Liver cancer or Hepatocellular Carcinoma (HCC) is an increasingly prevalent disease that affects, and is currently the most deadly type of cancer in the third world. Main risk factors for HCC is cirrhosis (hardening) of the liver. The main causes of cirrhosis in the world is hepatitis (B and C) and alcohol. In recent years, a new risk factor, which is known as 'fatty liver' or 'non-alcoholic hepatitis steato-' (NASH) have emerged, especially in developed countries where the intake of fat-rich foods higher. Some other causes include primary biliary cirrhosis or primary sclerosing cholangitis (inflammation of the bile duct), which is usually caused by a rare genetic mutation.
Prevention
Vaccination for Hepatitis B is the primary method for the prevention of HCC. Many studies have shown that HCC mortality is lower in countries that practice universal vaccination in newborns. Screening and if necessary for Hepatitis B vaccination, is highly recommended. Early detection and treatment for those already infected will reduce the risk cancer.
There is no vaccine for Hepatitis C, but no effective drugs to treat this disease, and they have been shown to reduce the risk of cancer. Both hepatitis B and C are transmitted through body fluids, especially blood and semen or vaginal fluids. Therefore, it is safe for patients with hepatitis to share a meal with their friends and family. However, sharing toothbrushes or razors should dihindari.Dr Salleh Ibrahim, Surgeons Asian Centre for Liver Diseases & Transplantation (ACLDT), Gleneagles Hospital Singapore revealed that "Diet and exercise and stop consuming alcohol can inhibit liver cirrhosis risk, and also reduces cancer risk. It has been proven that fatty liver is also associated with uncontrolled diabetes. With the help of a doctor, the right to address the management of diabetes reduces the risk of fatty liver and cancer in patients. Low fat, low cholesterol and non-greasy foods is recommended for such patients. Exercising at least three times a week for at least 45 minutes is also recommended.
Patients with fatty liver are overweight and need to have a proper cardiovascular system before undergoing an exercise program / any sport. However, patients should always consult with a cardiovascular specialist beforehand to determine whether they are fit enough to do the exercises ".
Detection
Patients with cancer of the liver in the early stages often do not show signs or symptoms specifically. Most of them will have symptoms of chronic liver disease such as ascites (abdominal bloating), jaundice (yellowing of the skin and eyes), easy bleeding and swollen feet. These patients have severe liver dysfunction and cancer hati.Sama like other cancers, early detection of liver cancer will significantly improve the chances of survival. Therefore, it is recommended for patients with hepatitis and / or cirrhosis get regular six-monthly ultrasound of the liver and blood of those who called Alpha fetoprotein. This test can be easily done and there is no contrast or radiological exposure is required, so it is safe for health.
If this test indicates a suspicious wound, either computed tomography (CT scan) and / or magnetic resonance imaging (MRI) of the liver will be taken. 97% of liver cancer are diagnosed through this test. Liver biopsy is rarely necessary.
Treatment
Treatment recommendations for patients with HCC are surgery, in which both parts of the infected liver cancers can be removed (hepatectomy) or the entire liver is removed and transferred to the donor liver (liver transplant). "Usually patients with good liver function, but a small portion of their liver have been infected with cancer may undergo hepatectomy at the Asian Centre for Liver Diseases & Transplantation (ACLDT), Gleneagles Hospital Singapore. Patients with poor liver function and where the cancer has not spread beyond the liver would be advisable to undergo a liver transplant. Liver transplantation is often the main treatment for patients with advanced liver cancer and who previously have undergone hepatectomy. This is known as a "cell transplantation rescue" "Reveal Dr Salleh.
Furthermore, Dr Salleh Ibrahim explains the two main types of liver transplantation - Living Donor Liver Transplant (LDLT) and Cadaveric Liver Transplantation (CLT). In LDLT, healthy donors contributed about 40 percent of their liver to a recipient who suffered from liver cancer and / or severe liver disease. The donor must be physically, mentally and psychologically stable by 'Transplant Ethics Committee' as the Ministry of Health. In Indonesia alone, the law governing organ transplants under Law 36 of 2009 on Health. Donors often a relative, or a person who has an emotional connection with the recipient. Surgical risk to the donor is minimal. Through long-term follow-up showed that the donor liver can be healthy and normal life after transplant surgery. At CLT, hearts of those who have experienced the death of brain transplanted into the recipient. Research has shown that there is no difference in survival between the two types of transplants. Each type of transplantation produces a cure rate of at least 80% over the two years post-surgery. However, it is important that this operation is performed in specialized centers with post-surgical care appropriate for the patient's prognosis depends on this.
LDLT is the primary method of liver transplantation in Asia because of the lack of cadaveric organs in the region ini.Walaupun there other options that are not too accurate, including the Trans-Arterial Chemotherapy (TACE), local radiotherapy (Yittrium) and systemic chemotherapy.
Conclusion
HCC is a deadly disease. However, early detection and treatment often provides clinical benefit to patients, including to have a long life expectancy and improved quality of life. Surgical remains the primary treatment option for patients with HCC. However, it is important that the surgical procedure performed in specialized facilities. Advances in surgical techniques and postoperative special care can improve the chances of survival for liver cancer patients.
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