Risk Factors and Symptoms of Liver Cancer

They say ignorance is bliss, unless you’re facing liver cancer. The truth is ignoring warning signs and symptoms will only do more harm than good. In patients, there are certain risk factors that make them more prone to being at risk for liver cancer.   This includes:

• Chronic Hepatitis B or C
• Steatohepatits
• Obesity
• Elevated Iron Levels
• History of Alcohol Abuse

Certain groups are also more likely than others. This includes those who are Asian or Hispanic, have a family history of the disease, and males who are age 55 or older.Liver cancer

When a person looks for signs of liver cancer, it is important to note that most of the time, there are no symptoms at first. You may experience some swelling in the liver. It isn’t until the liver cancer tumor grows that you experience pain in the abdomen, typically in the right side. There might be a sense of fullness quickly when eating, and you might begin to lose some weight. As the cancer spreads and worsens, you’ll experience jaundice, decreased appetite, swelling, and often wasting in the final stages.

Before liver cancer progresses this far, it is best to have an ultrasound done on the liver. Every six months those who are at a higher risk for this form of cancer should be inspected to boost the chance of survival. Additional tumor markers like the alfa-fetoprotein can help to determine if cancer is present. A biopsy of the liver may further inform your physician about whether any growth is benign or malignant.

Irreversible Electroporation in Pancreatic Cancer

Irreversible electroporation (IRE) is a non-thermal ablation technique for treatment of soft tissues.  It is an emerging method for treatment of pancreatic cancer.  The technique is allowing surgeons the opportunity to treat previously unresectable or locally-advanced pancreatic cancer.

IRE was developed by Dr. Rubinsky and colleagues at the University of California, Berkeley.[1]

The technique involves placing probes into the pancreatic tumor.  Some medical centers are inserting the probes through the skin, but more often, laparotomy is the preferred approach, to directly visualize the cancer and involved structures.  Using intraoperative ultrasound, the surgical team inserts several probes into the tumor.  Short, high-voltage pulses are delivered to the tissue. These pulses create leaky cells (electroporation), which then induce death of cancer cells (apoptosis).

More commonly used ablation technologies, such as radio frequency ablation (RFA) and microwave ablation can not be used near large blood vessels typically involved with pancreatic tumors.  IRE, however, is capable of killing tumor around these vessels without hurting the vessels at the same time.

Robert Martin, MD, and colleagues recently reported the largest experience with the IRE system for treatment of pancreatic cancer.[2]  200 patients with locally-advanced pancreatic cancer underwent IRE treatment.  While 37% of patients had complications, he reports an impressive median overall survival of almost 25 months.

IRE is now widely available throughout the United States and manufactured by Angiodynamics.

References:

[1] Edd JF, Horowitz L, Davalos RV, Mir LM, Rubinsky B. In vivo results of a new focal tissue ablation technique: irreversible electroporation. IEEE Trans Biomed Eng. 2006 Jul;53(7):1409-15. PubMed PMID: 16830945.

[2] Martin RC 2nd, Kwon D, Chalikonda S, Sellers M, Kotz E, Scoggins C, McMasters KM, Watkins K. Treatment of 200 locally advanced (stage III) pancreatic adenocarcinoma patients with irreversible electroporation: safety and efficacy. Ann Surg. 2015 Sep;262(3):486-94; discussion 492-4. doi: 10.1097/SLA.0000000000001441. PubMed PMID: 26258317.

Chemotherapy and Liver Cancer

When surgery is not an option for the treatment of primary liver cancer (hepatocellular carcinoma, cholangiocarcinoma)
or metastatic cancer to the liver (colorectal cancer), patients should consider chemotherapy.  However, current chemotherapy options for liver cancer are limited.  Historically, response rates (tumor shrinkage) was uncommon, but new drugs are under investigation. One such drug, Sorafenib, has demonstrates Chemotherapy Vialspromising results.

Chemotherapy typically requires administration of medication by vein in the arm. Some medications can be taken by pill or injection.  Specific chemotherapy regimens can be very involved and side effects vary widely from patient to patient.

Targeted therapies are also being explored that will offer better therapy for some kinds of cancer involving the liver. These drugs are new and unique in that they interfere with protein or blood flow or receptors and they can prevent the tumor from growing.  For example, researchers at Wake Forest Baptist Health are investigative a novel drug, CPI-613, for the treatment of metastatic colorectal cancer.

New therapies and new methods are being tried every day that can help to prevent liver cancer from progressing. A diagnosis of cancer today is not necessarily a death sentence.  Learn about your cancer and possible treatment options that can help you to live a longer life.