Liver Cancer Health Article

Prognosis

Liver cancer has a very poor prognosis because it is often not diagnosed until it has metastasized. Fewer than 10% of patients survive three years after the initial diagnosis; the overall five-year survival rate for patients with hepatomas is around 4%. Most patients with primary liver cancer die within several months of diagnosis. Patients with liver cancers that metastasized from cancers in the colon live slightly longer than those whose cancers spread from cancers in the stomach or pancreas.

Alternative and complementary therapies

Many patients find that alternative and complementary therapies help to reduce the stress associated with illness, improve immune function, and boost spirits. While there is no clinical evidence that these therapies specifically combat disease, activities such as biofeedback, relaxation, therapeutic touch, massage therapy and guided imagery have no side effects and have been reported to enhance well-being.

Several other healing therapies are sometimes used as supplemental or replacement cancer treatments, such as antineoplastons, cancell, cartilage (bovine and shark), laetrile, and mistletoe. Many of these therapies have not been the subject of safety and efficacy trials by the National Cancer Institute (NCI). The NCI has conducted trials on cancell, laetrile, and some other alternative therapies and found no anticancer activity. These treatments have varying effectiveness and safety considerations. (Laetrile, for example, has caused deaths and is not available in the U.S.) Patients using any alternative remedy should first consult their doctor in order to prevent harmful side effects or interactions with traditional cancer treatment.

Coping with cancer treatment

Side effects of treatment, nutrition, emotional well-being, and other issues are all parts of coping with cancer. There are many possible side effects for a cancer treatment that include:

• constipation
• delirium
• fatigue
• fever, chills, sweats
• nausea and vomiting
• mouth sores, dry mouth, bleeding gums
• pruritus (itching)
• affected sexuality
• sleep disorders

Anxiety, depression, feelings of loss, post-traumatic stress disorder, affected sexuality, and substance abuse are all possible emotional side-effects. Patients should seek out a support network to help them through treatment. Loss of appetite before, during, and after a treatment can also be of concern. Other complications of coping with cancer treatment include fever and pain.

Clinical trials

There are many clinical trials in place studying new types of radiation therapy and chemotherapy, new drugs and drug combinations, biological therapies, ways of combining various types of treatment for liver cancer, side effect reduction, and quality of life. Information on clinical trials can be acquired from the National Cancer Institute at <http://www.nci.nih.gov> or (800) 4-CANCER.

Prevention

There are no useful strategies at present for preventing metastatic cancers of the liver. Primary liver cancers, however, are 75% to 80% preventable. Current strategies focus on widespread vaccination for hepatitis B, early treatment of hereditary hemochromatosis (a metabolic disorder), and screening of high-risk patients with alpha-fetoprotein testing and ultrasound examinations.

Lifestyle factors that can be modified in order to prevent liver cancer include avoidance of exposure to toxic chemicals and foods harboring molds that produce aflatoxin. Most important, however, is avoidance of alcohol and drug abuse. Alcohol abuse is responsible for 60% to 75% of cases of cirrhosis, which is a major risk factor for eventual development of primary liver cancer. Hepatitis is a widespread disease among persons who abuse intravenous drugs.

See Also CT-guided biopsy; Hepatic arterial infusion; Immunologic therapy; Alcohol consumption

Resources

BOOKS

Berkow, Robert, et al., eds. "Hepatic and Biliary Disorders:Neoplasms of the Liver." In The Merck Manual of Diag nosis and Therapy. Rahway, NJ: Merck Research Laboratories, 1997.

Dollinger, Malin. Everyone's Guide to Cancer Therapy. Kansas City: Somerville House Books Limited, 1994.

Friedman, Lawrence S. "Liver, Biliary Tract, & Pancreas." InCurrent Medical Diagnosis & Treatment 1998. Stamford, CT: Appleton & Lange, 1997.

Isselbacher, K.J., and J.L. Dienstag. "Tumors of the Liver and Biliary Tract." In Harrison's Principles of Internal Medi cine. Fauci, Anthony S., et al., eds. New York:McGraw-Hill, 1998.

Loeb, Stanley, et al., eds. "Liver Cancer." In Professional Guide to Diseases. Springhouse, PA: Springhouse Corporation, 1991.

Rudolph, Rebecca E., and Kris V. Kowdley. "Cirrhosis of the Liver." In Current Diagnosis 9. Conn, Rex B., et al., eds. Philadelphia: W. B. Saunders Company, 1997.

Way, Lawrence W. "Liver." In Current Surgical Diagnosis & Treatment. Stamford, CT: Appleton & Lange, 1994.

PERIODICALS

El-Serag, H.B. "Epidemiology of Hepatocellular Carcinoma"Clinics in Liver Disease (February 2001): 87-107.

Macdonald, G.A. "Pathogenesis of Hepatocellular Carcinoma"Clinical Liver Disease (February 2001): 69-85.

Yu, M.C., et al. "Epidemiology of Hepatocellular Carcinoma"Canadian Journal of Gastroenterology (September 2000):703-9.

ORGANIZATIONS

American Cancer Society. 1599 Clifton Rd. NE, Atlanta, GA30329. (800) 227-2345. <http://www.cancer.org>.

American Institute for Cancer Research (AICR). 1759 R St.NW, Washington, DC 20009. (800) 843-8114. <http://www.aicr.org>.

American Liver Foundation. 908 Pompton Ave., Cedar Grove, NJ 07009. (800) 223-0179.

Cancer Care, Inc. 275 Seventh Ave., New York, NY10001.(800) 813-HOPE. <http://www.cancercare.org>.

Cancer Hope Network. Suite A., Two North Rd., Chester, NJ 07930.(877) HOPENET. <http://www.cancerhopenetwork.org>.

Hospicelink. Hospice Education Institute, 190 Westbrook Rd., Essex, CT, 06426-1510. (800) 331-1620. <http://www.hospiceworld.com>.

National Cancer Institute (National Institutes of Health). 9000Rockville Pike, Bethesda, MD 20892. (800) 422-6237.<http://www.nci.nih.gov>.

The Wellness Community. Suite 412, 35 E. Seventh St., Cincinnati, OH 45202. (888) 793-9355. <http://www.wellness-community.org>.

Rebecca J. Frey, Ph.D

Laura Ruth, Ph.D.