The liver is the largest organ inside your abdomen. It's found behind your ribs on the right side of your body.
The liver does important work to keep you healthy:
The liver gets its supply of blood from two vessels. Most of its blood comes from the hepatic portal vein. The rest comes from the hepatic artery.
Cancer begins in cells, the building blocks that make up tissues. Tissues make up the organs of the body.
Normal cells grow and divide to form new cells as the body needs them. When normal cells grow old or get damaged, they die, and new cells take their place.
Sometimes, this process goes wrong. New cells form when the body doesn't need them, and old or damaged cells don't die as they should. The buildup of extra cells often forms a mass of tissue called a growth, nodule, or tumor.
Growths in the liver can be benign (not cancer) or malignant (cancer). Benign tumors are not as harmful as malignant tumors:
1. are rarely a threat to life
2. can be removed and usually don't grow back
3. don't invade the tissues around them
4. don't spread to other parts of the body
1. may be a threat to life
2. sometimes can be removed but can grow back
3. can invade and damage nearby tissues and organs (such as the stomach or intestine)
4. can spread to other parts of the body
Most primary liver cancers begin in hepatocytes (liver cells). This type of cancer is called hepatocellular carcinoma or malignant hepatoma.
Liver cancer cells can spread by breaking away from the original tumor. They mainly spread by entering blood vessels, but liver cancer cells can also be found in lymph nodes. The cancer cells may attach to other tissues and grow to form new tumors that may damage those tissues. See the Stagingsection for information about liver cancer that has spread.
Studies have found the following risk factors for liver cancer:
If liver cancer is diagnosed, your doctor needs to learn the extent (stage) of the disease to help you choose the best treatment. Staging is an attempt to find out whether the cancer has spread, and if so, to what parts of the body.
When liver cancer spreads, the cancer cells may be found in the lungs. Cancer cells also may be found in the bones and in lymph nodes near the liver.
When cancer spreads from its original place to another part of the body, the new tumor has the same kind of abnormal cells and the same name as the primary tumor. For example, if liver cancer spreads to the bones, the cancer cells in the bones are actually liver cancer cells. The disease is metastatic liver cancer, not bone cancer. It's treated as liver cancer, not bone cancer. Doctors sometimes call the new tumor "distant" or metastatic disease.
To learn whether the liver cancer has spread, your doctor may order one or more of the following tests:
If you have symptoms that suggest liver cancer, your doctor will try to find out what's causing the problems.
You may have one or more of the following tests:
Treatment options for people with liver cancer are surgery (including a liver transplant), ablation,embolization, targeted therapy, radiation therapy, and chemotherapy. You may have a combination of treatments.
The treatment that’s right for you depends mainly on the following:
Surgery is an option for people with an early stage of liver cancer. The liver cancer specialist in Ahmedabad may remove the whole liver or only the part that has cancer. If the whole liver is removed, it’s replaced with healthy liver tissue from a donor.
Removal of part of the liver (Hepatectomy)
Surgery to remove part of the liver is called partial hepatectomy. A person with liver cancer may have part of the liver removed if lab tests show that the liver is working well and if there is no evidence that the cancer has spread to nearby lymph nodes or to other parts of the body.
The surgeon removes the tumor along with a margin of normal liver tissue around the tumor. The extent of the surgery depends on the size, number, and location of the tumors. It also depends on how well the liver is working.
As much as 80 percent of the liver may be removed. The surgeon leaves behind normal liver tissue. The remaining healthy tissue takes over the work of the liver. Also, the liver can regrow the missing part. The new cells grow over several weeks.
A liver transplant is an option if the tumors are small, the disease has not spread outside the liver, and suitable donated liver tissue can be found.
Donated liver tissue comes from a deceased person or a live donor. If the donor is living, the tissue is part of a liver, rather than a whole liver.
While you wait for donated liver tissue to become available, the health care team monitors your health and provides other treatments.
When healthy liver tissue from a donor is available, the transplant surgeon removes your entire liver (total hepatectomy) and replaces it with the donated tissue. After surgery, your health care team will give you medicine to help control your pain. You may need to stay in the hospital for several weeks. During that time, your health care team monitors how well your body is accepting the new liver tissue. You’ll take medicine to prevent your body’s immune system from rejecting the new liver.
Methods of ablation destroy the cancer in the liver. They are treatments to control liver cancer and extend life. This may be used for people who can’t have surgery or a liver transplant or for people waiting for a liver transplant . Surgery to remove the tumor may not be possible because of cirrhosis or other conditions that cause poor liver function, the location of the tumor within the liver, or other health problems.
Methods of ablation include the following:
Embolization For those who can’t have surgery or a liver transplant, embolization or chemoembolization may be an option. The doctor inserts a tiny catheter into an artery in your leg and moves the catheter into the hepatic artery. For embolization, the doctor injects tiny sponges or other particles into the catheter. The particles block the flow of blood through the artery. Depending on the type of particles used, the blockage may be temporary or permanent. Without blood flow from the hepatic artery, the tumor dies. Although the hepatic artery is blocked, healthy liver tissue continues to receive blood from the hepatic portal vein. For chemoembolization, the doctor injects an anticancer drug (chemotherapy) into the artery before injecting the tiny particles that block blood flow. Without blood flow, the drug stays in the liver longer. You’ll need to be sedated for this procedure, but general anesthesia is not usually needed. You’ll probably stay in the hospital for 2 to 3 days after the treatment. Embolization often causes abdominal pain, nausea, vomiting, and fever. Some people may feel very tired for several weeks after the treatment.
