus, lungs, stomach, gallbladder, breast, esophagus, or pancreas, and are more common than primary liver cancers.
Another liver condition that can be mistaken for primary liver cancer is a pseudo tumor. Made of regenerating cirrhosis nodules, the pseudotumor nodules often cluster and may resemble a tumor mass.
Also capable of fooling imaging equipment is a focal fatty infiltration of the liver, or fat deposits that are clumped together and resemble a tumor. Obesity, alcoholic liver disease, and diabetes are all potential causes; when the underlying condition is corrected, the fat deposits may disappear.
The alpha-fetoprotein (AFP) blood test can also mislead patients and doctors. Often used as a tumor marker, this test can detect but not diagnose HCC with elevated blood levels. But a higher-than-normal AFP result can also indicate pregnancy, cystic fibrosis, gastric cancer, pancreatic cancer, metastatic liver cancer (as opposed ro HCC, in which the liver is the primary organ where the cancer originated), or cirrhosis.
With all liver disorders-—-but especially when a cancerous tumor is suspected—patients should remember that making premature assumptions can be hazardous to their health! The best path to a positive long-term prognosis is a series of diagnostic procedures, rather than conclusions drawn from one blood test. This is especially true because of the many symptoms—including jaundice, unexplained weight loss, diminished appetite, and abdominal pain, among others—that may signal HCC or a pre- cancerous condition.
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A scar is usually good news because it indicates that repair and healing following an injury have begun. It is ironic, therefore, that in the case of cirrhosis, advanced scarring means that the liver is beyond repair. Scarring is perhaps the most serious consequence of liver diseases, although with the advances of modern medicine, cirrhosis isn’t the signal of doom that it once was.
As cirrhosis develops, scarred tissue replaces the healthy liver. Blood can no longer flow freely through the liver, and as the organ becomes hard and lumpy, its function deteriorates. This condition kills about 27,000 people each year, making it the 10th leading cause of death for men and the 12th for women in the United States.
Scientists have known about cirrhosis and its effects for many centuries. In the 4th century b.c., Hippocrates is believed to have said, “In cases of jaundice it is a bad sign when the liver becomes hard.” In 18th-century England, cirrhosis was known as “gin liver” because the disease developed when a surplus of corn crops brought an abundance of gin. Before 1820, French medical researcher René Laënnec named the disease cin-hose, deriving the term from the Greek word kirrhos, meaning “tawny”-—-the orange- tan color of cirrhotic livers.
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