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  • Liver cancer symptoms

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    Liver cancer is a malignant tumor. There are liver diseases, in which the likelihood of subsequent liver cancer increases. This background liver disease - hepatitis, in which the incidence of liver cancer increases dramatically. More information about hepatitis see here. Liver diseases - cirrhosis in 80% of cases are the causes of hepatocellular liver cancer. More information about cirrhosis see here.
    Malignant tumors of the liver include primary liver cancer and metastatic cancer. The latter occurs when the primary tumor node is in another organ, and the cells of this tumor have entered the liver and began to grow.

    Causes of

    Only 10% of malignant neoplasms are transmitted to us by inheritance, and more than 90% of tumors occur spontaneously or under the influence of unfavorable factors. The factors under the influence of which tumors can occur are usually called carcinogens.
    Physical carcinogens include ultraviolet irradiation, ionizing radiation( radiation), long-term mechanical effects.

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    A number of viruses have a carcinogenic effect. It has been proven that a widespread virus such as type II herpes can cause cervical cancer, cytomegalovirus contributes to Kaposi's sarcoma, and hepatitis B virus can lead to liver cancer.
    Long-term overload at work, nervous tension, stress, failure in personal life and career

    can lead to the development of cancer. Malignant liver tumors


    Primary cancers:
    a) hepatocellular carcinoma;B) cholangiocellular carcinoma;C) biliary cystoadenocarcinoma;D) hepatoblastoma;E) mixed hepatocholangiocellular carcinoma;E) undifferentiated cancer;G) gemangiosarcoma;H) embryonic sarcoma and other tumors.
    Secondary or metastatic cancers:
    1) from a colon tumor;
    2) from a stomach tumor;
    3) from a lung tumor;
    4) from the tumor of the esophagus;
    5) from the ovarian tumor;
    6) from a breast tumor;
    7) from a tumor of the prostate;
    8) from a kidney tumor;
    9) from a tumor of the biliary tract;
    10) from melanoma;
    11) from a pancreatic tumor;
    12) from the tumor of the cervix;
    13) from neuroendocrine tumors.

    When malignant tumor diseases of the liver, both primary and secondary, occur, a more caring attitude to oneself is required. It is necessary not only to strictly follow all the recommendations of an oncologist, but also to take an active part in the treatment of your illness. First of all, you should pay attention to nutrition during illness and treatment, the regime of the day, the possible intake of vitamins, adaptogens and antioxidants.

    It turned out that among all malignant tumors that are found in the population of all countries, liver cancer took the fifth place and, alas, entered the twelve most common neoplasms.
    Which tumors metastasize to the liver? Why does the liver develop metastases, which contributes to detachment from the primary tumor and the spread of tumor cells, as well as their subsidence in the liver?
    A large number of secondary or metastatic tumors are currently known. Most often metastasises in the liver are primary tumors of the large intestine. Also, metastases in the liver of a tumor of the stomach, lung, esophagus, breast, ovary, kidney, biliary tract, pancreas, cervix, neuroendocrine tumors and melanoma,
    According to modern data, when a tumor develops in various organs of the human, its cells can come offfrom the main tumor mass and through the blood or lymphatic vessels to enter other tissues of the body. With the flow of blood or lymph such cells settle, primarily in the liver. But this does not mean that they will immediately begin to grow. For their awakening and growth, appropriate conditions are needed. The impetus to the awakening of dormant tumor cells and the growth of metastases in the liver can be the weakening of the body's defense systems.
    That's why in any variant of antitumor specific treatment( surgical, chemotherapeutic, radiation) it is important not only to know the state of a person with a primary tumor, but also to strengthen the defenses of the body. In this respect, the patient himself can help the doctor and, of course, himself.
    It is necessary to carry out a number of simple recommendations that help increase the body's resistance to various factors, including the development of relapses and metastases.

