ce-este-cancerul-hepatic

Ce este cancerul hepatic?

Cancerul hepatic este frecvent la nivel mondial din cauza factorilor de risc, cum ar fi hepatita cronica B si infectiile cu hepatita C si expunerea la aflatoxina. 

Simptomele cancerului hepatic pot include icter (o ingalbenire a pielii), dureri in zona abdomenului superior, dureri ale omoplatului drept si pierderea in greutate. Medicii diagnostica afectiunea folosind o combinatie de teste imagistice si analize de sange.

In functie de marimea tumorii, optiunile de tratament pot include indepartarea tumorii, transplant de ficat, terapii tintite, chimioterapie si, uneori, radioterapie.

Cancerul hepatic apare in ficat, un organ situat sub coastele inferioare din partea dreapta a abdomenului. Este important sa distingem cancerul hepatic primar (carcinomul hepatocelular) si cancerul biliar (cololangiocarcinom) de tumorile care incep in alte locuri ale corpului si se raspandesc la ficat (metastaze hepatice).

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Metastazele hepatice sunt mult mai frecvente decat cancerele hepatice primare si sunt tratate in modul in care este tratat un cancer primar (cum ar fi cancerul pulmonar sau cancerul de san), in locul modului in care este tratat cancerul hepatic primar.

Functiile ficatului sunt importante de stiut in timp ce priviti posibilele simptome ale bolii. Ficatul joaca roluri in detoxifierea substantelor, secretand bila pentru a ajuta digestia si a produce hormoni care sunt importanti in producerea de globule rosii.

Pe langa cancerele mentionate mai sus, exista tipuri mai putin frecvente de cancer la ficat. Cateva dintre acestea includ hepatoblastomul, o forma rara de cancer la copil si angiosarcomul ficatului.

Simptomele cancerului hepatic

Simptomele cancerului hepatic sunt mai putin frecvente in stadiile incipiente ale bolii, cu exceptia cazului in care tumora se afla in apropierea unuia dintre canalele biliare si provoaca o obstructie (cu simptome similare unui atac vezical).

Stadiile timpurii includ stadiul 1, unde tumora nu s-a raspandit inca. In stadiul de 2 cancer la ficat, mai multe tumori mici pot fi prezente si se pot raspandi in vasele de sange din apropiere.

Pe masura ce tumora se raspandeste in organele din apropiere, devine clasificata ca fiind cancer de ficat in stadiul 3. Etapa 4 inseamna ca, cancerul s-a raspandit la organe si alte zone indepartate, cum ar fi plamanii, oasele si glandele suprarenale.

In general, simptomele pot include:

  • Durere in abdomenul superior drept.
  • masa in abdomenul drept (chiar sub coaste sau potential mai jos).
  • Icter, o decolorare galbena a pielii si a albului ochilor.
  • Scaun pal sau alb.
  • Urina intunecata.
  • Mancarime intensa.
  • Ascita, lichidul acumulat in abdomen.
  • Febra (38.3 grade sau mai mare, care dureaza cateva zile fara semne evidente de infectie).
  • Pierderea in greutate neintentionata, fara o schimbare semnificativa in alimentatie sau exercitii fizice.
  • Simptome nespecifice, cum ar fi pierderea poftei de mancare, oboseala si un sentiment general de a fi rau.

Cauze

Nu suntem siguri care sunt exact cauzele bolii, desi stim mai multi factori de risc pentru cancerul hepatic. Majoritatea acestor factori de risc au ca rezultat cicatrizarea (ciroza) a ficatului, desi cancerul hepatic se poate dezvolta si fara ciroza.

Cel mai frecvent factor de risc pentru cancerul hepatic este una dintre formele de hepatita. Impreuna, se considera ca hepatita B si hepatita C sunt cauza a peste jumatate din cancerele hepatice din intreaga lume. Unii dintre factorii de risc includ:

  • Consumul de alcool si fumatul: consumul excesiv de alcool pe termen lung este clar asociat cu dezvoltarea cirozei, si poate creste de asemenea riscul de cancer la ficat.Fumatul pare sa creasca riscul, in special atunci cand este combinat cu alti factori de risc, cum ar fi hepatita B.
  • Istoric familial si boli genetice: Daca aveti un membru al familiei care are cancer la ficat, riscul dvs. este mai mare decat pentru persoanele care nu au pe nimeni in familie cu acest tip de cancer. Riscul este crescut si pentru cei care au boli genetice, cum ar fi hemocromatoza si boala Wilson.
  • Conditii medicale: Afectiunile medicale care cresc riscul de cancer la ficat includ colangita sclerozatoare primara, ciroza biliara primara, boala hepatica grasa non-alcoolica si diabetul.
  • Expunerea la afatoxina: Expunerea la aflatoxine (toxine eliberate de ciuperci care cresc pe boabe si nuci depozitate necorespunzator), este o cauza semnificativa a cancerului de ficat.

