CANCER OF THE LIVER
Cancer of the liver is a rare malignancy in the United States, but in parts
of Asia and Africa, it is one of the most common malignancies. In the
United States, the average age on onset is 60 to 70 years; the disease
occurs more frequently in males than females.
There is a strong association between chronic hepatitis B infection and
the development of heptaocellular carcinoma. People with cirrhosis also
have an increased risk of liver cancer. Other possible hepatocarcinogens
include aflatoxin, nitrosamines, oral estrogen compounds, and numerous
Clinical Manifestations and Diagnosis
Signs of liver cancer include weakness, anorexia, fever of unknown
origin, abdominal fullness or bloating, and dull upper quadrant abdominal
pain. The clinical presentation will vary depending on the presence or
absence of cirrhosis. Patients with cirrhosis exhibit rapid onset of
symptoms; in the absence of cirrhosis, signs are much more subtle. As
the tumor grows, pain may radiate to the back. Patients must be assessed
carefully, as weight loss is often obscured by ascites. The liver is
generally tender to palpation, and jaundice and portal hypertension may
Diagnosis is made using radioisotope scans, CT scans, or hepatic
arteriography. Many patients will have advanced disease at diagnosis.
Cancer of the liver spreads throughout the organ and invades the portal
vein and lymphatics. The most common sites of distant metastases are the
lungs and brain.
Surgical resection is attempted if no nodal involvement or distant spread
is found. Even with resection, recurrence of liver cancer is common, and
5-year survival is rare. Patients may be treated with chemotherapy
infused directly into the hepatic circulation. With this type of treatment
(intra-arterial chemotherapy), a catheter is surgically placed in the
hepatic artery and the chemotherapeutic agent is continuously infused.
The most commonly used agents are 5-FU, doxorubicin, and
methotrexate. Side effects of this technique include toxic hepatitis (which
subsides after discontinuation of therapy) and catheter displacement or
Radioimmunotherapy is an experimental form of treatment used for some
types of liver cancer. A radioactive isotope is attached to a radiolabeled
antibody against ferritin, a specific protein found in human liver tumors.
The isotope is given intravenously and concentrates in the liver, where it
radiates the tumor internally. No immediate treatment side effects have
been noted, but thrombocytopenia and neutropenia occur 4-6 weeks
normal metabolic and storage functions of the liver are impaired, patients
are at risk for nutritional and bleeding complications.
National Cancer Institute
PDQ: (800) 4 CANCER
Web site: http://cancernet.nci.nih.gov/
Provides current, comprehensive information on all major types of cancer, treatments, and clinical trials, plus referrals to treatment facilities and doctors, via telephone, fax, on-line, and print.
American Liver Foundation
1425 Pompton Ave.
Cedar Grove, NJ 07009
Web site: http://www.liverfoundation.org/
Provides medical referrals for people with liver cancer and other liver diseases, and educational and research grants to professionals.
76% Liver Cancer - A normal or elevated bilirubin level (depending
on if the bile system is
secondarily affected), elevated white cell count and greatly elevated liver enzymes. A simple,
uncomplicated bile obstruction (very rarely seen) will have usually a greatly elevated bilirubin level,
some elevation of liver enzymes and often no effect on the white cell count.
Results of search for "LIVER" - Posted 7/18/98 2:34:13 PM
I. Phase I/Pilot
Tumors of the Liver
Gene Therapy of Primary and
Metastatic Malignant Tumors of the
Liver Using SCH58500 Via Hepatic
Artery Infusion, A Phase I Study
Unresectable colon carcinoma
metastatic to liver. Primary hepatic
adenocarcinoma, resectable or
unresectable. Evidence of p53
alteration in tumor tissue. Prior
treatment allowed after 28 days have
elapsed (3 months if investigational).
Adenoviral vector carrying wild-type
p53 injected via hepatic artery. Part A
patients receive a single bolus dose
during arteriogram. Part B patients
receive 5 consecutive daily bolus
doses via hepatic arterial infusion
RN (215) 349-8399
MD (215) 662-7866
Radiofrequency Destruction of Liver
Resectable malignant liver tumors,
either primary hepatic adenocarcinoma
or metastatic colon carcinoma
Up to four liver lesions are treated
intra-operatively, then resected. A
needle electrode is inserted into the
center of each lesion, and
radiofrequency waves are used to heat
and kill tumor tissue.
RN (215) 349-8399