Hepatocellular carcinoma is a tumor disease of the liver. The tumor arises directly from the liver cells.
What is hepatocellular carcinoma?
Symptoms of liver cell carcinoma only appear relatively late. These are mostly non-specific symptoms such as loss of appetite, nausea and vomiting.
In medicine, liver cell carcinoma is also known as liver cell carcinoma or hepatocellular carcinoma. This means a malignant tumor in the liver. In most cases, it results from chronic liver inflammation or liver cirrhosis. While there are no symptoms in the early stages, weight loss and pain in the upper abdomen occur later on. See AbbreviationFinder for abbreviations related to Hepatocellular Carcinoma.
Hepatocellular carcinoma is more common in men than in women. In Germany, the serious illness is recorded relatively rarely. Hepatocellular carcinoma, on the other hand, occurs more frequently in Africa and Asia. In western industrialized countries, liver disease is primarily caused by heavy alcohol consumption. On the other hand, infections with hepatitis B and hepatitis C as well as mold have an influence on the development of liver cancer in developing countries.
A distinction is made between three different types of liver cancer. In addition to hepatocellular carcinoma, these include cholangiocellular carcinoma, which arises from the cells of the bile ducts, and angiosarcoma, which develops from the blood vessels in the liver. With a share of around 80 percent, hepatocellular carcinoma is the most common variant of liver cancer.
Causes
What causes liver cell carcinoma has not yet been clarified exactly. However, there are some known risk factors that have a favorable effect on the disease. These primarily include alcohol consumption and obesity. Otherwise, there are different risk factors for the three different types of liver cancer.
In the case of hepatocellular carcinoma, this is primarily cirrhosis of the liver, also known as shriveled liver. In most cases, liver cirrhosis is caused by chronic viral infections, which include hepatitis B and C. Liver cirrhosis and chronic liver inflammation have in common that they cause the liver cells to die off.
By forming new liver cells and connective tissue, the liver attempts to compensate for the loss. When the cells divide, however, there is a risk that errors in the genetic code will occur. If there is increased cell formation in the diseased liver, this leads to an increased risk of degeneration. This leads to faster than average growth and more frequent division of the diseased liver cells. This is how a tumor is eventually formed.
Mold toxins are also risk factors for liver cell carcinoma. The mold (Aspergillus flavus) produces highly toxic aflatoxins with carcinogenic effects. The fungus is mostly found in types of grain or nuts that have grown under poor conditions and have been stored in damp conditions.
In most cases, hepatocellular carcinomas occur in Africa and Asia due to mold toxins. Another risk factor is congenital iron metabolism diseases. Here, too much iron is absorbed from the organism and deposited in the liver, which ultimately leads to its damage.
Symptoms, Ailments & Signs
Symptoms of liver cell carcinoma only appear relatively late. These are mostly non-specific symptoms such as loss of appetite, nausea and vomiting. In addition, there is pressure pain in the right upper abdomen, which is due to the capsule tension in the liver.
As the liver cell carcinoma progresses, the tumor can also be felt with the hand in the right upper abdomen. Typical side effects are wasting and ascites. Other symptoms of hepatocellular carcinoma can be unexplained weight loss, a general feeling of weakness and jaundice.
Diagnosis & course of disease
As a rule, the symptoms lead the patient to the family doctor or to an internist. The doctor looks at the anamnesis (medical history) of the patient and asks whether cases of chronic liver inflammation and liver cirrhosis have already occurred in the family, whether trips abroad to Africa or Asia have been made and what amounts of alcohol are consumed.
During the physical examination, the doctor looks for an enlargement of the liver under the right costal arch. In the case of cirrhosis of the liver, the surface of the liver turns out to be irregular, which can be felt. The doctor also taps the abdomen with his fingers to determine any accumulation of water in the abdominal cavity.
A blood test can provide further information. The AFP value in the blood serum increases in 50 percent of all patients with hepatocellular carcinoma. Imaging methods such as computed tomography (CT) or magnetic resonance imaging (MRI) are also important, as they make the tumor visible and indicate liver cancer metastases.
It is also possible to take a tissue sample and examine it in a laboratory. The course of a hepatocellular carcinoma is usually poor because it is often only discovered late. Without treatment, the patient dies after about six months.
Complications
In many cases, liver cell carcinoma is only diagnosed very late, so that treatment is only given late. In most cases, the patents suffer from nausea or vomiting. There is also a severe loss of appetite, which often leads to a significant loss of weight. Pain in the upper area of the abdomen also occurs, which can lead to limitations in everyday life.
In addition, patients suffer from significant accumulations of fluid in the abdomen and a general feeling of weakness. Furthermore, hepatocellular carcinoma also leads to jaundice and a greatly reduced resilience of the affected person. As a rule, liver cell carcinoma can only be treated with surgery. In most cases, there are no particular complications.
However, in severe cases, patients are dependent on a liver transplant to prevent death. The complications that may arise depend heavily on the patient’s state of health. Liver cell carcinoma may also significantly reduce the life expectancy of those affected. Furthermore, chemotherapy is often necessary, which can also lead to various side effects.
When should you go to the doctor?
Non-specific symptoms such as lack of appetite and nausea can indicate hepatocellular carcinoma. The affected person should therefore have the symptoms clarified quickly by a doctor so that appropriate treatment can be initiated without delay. If the signs of illness suddenly become stronger, an immediate visit to the doctor is indicated. The same applies if other side effects of hepatocellular carcinoma occur, such as wasting and ascites. Other warning signs that should be checked out are jaundice, weakness and recurring attacks of dizziness.
People suffering from liver disease should contact the responsible specialist if they experience loss of appetite and other unusual symptoms. Other risk groups, such as hepatitis B and C patients and people with a congenital iron metabolism disease, must also see a doctor immediately if there are warning signs. If the cancer is not treated, chronic symptoms can set in. In addition, untreated liver cell carcinoma significantly reduces life expectancy. Therefore, if there is any suspicion, the family doctor, a hepatologist or a gastroenterologist should be consulted. In the case of chronic diseases, a therapist can be involved in the treatment in consultation with the doctor.
Treatment & Therapy
The treatment of liver cell carcinoma depends on the stage of the disease. Surgery is usually required to remove parts of the liver. In some cases, a liver transplant is also possible, in which the diseased liver is replaced with a donor organ. The state of health and the age of the patient also play an important role in the treatment.
Destruction of liver cancer tissue can be carried out with laser therapy or radio frequency therapy. Cytostatics, on the other hand, respond poorly to hepatocellular carcinoma. Only the tyrosine kinase inhibitor sorafenib is effective. Tumor embolization can be used for palliative treatment. Local chemotherapy with substances that have a necrotizing effect can also take place.
Outlook & Forecast
In the case of hepatocellular carcinoma, the prognosis depends on the progression of the disease. The sooner a diagnosis is made and treatment can be started earlier, the better the chances of alleviating the existing symptoms. Nevertheless, it must be taken into account that liver cell carcinoma is often noticed at an advanced stage of the disease. This makes treatment options considerably more difficult and can contribute to the spread of cancer cells.
Recovery can occur in young people, with a stable immune system and no other existing diseases. However, complications and further formation of metastases often occur. These worsen the prospect of a cure and can result in the premature death of the person concerned. Since no spontaneous healing is to be expected with this disease, a refusal of medical help inevitably leads to the death of the person concerned. If a donor organ can be found, the prognosis improves.
Although liver transplantation carries various risks and side effects, it is a good way to achieve recovery. If the operation proceeds without further disturbances and if the organism accepts the donor organ well, the carcinoma can heal. The affected person is nevertheless bound to medical care for life and experiences a restriction in physical resilience.
Prevention
Avoiding alcohol makes sense to prevent liver cell carcinoma. Mold should also be avoided.
Aftercare
In most cases, the follow-up measures for hepatocellular carcinoma prove to be reactively difficult or are not available to the person concerned. The disease must be recognized and treated by a doctor very early on, so that there are no further complications in the everyday life of the person affected. If hepatocellular carcinoma is not treated properly, the patient dies prematurely in most cases.
In some cases, various medications can be used to relieve the symptoms of hepatocellular carcinoma. The person concerned should always pay attention to the correct intake and also to the correct dosage. If anything is unclear or if you have any questions, consult a doctor first and always follow the doctor’s instructions. However, in many cases hepatocellular carcinoma can only be cured by complete liver transplantation.
After such a procedure, strict bed rest is required. The affected person should not perform any physical or stressful activities in order not to unnecessarily burden the body. Help and support from friends and family can have a very positive effect on the course of the disease. However, liver cell carcinoma significantly reduces the life expectancy of those affected.
You can do that yourself
The treatment of hepatocellular carcinoma depends on the stage of the disease. If the tumor is detected at an early stage, the patient only has to ensure a healthy and active lifestyle. In conjunction with drug therapy, this is often sufficient to prevent further growth of the carcinoma.
For larger tumors, surgery is necessary. The patient can support recovery by taking it easy after the procedure and following the doctor’s diet and hygiene guidelines. If symptoms or complications arise, the doctor must be informed. You should also make sure that the wound heals well. At the same time, the doctor will refer the patient to a counseling center for tumor diseases. In the case of serious illnesses in particular, it makes sense to speak to a therapist and other people affected.
Hepatocellular carcinoma can usually be treated well, but there is a relatively high risk of recurrence. The diet should therefore be maintained even after the end of the treatment. Above all, stimulants such as alcohol, nicotine and coffee must be avoided. Regular check-ups must be observed.