Diagnostic

Cei care au simptome de cancer la ficat sau factori de risc pentru dezvoltarea bolii trebuie sa se vada cu medicul lor. Un medic poate lua un istoric atent si poate efectua un examen fizic. Pentru unii, testele de screening pot fi luate in considerare. In functie de evaluare, se poate face si o combinatie de analize de sange si studii imagistice pentru a forma un diagnostic:

  • Teste de laborator: Testele sange (cum ar fi testele functiei hepatice), un panou de hepatita si markerii tumorii sunt adesea primii pasi in diagnosticul cancerului hepatic. Un test specific, testul markerului tumoral alfa-fetoprotein (AFP), poate fi ordonat sa analizeze bolile hepatice.
  • Imagistica: Primul test imagistic care se face de obicei este o ecografie.
  • Alte teste care pot fi utile in diagnosticare includ RMN si tomografii. De asemenea, poate fi recomandata o angiograma a ficatului.
  • Biopsie: Spre deosebire de multe tipuri de cancer, diagnosticul de cancer la ficat este adesea pus pe baza descoperirilor imagistice, mai degraba decat pe biopsie. Este posibil sa nu fie necesara o biopsie decat daca este important sa se inteleaga caracteristicile moleculare ale tumorii, cum ar fi intr-un studiu clinic.

Tratament

Optiunile de tratament disponibile pentru cancerul de ficat depind de stadiul bolii, starea generala de sanatate, si multe altele. Optiunile de tratament se incadreaza in doua tabere:

Tratamente sistemice

Acestea trateaza celulele canceroase oriunde se intampla si sunt principala optiune pentru cancerul hepatic avansat. Optiunile includ:

1. Chimioterapie

Exista diferite combinatii de medicamente pentru chimioterapie care pot fi administrate pentru cancerul hepatic. Chimioterapia functioneaza prin atacarea celulelor care divizeaza rapid in organism.

Din pacate, in organism exista celule normale care se impart rapid, ceea ce da nastere la efectele secundare bine cunoscute ale chimioterapiei, cum ar fi pierderea parului si riscul crescut de infectie.

Chemoembolizarea este o procedura in care chimioterapia este administrata direct intr-o artera mare (transarteriala) care intra in ficat. Chemoembolizarea poate fi folosita ca tratament principal, dar este de asemenea folosita pentru a incerca sa incetineasca cresterea unei tumori in timp ce o persoana asteapta un transplant de ficat.

2. Terapie vizata

Medicamentele terapeutice vizate difera de chimioterapie prin faptul ca „vizeaza” o anumita cale in cresterea unei celule canceroase.

Terapii locale

Acestea trateaza cancerul de unde isi are originea. Optiunile care pot fi luate in considerare includ:

Hepatectomie partiala

Aceasta este indepartarea chirurgicala a cancerului si a unor tesuturi normale din jur. Aceasta poate fi o optiune pentru tumorile hepatice mai mici (cu mai putin de 5 cm in diametru), in functie de locatia lor.

Transplant hepatic

Ficatul bolnav este indepartat si este inlocuit cu o parte sau un intreg ficat sanatos. Aceasta poate fi o optiune buna pentru cei cu boala extinsa sau care au insuficienta hepatica decompensata, dar sunt in alt mod intr-o stare de sanatate rezonabila.

Radioterapie

Aceasta poate implica radioterapie cu fascicul extern (tratarea unei zone mari a tumorii, de obicei pentru a reduce simptomele sau a prelungi viata, nu pentru a vindeca o tumora); radioterapie corporala stereotactica sau SBRT (foloseste o doza mare de radiatii pentru o suprafata mica de tesut pentru eradicarea unei tumori); sau brahiterapie (plasarea perlelor radioactive in ficat).

Ablatia radiofrecventei (RFA)

Aceasta este utilizarea unei sonde care are electrozi minusculi care distrug celulele canceroase.

Crioterapie

Aceasta implica inghetarea tesutului canceros.

Injectia percutanata cu etanol

Aceasta implica o injectie de alcool in ficat, si este o procedura relativ sigura pentru tumorile mici, dar a fost folosita in mare parte inlocuita de ablatia de radiofrecventa in ultimii ani.

Ingrijire paliativa

Ingrijirea paliativa presupune tratarea simptomelor cancerului si a tratamentelor impotriva cancerului, mai degraba decat a cancerului in sine. Spre deosebire de ingrijirile ospiceale, ingrijirea paliativa poate fi folosita chiar si pentru persoanele cu cancer intr-un stadiu foarte avansat.

Pe langa imbunatatirea calitatii vietii, un studiu din 2018 sugereaza ca acest tip de ingrijire poate imbunatati rezultatele si pentru persoanele cu cancer la ficat.

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  62. Japandi is a design style that combines the best of Japanese and Scandinavian aesthetics. It is characterized by clean lines, natural materials, and a focus on simplicity and functionality. Japandi furniture is often made of wood or bamboo, and it often features minimalist designs. The colors used in Japandi decor are typically muted, with white, black, and grey being common choices. Japandi style is also known for its use of negative space, which can create a feeling of calm and serenity. In recent years, Japandi has become increasingly popular as people seek out ways to create a more peaceful and relaxing home environment. If you’re looking to add a touch of Japandi to your home, consider incorporating some of these element into your decorating scheme.

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