People with liver cancer who can’t have surgery or a liver transplant may receive a drug called targeted therapy. Sorafenib tablets were the first targeted therapy approved for liver cancer.Targeted therapy slows the growth of liver tumors. It also reduces their blood supply. The drug is taken by mouth. Side effects include nausea, vomiting, mouth sores, and loss of appetite. Sometimes, a person may have chest pain, bleeding problems, or blisters on the hands or feet. The drug can also cause high blood pressure. The health care team will check your blood pressure often during the first 6 weeks of treatment.
Radiation therapy uses high-energy rays to kill cancer cells. It may be an option for a few people who can’t have surgery. Sometimes it’s used with other approaches. Radiation therapy also may be used to help relieve pain from liver cancer that has spread to the bones.
Liver cancer surgeon in Ahmedabad uses two types of radiation therapy to treat liver cancer:
The side effects from radiation therapy include nausea, vomiting, or diarrhea. Your health care team can suggest ways to treat or control the side effects.
Chemotherapy, the use of drugs to kill cancer cells, is sometimes used to treat liver cancer. Drugs are usually given by vein (intravenous). The drugs enter the bloodstream and travel throughout your body. The side effects of chemotherapy depend mainly on which drugs are given and how much. Common side effects include nausea and vomiting, loss of appetite, headache, fever and chills, and weakness.
Some drugs lower the levels of healthy blood cells, and you’re more likely to get infections, bruise or bleed easily, and feel very weak and tired. Your health care team will check for low levels of blood cells. Some side effects may be relieved with medicine.
Depending on your cancer type and stage, our goals for treatment are:
Surgery can be done for many reasons for treatment of cancer.
Diagnostic & Staging Surgery
How surgery is performed? (Special surgery techniques): Open Or Laparoscopic
Biopsy is procedure to confirm the presence of cancer. It’s not essential before surgery. Usually biopsy is performed when 1. Suspicion is cause other than cancer, 2. When surgery cannot be done for cancer due to advanced stage of cancer or 3. Patient is unfit to undergo surgery. In these situation, biopsy guides for further therapy.
If all investigations suggest that cancer can be removed in totality from body, then biopsy can be avoided in to minimize the risk of spillage of cancer cell during biopsy procedure.
There is variety of way to perform biopsies:
Fine Needle Aspiration (FAN) biopsy
Core Needle biopsy
Excisional or Incisional biopsy
Our expert team members shall help you to prepare you for surgery. You are strongly advised to stop smoking, stop drinking alcohol, try to improve your diet, lose weight, or actively exercise before surgery.
In most cases, you will need some tests before your surgery. The tests routinely used include:
Our expert team of Anaesthetist will ask you questions pertaining to your health and to assess your fitness for surgery. You are requested to tell them in detail about your current and past medical ailments, allergic reactions you’ve had in the past and current medicines that you are taking like blood thinning medicine. This medicine should be stopped 1 week prior to surgery.
Informed consent is one of the most important parts of “getting ready for surgery”. It is a process during which you are told about all aspects of the treatment before you give your doctor written permission to do the surgery.
Depending on the type of operation you have, there may be things you need to do to be ready for surgery:
Anaesthesia is the use of drugs to make the body unable to feel pain for a period of time. General anaesthesia puts you into a deep sleep for the surgery. It is often started by having you breathe into a face mask or by putting a drug into a vein in your arm. Once you are asleep, an endotracheal or ET tube is put in your throat to make it easy for you to breathe. Your heart rate, breathing rate, and blood pressure (vital signs) will be closely watched during the surgery. A doctor watches you throughout the procedure and until you wake up. They also take out the ET tube when the operation is over. You will be taken to the recovery room to be watched closely while the effects of the drugs wear off. This may take hours. People waking up from general anaesthesia often feel "out of it" for some time. Things may seem hazy or dream-like for a while. Your throat may be sore for a while from the endotracheal (ET) tube.
There are risks that go with any type of medical procedure and surgery is no longer an exception. Success of surgery depends upon 3 factors: type of disease/surgery, experience of surgeon and overall health of patients. What’s important is whether the expected benefits outweigh the possible risks.
Doctors have been performing surgeries for a very long time. Advances in surgical techniques and our understanding of how to prevent infections have made modern surgery safer and less likely to damage healthy tissues than it has ever been. Still, there’s always a degree of risk involved, no matter how small. Different procedures have different kinds of risks and side effects. Be sure to discuss the details of your case with our health care team, who can give you a better idea about what your actual risks are. During surgery, possible complications during surgery may be caused by the surgery itself, the drugs used (anesthesia), or an underlying disease. Generally speaking, the more complex the surgery is the greater the risk. Complications in major surgical procedures include: