Etiology for hepatoma
Liver cirrhosis, Hepatitis (HBV, HCV), Fungal infection, abnormality metabolism: iron, copper, alcohol, and drug abuse
Signs and Symptoms of hepatoma
no S&S, upper right epigastric pain, sharp pain, dull pain (or croscento), rupture, bleeding, aneurysm; jaundice, fever, sign and symptom of liver cirrhosis: fatigue, ascitis, edema, swollen spleen, palm ruddiness.
Treatment for hepatoma
Surgery
Hepatoma belongs to solid tumor; primary treatment approach is surgery excision. Mostly, patient survived through final stage of hepatoma depend on hepatoectomy. For normal circumstances, most of the individual can manage to survive with 1/8 of liver remain. Due to the fact that most of hepatoma patients have over 85% of liver cirrhosis complication, thus worsen the situation.
TAEˇGtranscatheter arterial embolization)
Kuffer cells receive nutrient from portal system, both hepatic vein and hepatic artery. About 3/4 of kuffer cells rely on hepatic vein, but cancerous cells receive nutrient from hepatic artery. Thus by using TAE method, can wall of cancerous cell from getting sufficient nutrient, with normal cells intact.
Alcohol infusion to tumor cells
Alcohol infusion can only apply to limited area; for those are suitable or refused on surgical approach, alcohol infusion is the treatment of choice. The advantage of alcohol infusion are: no incision required, easy and safe to operate, economic, less side effect, but only can only apply to small size of hepatoma
Radiotherapy
Radiotherapy on hepatoma is very limited, which is not widely practiced. A renovation new radiotherapy called proton ray therapy / gamma knife, based on three dimensional fixation system, make precision pinpoint to treatment area with higher X-ray exposure. The advantage is, because gamma ray is focused on treatment area only, makes normal tissue save from gamma ray exposure, with less side effect, and this technology has been successfully apply to brain tumor for therapy, this gamma knife is still in study phase. The time required for each session of therapy takes 30 to 40 minutes with total of 10 to 15 therapy session of approximately 3 to 4 weeks, but the therapeutic approach may vary depends on different hospitals.
Chemotherapy
Chemotherapy is not effective against hepatoma. In case the tumor is too big or already metastasize to portal entry, chemotherapy will be therapy of choice. Cosistant applying drugs like doxifluridine (a type of 5-FU) infusion, it will prolong the survival time for those are not suitable for surgery
direct injection of OK-432 to tumor
OK-432 is a mediator extracted from Streptococcus Su. OK-432 injection is usually for unoperable small size hepatoma. The main mechanism for OK-432 to combat hepatoma are many, such as: direct anti tumor effect, incite polymorphonucleic cyte, macrophages, NK cell, T cell, and other cell regulated cytokine. It is believed by local researchers that the main mechanism is direct tumor suppression.
