HEPATOCELLULAR CARCINOMA

HEPATOCELLULAR CARCINOMA

1. Definition: Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, arising from hepatocytes.

2. Types:

   • Macronodular cirrhosis: large regenerative nodules
   • Micronodular cirrhosis: small regenerative nodules
   • Mixed cirrhosis: combination of large and small nodules

3. Causes:

   • Hepatitis B and C infections: chronic infection can lead to cirrhosis and HCC
   • Cirrhosis: scarring of the liver due to chronic liver disease can increase the risk of HCC
   • Alcohol consumption: heavy drinking can lead to cirrhosis and increase the risk of HCC
   • Non-alcoholic fatty liver disease (NAFLD): accumulation of fat in liver cells can increase the risk of HCC

4. Clinical Features:

   • Abdominal pain
   • Fatigue
   • Weakness
   • Weight loss
   • Jaundice
   • Abdominal mass

5. Investigations:

   • Liver function tests (LFTs): elevated liver enzymes and bilirubin
   • Alpha-fetoprotein (AFP): tumor marker for HCC
   • Ultrasound: imaging modality for liver and bile ducts
   • Computed tomography (CT) scan: detailed imaging of liver and surrounding structures
   • Magnetic resonance imaging (MRI): detailed imaging of liver and surrounding structures
   • Biopsy: tissue sample for histopathological examination

6. Complications:

   • Liver failure
   • Portal hypertension
   • Hepatic encephalopathy
   • Malignant ascites

7. Management:

   • Surgery: resection or transplantation of the liver
   • Transarterial chemoembolization (TACE): delivery of chemotherapy and embolization of the tumor
   • Radiofrequency ablation (RFA): destruction of tumor cells using heat
   • Sorafenib: targeted therapy for HCC

8. Treatment:

   • HCC is often diagnosed at an advanced stage, and treatment options depend on the stage and overall health of the patient
   • Surgery is usually the preferred treatment for early-stage HCC
   • TACE and RFA are options for intermediate-stage HCC
   • Sorafenib is often used for advanced-stage HCC

9. Homoeopathic Therapeutic Medicines:

   • Lachesis: Indicated for liver cirrhosis with ascites
   • Arsenicum album: Indicated for liver cirrhosis with jaundice
   • Phosphorus: Indicated for liver cirrhosis with portal hypertension