Hepatocarcinoma
Malignant hepatoma, which is primary cancer of the liver is termed hepatocarcinoma. Hepatocarcinoma is secondary in about 20% to either a viral hepatitide infection (hepatitis B and C) and about 80% to cirrhosis. In some cases, it is metastasis of cancer, spread from elsewhere in the body. It is also associated with chronic alcohol abuse. Hepatocellular carcinoma is relatively rare in the United States but quite common in the African and Southeast Asian countries. Infact, this is the fifth most common tumor worldwide. In some African countries the disease onsets between late teens and 30s although the normal occurrence is in patients over age 50. Hepatocarcinoma is more common in males than females.
Hepatocarcinoma patients are put under surveillance with ultrasound. Possibly the best method of diagnosis involves a CT scan of the abdomen. This is done using intravenous contrast agent and three phase scanning, enabling the radiologist to detect subtle tumors as well. Another possible alternative to a CT imaging is MRI, using contrast agents which is used to detect the presence of a tumor capsule. Diagnosis is further confirmed by percutaneous biopsy and histopathological parameters.
Treatment for hepatocarcinoma depends especially on the size of the tumor and staging. Some of the treatment options are liver transplantation, which is to replace the liver with a cadaver liver or a live donor lobe; surgical resection wherein the tumor is removed if diagnosed early; Percutaneous ethanol injections in case of solitary tumors and transcatheter arterial chemoembolization for large tumors.
Sometimes sealed source radiotherapy is used to destroy the tumor from within. Here, the radioactive particles are deposited to the area of interest using a catheter. Radiofrequency ablation uses high frequency radio waves to ablate the tumor. As an adjuvant therapy in resected patients, intra-arterial-iodine-131-lipiodol administration is performed. High intensity frequency ultrasound is a relatively new but powerful technique used to treat the tumor. Hormonal therapy and adjuvant chemotherapy are other treatment modalities adopted. Cryosurgery is yet another new technique that can destroy tumors in a variety of sites, in the brain, breast, kidney, prostrate and liver.
Pancreatic Cancer
Pancreas lies deep within the abdomen and secrete enzymes that are vital to digestion. Hormones secreted by the pancreas aid in maintaining sugar levels in the body. Pancreatic cancer is a condition where there is a malignant tumor, mostly found in the exocrine portion of the pancreas. Pancreatic cancer is not easily detectable in the early stages. Besides, it spreads rapidly and can metastasize to other organs such as bile duct, duodenum (small intestine), spleen, colon, adrenal gland, kidney, or vertebra.
Typical symptoms associated with pancreatic cancer are loss of appetite, nausea, vomiting, abdominal pain and weight loss. The patient is likely to suffer from back pain and complain of tiredness and fatigue. Pancreatic cancer may result in blood clots and liver dysfunction. The abdominal pain associated with pancreatic cancer is likely to radiate to the upper and middle back. There may be yellowing of the skin since most persons suffering from cancer of the pancreas tend to develop jaundice. In advanced stages of pancreatic cancer, there is considerable accummulation of bile acids in the skin leading to severe itching.
Some peope have a heriditary genetic predisposition to cancer while there are certain factors that increase the likelihood of developing pancreatic cancer.
- High fat diet consisting largely of animal fat and lesser vegetables and fruits
- Smoking
- Obesity
- Sedentary lifestyle
Blood test for serum bilirubin will show high bile pigment. Abdominal ultrasound and abdominal MRI aids in diagnosing the extent of tumor in the pancreas. ERCP (Endoscopic retrograde cholangiopancretography) is a procedure that allows a physician to observe the common bile duct and pancreatic ducts. A pancreatic biopsy can help understand the kind of tumor in the pancreas. Pancreaticoduodenectomy (Whipple procedure) involves surgical removal of the pancreatic tumor. This surgical procedure is conducted on patients whose tumors are located in the head of the pancreas or regions adjacent to it. Surgery may involve remove a section or the entire pancreas. A combination of radiation therapy and chemotherapy is given to those patients whose tumor is not removed.
CA 125 blood test
CA 125 blood test measures the level of blood antigens that are considered tumor markers. Typically the CA 125 blood test is used monitor the progress of ovarian cancer. But the CA 125 blood test is not considered a very accurate diagnostic tool. This test is used in combination with transvaginal ultrasound and pelvic examination. CA 125 blood tests often return false positive results. Besides hardly about 50% of women with ovarian cancer have elevated levels of CA 125. CA 125 levels can be elevated due to menstruation, endometriosis, fibroids and pregnancy. The newer CA 125 blood test is said to be more accurate. This test is called CA 125 - II. Readings of above 35 U/ml are considered abnormal. CA 125 blood test is used to check the effect of treatment on women suffering from ovarian cancer. It is not used to check otherwise healthy women for ovarian cancer.
Bibliography / Reference
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