    Treatment of

    There are many methods of treating liver tumors. Choosing the right method, the doctor takes into account all the pros and cons, evaluates all the concomitant diseases. Unfortunately, people who already suffer, for example, ischemic heart disease, stomach ulcer or duodenal ulcer, diabetes mellitus, etc., are not insured from malignant tumors.
    1. Surgical removal of primary or metastatic liver cancer.
    2. Combined treatment of liver tumors, combining surgical interventions with various variants of intervention effects( administration of drugs through various vessels).
    3. X-ray endovascular interventions( administration of various medicinal compositions under the control of X-ray machines):
    a) arterial chemoinfusion in the hepatic artery, embolization of the hepatic artery and chemoembolization of the hepatic artery( with this option, a special substance is introduced into the artery that stops feeding the liver tumor);B) in-portal: chemoinfusion into the portal vein, chemoembolization of the portal vein and mechanical embolization of the portal vein( same as in point a, only a special substance is injected not into the artery, but into the vein);C) methods of percutaneous local destruction of neoplasms: ethanol therapy( destruction of
    by ethyl alcohol), cryodestruction, radiofrequency ablation;
    d) endobiliary intervention: installation of permanent external internal drainage or stents.
    4. Liver transplantation.
    5. Isotope treatment( the introduction of special radioisotopes that accumulate in tumor cells of the liver and kill it).
    6. Chemotherapy of primary tumors( administration of antitumor drugs: fluorouracil, doxorubicin, mitomycin C, mitoxantrone, etc.) and metastatic( mainly according to the principles of primary carcinoma treatment, ie, tumors from which liver metastases have arisen).
    7. Systemic chemotherapy and radiation therapy in the progression of liver tumors.
    8. Target therapy( targeted therapy directly to the tumor of the liver with the specially created Arglabin preparation).
    9. Complimentary therapy( additional therapy for the control of metastases, relapses and complications of specific antitumor therapy).
    The following medicines are used for complementary therapy: polyprenoic acid, metadoxil, adaptogenes, antioxidants, etc.
    Until recently, transplantation of the liver affected by the tumor process was considered a fantasy, it could only be dreamed of. But 10 years ago, scientists of the St. Petersburg Central Research Institute of Radiology and Radiology( CNIRIR), headed by the director and academician of the Russian Academy of Sciences, AM Granov, for the first time in Russia carried out these bold transplants. Until now, in the clinic of the FGI Central Research Institute there is a patient who was given this operation. There are other positive results of liver transplantation. However, such operations are very expensive and not available to everyone. In addition, there are difficulties in obtaining donor organs. Perhaps in the third millennium, medicine will learn how to grow various cells and organs for these purposes.
    We can not help acquainting you with the novelty of the end of the last century. This method of treating liver tumors is called radiofrequency ablation. He is mastered and practiced at the Moscow Vishnevsky Institute of Surgery, RAMS.During such treatment, the surgeon inserts a needle through the abdominal wall of the patient into the liver tumor. Through this needle the radio-frequency effect on tumor cells is carried out. Cancer cells of the patient's liver are literally welded and destroy the tumor. At the site of the tumor, a scar is formed. Currently, there are already positive results in 40 patients of this institute.
    Science does not stand still, scientists are finding more effective methods of treating liver tumors, and cancer patients have more hope for recovery.

    Preparing for operation


    The experience of surgical practice shows that the results of the planned operation essentially depend on the advance preparation of the organism.
    The more carefully prepared for the operation, the easier it will be for post-amniotic period, the less complications there will arise, the faster the scars will heal.
    Let's designate the most important preparatory measures.
    First of all, the patient is well fed with microelements and vitamins, especially from the group of antioxidants: A, C and E. Both of them are abundant in vegetable juices.
    It is advisable to drink 1/2 cup of freshly prepared carrot juice( preferably carrot varieties of punisher, the top for the preparation of a drink not to use) before breakfast. If the carrot juice is not well tolerated, then, as already mentioned, it is necessary to slightly change the nature of its main food. Namely: to exclude from the diet( or significantly reduce) foods containing sugar, flour and starch( recommendation of the doctor of medicine R. Pope).If, however, after the consumption of carrot juice the condition worsens, you can add a little milk cream to it, but do not stop taking it. Carrot juice can be replaced with beetroot or, with good tolerance, a mixture of these two juices.
    For the preparation of the beverage, a beet is used without white veins, cylindrical shape( the apex should not be used).Drink in the same volume before breakfast. But remember that before drinking beet juice should be kept for at least 2-3 hours. This is due to the presence in it of substances that can cause vascular spasm. Fortunately, they decompose in the open air.
    Closer to the evening it would be nice to drink a 7g glass of wild rose hips.
    Three days before the operation, the intake of juices and infusions should be discontinued.
    After surgery, on the 3-4th day( after consulting with the treating surgeon), you can include in the ration of 1/4 or 1/2 cup of fresh vegetable juice. Drink juice before sips with food. It is very useful to drink during the day 1/2 cup of compote from dried fruits.
    The results of operative treatment of malignant liver tumors will depend on a number of factors, among which psychological attitudes are not the last. The founder of Russian oncology, Academician Nikolai Nikolaevich Petrov, wrote in 1945: "Surgery reaches the heights of its capabilities only when it is decorated with the highest manifestations of disinterested care for a person, and not only about his body, but also about the state of his psyche".
    Any surgical intervention, and even more radical surgery to remove a large portion of the liver, requires the patient and the surgeon to work together to improve their overall health. It is important to strengthen the immune system, because in primary liver cancer, as well as with metastases in the liver, cellular immunity responsible for antitumor protection is suppressed. How to do it? How to win the winner in a severe fight with the disease?
    In the field of oncology, most researchers believe that to improve the quality of life of patients and reduce side effects after surgery, it is necessary to use natural agents that have antioxidant and adaptogenic properties. A number of surgeons-hepatologists( doctors who perform operations on the liver) believe that parenteral nutrition plays a decisive role in the prevention and treatment of postoperative complications in patients with liver tumors, with mandatory inclusion of vitamins and trace elements in the diet.
    Doctors from the Moscow Cancer Research Center RAMS for the elimination of metabolic disorders in patients with malignant liver tumors developed an antioxidant vitamin complex that must be taken within 7 days before the operation.
    The complex consists of retinol( vitamin A), alpha-tocopherol( vitamin E) and ascorbic acid( vitamin C) in elevated doses. According to the specialists of the Moscow Cancer Center of the Russian Academy of Medical Sciences, the introduction of this antioxidant complex improved the health of patients and reduced the number of purulent complications after operations. Any balanced vitamin and mineral complex will be superfluous, which should be taken 2 to 3 weeks 2-3 times a year.
    It is important to remember that vitamins and minerals necessary for an oncological patient are also contained in fresh vegetables and fruits that must be included in the diet.
    Fresh carrot juice, prepared from carrots of good quality, varieties of punisher( top not to use) is considered miraculous. It is advisable to use freshly prepared carrot juice 1 / g glass a day for 1 month.
    Carrot juice is rich in microelements( sodium, potassium, calcium, magnesium, iron, phosphorus, sulfur and silicon).These trace elements are vital for the body of a person who underwent an operation to remove a tumor from the liver. In the juice they are kept in a form convenient for the body. We want to draw your attention to the fact that the juice must be necessarily fresh, not canned, and it must be drunk immediately after preparation.
    When consuming carrot juice, starch, flour and concentrated sugar must be completely eliminated.
    Carrot juice is only an addition to the diet of a person with a sick liver. His daily diet should include both proteins, and fats, and carbohydrates, as well as vitamins and trace elements.

    Nutrition
    The main requirement for a diet of a patient with a malignant liver tumor is to exclude foods that burden the liver.

    All diets for such patients are formed in accordance with the following rules and principles:
    1) exclude products containing a lot of cholesterol and purine bases( extracts of meat, fish, mushrooms);
    2) do not fry products, but boil in water or steam or bake;
    3) do not eat very cold drinks and dishes;
    4) to limit the fat content in the diet;
    5) abandon the use of alcoholic beverages and smoking.
    The patient should take food 4-5 times a day.
    With any treatment for tumor pathology, intestinal flora suffers. Even if you do not have obvious signs of dysbacteriosis and the intestinal disorders caused by it( abdominal pain, nausea, increased gas formation, violation of passage of stool, etc.), it is necessary to carry out a recovery course for 1 month. For this purpose, bacterial preparations( bifidumbacterin, bifikol, lactobacterin, linex, etc.) are used.
    Further preventive courses of treatment with bacterial preparations should be carried out regularly, every spring and autumn.
    The most popular in the treatment of tumoral diseases of the liver are the so-called diets № 5 and № 5а.

