What is hepatocellular carcinoma?
Hepatocellular carcinoma (HCC) or liver cell carcinoma is a rare form of cancer in the Netherlands that arises from liver cells. The hepatocellular carcinoma is almost always generated in the liver cirrhosis, or in a chronic inflammatory liver on the basis of hepatitis. In the Western world is alcohol abuse, the most common cause of the formation of cirrhosis of the liver, together with chronic hepatitis C. Hepatocellular carcinoma is therefore in particular seen in patients with a history of alcohol abuse or patients who have chronic hepatitis C (or to a lesser extent, hepatitis B) have gone through.
The treatment of hepatocellular carcinoma is dependent on many factors. In particular, the tumor size, but also the presence of metastases (secondary tumors), and the tumor characteristics of the tumor are decisive for the treatment. If hepatocellular carcinoma is detected early and has not spread can be operated to cure the cancer intent. As with other forms of cancer, if the tumor is large and / or spread, which would then be less, and treatment options are the likelihood of healing is significantly reduced.
Hepatocellular carcinoma is quite rare in the Western world but one of the most common cancers for example in Africa and Asia. When there is a tumor in the Netherlands have been found in the liver, this is almost always a metastasis from the large intestine (colon carcinoma), or, for example, the stomach.
Signs and symptoms of hepatocellular carcinoma
As with many forms of cancer will therefore, on the presence of hepatocellular carcinoma in the first instance are few complaints. When the tumor grows, vague abdominal symptoms occur. Often there is a relatively long period of vague abdominal pain, weight loss, fatigue, general malaise and poor appetite. When the tumor pressed on the bile ducts may jaundice occur. In patients with known liver cirrhosis is important that when the above symptoms occur, further study of the existence of a hepatocellular carcinoma.
Risk factors of hepatocellular carcinoma
The main risk factors for the development of hepatocellular carcinoma;
- alcoholism
- hepatitis B
- hepatitis C (25% of the world's cases of hepatocellular carcinoma)
- aflatoxin
- cirrhosis
- hemochromatosis
The risk factors vary greatly worldwide. In the West, because of the Hepatitis B vaccination among other few occur no major cause for the development of hepatocellular carcinoma. In the West, alcoholism and liver cirrhosis caused by this major risk factor.
Hepatocellular carcinoma diagnosis
Hepatocellular carcinoma is as mentioned particularly in patients with known liver cirrhosis and / or hepatitis C and B. These people can then be screened by ultrasound of the liver. In an echo of the liver tumor can be seen whereupon CT examination can be performed to see if the tumor has spread. Through CT examination can usually diagnose hepatocellular carcinoma are officially and do not have to biopsy are performed. In addition, use can be made of a certain substance produced by the tumor and commonly found in the blood; alpha-fetoprotein. As a tumor marker alpha-fetoprotein has called a high specificity but low sensitivity. This means that the fabric does not always have to be increased in a hepatocellular carcinoma. If a discrepancy is found, however, in the liver and the alpha-fetoprotein elevated in the blood is present then it is fairly certain that the liver concerns, hepatocellular carcinoma.
When there is a hepatocellular carcinoma on CT scan found there may be distinguished by the doctor in growth mode, which affects the prognosis. A single tumor there can thus be found, multiple tumors or tumor with an unsharp limited infiltration of surrounding tissue. The last habit has a worse prognosis because they often already spread when it is found.
Hepatocellular carcinoma treatment
Unfortunately, it is so that it often leaves hepatocellular carcinoma is discovered. As a result, operation (in the sense of removing a whole of the tumor) is often no longer possible. If this is the case, a surgeon will try to remove the entire tumor with the aim to cure the cancer. Often there is in discovering a tumor but all tumor invasion into surrounding tissue and can be treated only prolonging and palliative. The following life sustaining treatments are most often carried out in patients with hepatocellular carcinoma:
- Radiofrequency ablation (RFA)
- Transcatheter arterial chemoembolization (TACE)
- Injections into the tumor
- Sorafenib
Hepatocellular carcinoma prognosis
The hepatocellular carcinoma has a particularly poor prognosis. This is mainly located in the fact that this tumor gives late complaints. The tumor is often already far into surrounding tissue ingrown and is often already spread. At some 10-20% of patients is it at all possible to surgically remove the tumor at all. In General, a non operable hepatocellular carcinoma within half a year is fatal. With new treatments and better expertise increases the life expectancy of patients something.