Liver&Gallbladder Cancer/ksw 11/5/12
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The liver is divided into ____ lobes and is in the _____of the abdomen. The ____lobe is larger. It is considered an exocrine gland that secretes ____, produces_____, and filters toxins.
2, RUQ, bile, bile
Hepatobillary tumors(liver and gall bladder) are linked to hepatitis ___& ____, liver _____, and ______ingestion.
B, C, cirrhosis, aflatoxin(a mycotoxin produced a fungus -found in some foods like peanut butter)
The primary histology of hepatobillary cancer in the US is _____ ____ due to the increasing incidence of Hepatitis C.
Other histologies include:
- Hepatocellular carcinoma(HCC)
- intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, adenocarcinoma, and
- mucinous carcinoma of the gallbladder
What are the clinical presentations for hepatobillary ca?
- #1 JAUNDICE
- weight loss
- night sweats
Where dose the hepatobillary ca spread within the lymphnodes?(5 sites) HCC can appear spreading or show multiple sattelite tumors that evetually take over the liver.
- porta hepatic
- *memory aid(warning crude)
- Penises Can Cause People Happines(or harm...you pick)
When spread is through the blood it goes to the _____ and _____.
Workup for hepatobillary cancer includes:
- CBC with chemistry, liver function
- CT abdomen and pelvis
What are the lab tests used in the workup for hepatobillary ca?
- AFP(AFP is a glycoprotein synthesized by the fetal yolk sac, fetal, liver, testicular non-seminomatous germ cell) cancers,
- CA-19-9(it is a protein that is shed by the tumor cells, making it useful as a tumor marker to follow the course of the cancer.)
- CEA(Elevated CEA levels are found in a variety of cancers other than colonic, including pancreatic, gastric, lung, and breast.)
- Liver function
- (CBC with chem panel)
Treatment for hepatobillary cancer: Surgery is the mainstay., and liver transplants can be performed.Chemotherapy is also used , but not radiation therapy is not done mcuh because the liver moves up and down with each breath, and the gallbladder can be removed. If RT is done, the dose is ______ and the critical structures include the _____, _____ , and cord.
- 36-60 Gy
- bowel, kidneys, cord
Liver cancer is rare in the US, but more common in the ____ and ___ due to soil and water.
Africa and Asia
Is liver cancer more common in men or women?
- Men more common than
- women (2:1)
- (anal and gallbladder cancer are two of the few that are more common in women so it's almost always safe to guess men if you're nor sure!!)
Peak aage for liver cancer is_______.
60-70 years of age
Causes of liver cancer include:
cirrhosis,.Hepatitis B, oral steroids, and exposure to toxins and vinyl chloride
Symptoms of liver cancer include:
- loss of appetite,
- bloating and dull pain,
- weight loss,
Liver cancer histology is either ________(usually) or __________.
hepatocellular carcinoma(HCC) or cholangiocarcinomas (adenocarcinoma)
Spread of lung cancer is to regional lymph nodes then to
_____,______ and ______.
Distant mets occurs in _____% of liver cancer
Treatment options are surgery, chemotherapy ________ or radiosurgery. Liver tolerance dose is ____Gy
(Adriamycin), 30 Gy
5 year survival from liver cancer is ____%
Gallbladder cancer is more common in _______( __:__) and is associated with gallstones.
Average age of diagnosis for gallbladder cancer is _____years of age.Symptoms include: _(6 symptoms).
Because the gallbladder is not essential, the treatment of choice is ________. Invasion of the liver
is early so partial removal of the liver
is often necessary.Histology is
__________, _________, or __________. 5 year survival is ___________%.
- nausea and vomiting,
- RUQ pain,
- adenocarcinoma,squamous cell, or sarcoma
- 10% - 30%
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