Gastro - Liver Cancer Flashcards
What is primary liver cancer?
Cancer originating in the liver
Main type is hepatocellular carcinoma
What is secondary liver cancer?
Originates outside the liver and metastasises to the liver
Poor prognosis where there is cancer with liver metases
What are the risk factors for developing hepatocellular carcinoma?
Liver cirrhosis due to :
- Alcohol-related liver disease
- NAFLD
- Hepatitis B
- Hepatitis C
- Rarer causes
How often are patients with liver cirrhosis offered screening for hepatocellular carcinoma?
Every 6 months
Alongside USS and alpha-fetoprotein
How does liver cancer present?
Often asymptomatic
- Weight loss
- Abdominal pain
- Anorexia
- Nausea and vomiting
- Jaundice
- Pruritis
- Upper abdominal pain on palpation
What investigations are used in assessing liver cancer?
Alpha-fetoprotein (tumour marker for HCC)
Liver ultrasound- first-line imaging
CT and MRI
Biopsy
How is liver cancer managed?
Hepatocellular carcinoma has a very poor prognosis unless diagnosed early
Surgery is possible early on
Resection in a removable liver area
Liver transplant is an option when the tumour is isolated to the liver and patient meets specific criteria
What other options are available for treating liver cancer?
Radiofrequency ablation
Microwave ablation
Transarterial Chemoembolisation
Radiotherapy
Targeted drugs (kinase inhibitors and monoclonal antibodies)
What is transarterial chemoembolisation?
Interventional radiology procedure
Chemotherapy drug injected into hepatic artery, delivering dose to tumour
Followed by embolisation of the vessel to block tumours blood supply
What is a cholangiocarcinoma?
Cancer originating in the bile ducts
Majority are adenocarcinomas
Most common site is the perihilar region
What is cholangiocarcinoma associated with?
Primary sclerosing cholangitis
Only 10% of patients
What are the key presenting features of obstructive jaundice?
Pale stools
Dark urine
Pruritis
What is the tumour marker for cholangiocarcinomas?
CA19-9
What is the likely diagnosis of painless jaundice?
Head of pancreas cancer
Cholangiocarcinoma
More commonly pancreatic cancer
What is a haemangioma?
Common benign tumours of the liver
Found incidentally
Cause no symptoms and no potential to become cancerous
No treatment needed