    Diet № 5
    Indications: diseases of the liver and biliary tracts outside the stage of exacerbation.
    Characteristics: mixed table with restriction of animal fats, extractives, fried foods and the introduction of lipotropic substances.
    Ingredients: bread white and black, yesterday, porridge( better buckwheat, oatmeal), butter( 60-70 grams per day together with the amount that goes to cooking), curd, kefir, yogurt, milk, protein omelet,vegetable soups, fruit, dairy, cereals;meat, fish, poultry of low-fat varieties in cooked form;vegetables, greens, fruits, berries boiled and raw.
    Optimal nutritional value of diet number 5( in grams): proteins - 90-100 g, fats 60 g, carbohydrates 350-400 g;
    table salt - 5-10 g;calcium - 0.8 g, phosphorus - 1.6 g, magnesium - 0.5 g, iron - 15 mg;vitamins: C - 100 mg, B1 - 4 mg, B2 - 4 mg, PP - 15 mg, A - 2 mg( without provitamin A);the caloricity of the daily ration is 2800-3000 kcal.
    Professor O. P. Marshak allows to include in the menu of diet No. 5 the foods and dishes listed below.
    Drinks: tea, tea with milk, natural and surrogate coffee.
    Bread products: wheat and rye bread of yesterday's baking, biscuits and flour products, oatmeal cookies, doctor's bread.
    Snacks: mild cheese, low-fat, low-fat ham, soaked high-quality herring( eg Kerch), cod liver.
    Milk, dairy products: whole milk, dry, condensed, cream, fresh sour cream( in moderation), fresh yogurt and kefir;curd and curd dishes( mostly from low-fat cottage cheese) in a boiled and baked form.
    Fats: creamy, olive, refined sunflower oil( in a moderate amount - about 50 g per day, of which 25 g of vegetable oil).
    Eggs, egg products: egg yolks( no more than 1 yolk per day);eggs used mainly for adding to culinary products;omelet steam or baked is prepared from proteins or with the addition of 72 yolks.
    Soups: borscht, beetroots, cabbage soup, vegetable soups, cereal soups with vegetables on vegetable broth with vegetable oil without roasting, fruit and milk soups.
    Meat, fish: products from low-fat beef, low-fat birds, partial fish( in boiled or baked form), preferably eat meat of mature animals, including poultry( avoid veal and chicken).Also avoid chopped dishes. Meat should be boiled for 5 minutes in boiling water in pieces weighing 100 grams, and then from it prepare sauce or baked dishes.
    Cereals, pasta: crumbly and semi-viscous cereals, puddings, casseroles, croutons, boiled pastas or casseroles. Especially recommended dishes of oatmeal, "oatmeal" and buckwheat with milk, cottage cheese.
    Vegetables, greens: different dishes( except rhubarb, sorrel, spinach) in raw, boiled and baked form;especially recommended carrots and pumpkins.
    Fruits, berries, sweet dishes, sugary products: fruits and berries in raw, boiled and baked types( except for very acidic ones, such as cranberries, red currants, lemon, etc.);compotes, jelly, jelly, sugar, jam;especially recommended honey( in moderation).
    Sauces, spices: sour cream and milk sauces, sweet sauces, vegetable sauces, cooked without toasting flour and roots. Sauce from butter, cumin, dill, cinnamon, vanillin.
    Vitamin products: decoctions of hips, various non-acidic berry and fruit juices;fresh raw berries and fruits, tomatoes;puree from raw carrots, especially recommended juices.
    You can salt the food to taste, within reasonable limits( only if you exacerbate by the advice of a doctor, use salt to limit).
    It is recommended to take food 5 times, at least 4 times a day.

    Diet № 5а
    Indications: exacerbation of diseases of the liver and biliary tract.
    Characteristic: the same as diet No. 5, but mechanically sparing, with the restriction of meat dishes.
    Ingredients: mashed porridge, vegetable soup, jelly, jelly, compote, fruit and berry juices, yesterday's white bread, butter( 30 g), dry biscuits. Meat is excluded from the ration for 2-3 days, then it is given in a grubby form.
    If you follow a diet, patients will be able to avoid complications and pain. But for a qualitative recovery of the body you need not only diet food, but also a healthy psyche.

