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Hepatocellular carcinoma and treatment of cancer patients in times of # COVID-19

Marcela Boyacá Mesa
Latin News Agency for Medicine and Public Health

Hepatocellular carcinoma also known as primary liver cancer is the most common cancer that affects this organ. However, what most affects the liver are tumors or cells that come from another part of the body, this process is known as metastasis, as explained in an exclusive interview for the Journal of Medicine and Public Health (MSP) by the hematologist and oncologist. José Cangiano Lespier who made an extensive tour of the symptoms, diagnosis and treatment of this disease.

Symptoms

The liver is a filter, all the blood goes through the hepatoportal circulation, if there is any factor that is affecting the liver, the mechanism of this organ is immediately affected.

“Bilirubin is a waste that the liver works with it begins to rise many times, the filtering mechanism begins to be damaged, so the patient may begin to have symptoms that can range from nausea, weight loss, the taste it changes the patient, fullness symptoms on many occasions, and one of the most common things when the situation is already a little advanced is what is called jaundice and that bilirubin accumulates instead of going into the excreta that a pigment for the excreta it accumulates and the patient begins to turn yellow, the whites of the eyes called the sclera, the palate shows yellow, the palms of the hands begin to show yellow, and the patient often sees the urine, this waste of the urine is very yellow and it excretes many times as that color is not going out there the traditional color of the excreta is lost, which is a brown or dark brown color and this sometimes people do not like it to be spoken but it is i important ”.

See the full interview here

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Risk factor’s

One of the main risk factors for hepatocellular cancer is hepatitis infections, specifically B and C, in Puerto Rico the frequency of hepatitis C is quite high.

“Cirrhosis, damage to the liver structure and cirrhosis can arise from alcohol-induced hepatitis, from medications, from infections that are not hepatitis. In Puerto Rico at one point, those of us who are not so young have heard of bilharzia, the schistosoma that infection that was lodged in the liver and with time a cirrhotic damage was created, the liver was damaged, its functioning and its quality of organ ”.

Diagnosis

Cancer is normally diagnosed through a biopsy, however the hematologist and oncologist Cangiano stated that with hepatocellular carcinoma there are specific characteristics that can be seen at the radiological level and at the biochemical or laboratory level.

“For example, a patient who has hepatitis known for a long time, in radiological studies has a fairly significant cirrhosis, there is a study that can tell us to what extent this cirrhosis is reaching only a non-invasive level, there are radiological studies and there are others They are made as if it were a sonography that gives the quality of that liver tissue and the biochemistry part in a marker called alpha-fetoprotein, so a very high alpha-fetoprotein, more than 400 with a patient who has radiology or an emergency of cirrhosis with a history of hepatitis C already known and obviously there is a mass, there is something that seems to look like cancer, we could highly say and diagnose that this patient has hepatocellular carcinoma ”.

At this point he concluded by indicating that in clinical practice biopsy is always recommended for diagnosis, however these patients are in a very delicate state and submitting them to a biopsy is complex.

Treatment

This will depend on the stage of the patient, the size and location of the mass, how the patient’s quality of life is, if there is circulation within the mass.

Surgery

If it is an early stage tumor, the part can be operated on and removed and in this case the patient is completely healed.

Targeted therapy

You can inject alcohol, chemotherapy, and other substances that cause the tumor to stop growing because your circulation is cut off or finish it from the inside out with an injectable substance like a “poison.”

These two treatments can also be combined so that if the tumor is very large, targeted therapy is first given to reduce size, and then the surgeon can enter.

Radioembolization

“Radioembolization, which is through the bloodstream, uses a certain substance that can embolize, that is, we create a lack of circulation in that tumor and since there is no circulation, there is no blood, there is no blood stream, so the tumor is going to starve” .


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