[MOL] For your files..... [00118] Medicine On Line

[Date Prev][Date Next][Thread Prev][Thread Next][Date Index][Thread Index]

[MOL] For your files.....

Various Cancer Educational Series For Molers

                                                    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
                   other chemicals.

                            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
                   be present.

                   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
                   after treatment.

                    Because the
                   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
CancerFax: (301)402-5874
CancerNet: mailto:cancernet@icicc.nci.hih.gov
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
(973)256-3214 FAX
E-mail: mailto:info@liverfoundation.org
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
            UPCC 8997
            NEW STUDY
                     Primary and
                     Metastatic Malignant
                     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
                                                               Cynthia Helsabeck,
                                                               RN (215) 349-8399

                                                               Physician Contact:
                                                               Douglas Fraker,
                                                               MD (215) 662-7866
 XV. Ancillary
            UPCC 7997
            NEW STUDY
                     Resectable Malignant
                     Liver Tumors
                                    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.
                                                               Cynthia Helsabeck,
                                                               RN (215) 349-8399

                                                               Physician Contact:
                                                               Douglas Fraker,
                                                               MD (215)