    Prevention

    To date, the prophylactic value of the following vitamins has been proven:
    - beta-carotene( provitamin A);
    - retinol( vitamin A);
    - tocopherol( provitamin E);
    - vitamins E and C.

    Beta-carotene is non-toxic even at high doses( in contrast to vitamin A).It has antioxidant and antimutagenic action, increases the body's resistance to tumors.
    In epidemiological surveys of residents of different countries, it is established that with a decrease in beta-carotene in the blood, the likelihood of developing cancer is increasing.
    High beta-carotene deficiency is found in smokers or patients with severe illness, as well as in elderly people.
    In the Cancer Research Center. NN Blokhin specifically studied the level of beta-carotene in the blood of patients. It turned out that practically all the beta-carotene content in blood plasma was 1.5-2 times lower than normal, and after radiotherapy of tumors it was further reduced by 2-3 times.
    Many years of research have been initiated to substantiate the oncopofilactic effect of synthetic beta-carotene abroad. Preliminary results are mixed. So, in China, the five-year application of beta-carotene in combination with selenium and vitamin E has confirmed its effectiveness. At the same time in Finland, the eight-year use of this complex in smokers gave a negative result. Apparently, an overdose of beta-carotene can lead to the opposite effect. The physiological requirement for beta-carotene is 5-6 mg.
    Preventive preparations of beta-carotene have been developed, for example: Betaviton, Vetoron, Liposomal beta-carotene. For preventive reception it is possible to recommend "Vetoron" and "Liposomal beta-carotene", which has proved itself well. The dose of the drug and the duration of the course will be determined by the doctor.
    Preparation "Betaviton" is an aqueous emulsion of beta-carotene with the addition of vitamins "E" and "C".In 1 ml of the emulsion contains 20 mg beta-carotene, 05% tocopherol acetate( vitamin "E") and 0.02% ascorbic acid( vitamin C).The daily physiological requirement for beta-carotene is provided by 2-3 drops( 0.3 ml) of Betavitone. Beta-carotene is not toxic in large doses. With long-term use of it, there are no restrictions( on toxicity!).
    To increase the amount of antioxidants in the diet, it is useful to drink 3-4 cups of green tea without sugar every day, as well as vitamin teas from rose hips, black currant, red mountain ash and other berries and fruits.
    Each person can individually choose, according to their tastes and habits, vegetables and fruits enriched with beta-carotene
    Vitamin A is found in animal fats, in butter, milk, cheese, egg yolk, caviar, fish liver( especially much in the livercod, sea bass, etc.), fish oil.
    Scientists have proved that vitamin A and carotenoids are active oxygen carriers, which stimulates peroxide oxidation of membrane lipids. This is very important for the structural stabilization of their biological layer and the preservation of body cells.
    Scientists have studied the relationship between vitamin E content in plasma and the risk of cancer. The results were not unambiguous. So, according to a large-scale study conducted in Finland, with a daily intake of 50 mg of vitamin E, the risk of prostate cancer in smokers is reduced.

    In nature, vitamin E is found only in plants. Especially rich in this vitamin is wheat germ oil, sunflower oil. The action of vitamin E enhances the rare-earth element of selenium. Selenium plays an important role in the system of antioxidant defense of the body.
    Vitamin E is found in many cultivated plants, but the amount of selenium in plant proteins strongly depends on the soil on which the plant was grown. It is known that in Europe the soils are poor in selenium, so its additional approach is advisable. However, one should not take it together with vitamin C, because these substances mutually inhibit the assimilation of each other. If your body needs both substances, it is recommended to take selenium in the morning on an empty stomach, and vitamin C, including products containing it, should be consumed not earlier than in an hour.
    Prophylactic doses of antioxidant vitamins and selenium are different depending on sex and age.
    ME is an international unit of action.1ME-P, 3 μg.1 mg of vitamin A corresponds to 3300 IU.
    Large doses of antioxidant vitamins increase the effectiveness of antitumor treatment by normalizing the level of free radicals and increasing the activity of antioxidant defense enzymes.