التشخيص
لتشخيص سرطانة الخلايا الكبدية، قد يجري لك اختصاصي الرعاية الصحية فحصًا بدنيًا ويطرح عليك أسئلة حول السيرة المرَضية. وقد تتضمن الاختبارات والإجراءات الطبية الأخرى الاختبارات التصويرية واختبارات الدم واستئصال بعض الخلايا لفحصها.
الاختبارات التصويرية
تُستخدم الاختبارات التصويرية لإنشاء صور للجسم. ويمكنها أن تُظهر موقع سرطانة الخلايا الكبدية وحجمها. وقد تشمل تلك الاختبارات:
- التصوير بالموجات فوق الصوتية.
- التصوير المقطعي المحوسب.
- التصوير بالرنين المغناطيسي.
- التصوير المقطعي بالإصدار البوزيتروني.
Liver function tests
Blood tests can give your healthcare team clues about what's causing your symptoms. These might include tests that measure how well the liver is working, such as:
Tumor marker test
Tumor marker tests look for chemicals made by the cancer cells. The alpha-fetoprotein (AFP) blood test is a tumor marker test used for hepatocellular carcinoma.
AFP is a protein made by liver cells as a baby grows in the womb. Blood levels of AFP drop soon after birth. For most people, a high level of AFP in the blood isn't typical, except during pregnancy.
When liver cells are injured, they may make AFP as they try to repair themselves. This raises AFP levels in the blood. For most people with hepatocellular carcinoma, the cancer causes very high AFP levels. Having high AFP doesn't mean someone has cancer, though. There are other things that can cause it, such as pregnancy, acute liver injury and liver fibrosis.
Healthcare teams may use AFP test results along with other results to decide whether a growth in the liver might be cancer. They might track AFP levels over time to see whether treatment is working.
الخزعة
الخزعة إجراء طبي يهدف إلى أخذ عينة من الأنسجة لفحصها في مختبر. في حالات سرطانة الخلايا الكبدية، تُستخدم إبرة لأخذ عينة من النسيج. أثناء خزعة الكبد، يُدخل اختصاصي الرعاية الصحية إبرة عبر الجلد وصولاً إلى موقع الورم. ثم يستخدم الإبرة لسحب عينة من خلايا الكبد.
وتخضع العينة للاختبار في المختبر لمعرفة ما إذا كانت سرطانية أم لا. وتوجد اختبارات خاصة أخرى يمكن أن تعطي تفاصيل أكثر عن الخلايا السرطانية. ويستند فريق الرعاية الصحية إلى هذه المعطيات لوضع خطة العلاج.
لا يحتاج جميع المصابين إلى خزعة لتشخيص سرطانة الخلايا الكبدية. إذ يمكن لفريق الرعاية الصحية تشخيص هذا السرطان في بعض الحالات اعتمادًا على نتائج فحوصات أخرى.
للمزيد من المعلومات
العلاج
Treatment for hepatocellular carcinoma depends on the location and the extent of the cancer. Treatment also may depend on the condition of the liver. Surgery may be used to remove the cancer. In some people, a liver transplant may be an option. Other treatments may include ablation, embolization, radiation therapy, immunotherapy and targeted therapy.
Which treatments are best for you will depend on your cancer and your overall health. Here's a look at common approaches to hepatocellular carcinoma treatment.
- When there is one or a few areas of cancer in the liver, treatment might involve surgery to remove the cancer, when possible. In people with liver cirrhosis, surgery might involve removing the liver and replacing it with one from a donor.
- When cancer is only in the liver and surgery isn't possible, healthcare professionals might use other procedures to treat the cancer. These might include ablation treatments, embolization procedures and radiation therapy. If the cancer involves many parts of the liver, medicines might help control it or slow its growth.
- When the cancer spreads or grows beyond the liver, treatment often involves medicines to help control it or slow its growth.
- When there is multifocal cancer, treatment may depend on how much of the liver is involved. Multifocal means there is more than one area of cancer in the liver. If the areas of cancer are near each other, surgery to remove the cancerous parts of the liver might be possible. If the cancer involves more of the liver, transplant might be an option. If a lot of the liver is affected by cancer, treatment might involve medicines.
- When there is cirrhosis and cancer, treatment can be difficult because advanced liver disease can make cancer treatments harder to take. If the liver is working well, liver transplant might be an option. This treatment can cure the cancer and the cirrhosis. In people who aren't healthy enough for surgery, other liver procedures and medicines may help control the cancer.
Surgery
Treatment for hepatocellular carcinoma may start with surgery to remove part of the liver including the cancer or the whole liver with a transplant. Surgery options include:
- Surgery to remove the cancer. A partial hepatectomy is used for people whose cancer is in one part of the liver. This surgery removes the cancer and some healthy tissue around it. Whether this is an option for you depends on the location of your cancer within the liver, how well your liver functions and your overall health.
- Liver transplant surgery. Sometimes surgery to remove the cancer is combined with a liver transplant. A surgeon removes the cancer and all of the liver. Then the surgeon puts a healthy liver from a donor into the body. A liver transplant may be an option in otherwise healthy people whose cancer hasn't spread beyond the liver. Other treatments may be used to treat the cancer while waiting for a transplant.
Surgery carries a risk of bleeding and infection. After a liver transplant you typically take medicine to prevent complications from receiving a liver from a donor. There may be side effects of this medicine, such as having a weakened immune system.
Other liver procedures
Other procedures on the liver can help treat hepatocellular carcinoma. These treatments may be used in people who can't have surgery to remove the cancer. These other liver procedures for hepatocellular carcinoma include:
- Radiofrequency ablation. Radiofrequency ablation uses electric current and heat to hurt the cancer cells. During this procedure, a healthcare professional places small needles into the cancer. The needles deliver hot temperatures that hurt the cancer cells.
- Cryoablation. Cryoablation uses cold to hurt the cancer cells. During the procedure, a healthcare professional places small needles into the cancer. The needles deliver cold temperatures that hurt the cancer cells.
- Chemoembolization. Chemoembolization gives chemotherapy medicines directly to the cancer. It also uses medicine that blocks the flow of blood to the cancer. Blocking the blood flow to the cancer may cause the cancer to shrink, grow more slowly or not grow at all.
- Radioembolization. Radioembolization uses tiny beads that hold radiation. The healthcare team puts the beads into a blood vessel that goes to the liver. The beads give off radiation directly to the cancer.
- Radiation therapy. Radiation therapy treats cancer with powerful energy beams. The energy can come from X-rays, protons or other sources. The beams can target the cancer in the liver.
The side effects of these procedures depend on what procedure you're having and how much of the liver is being treated.
Immunotherapy
Immunotherapy for cancer is a treatment with medicine that helps the body's immune system kill cancer cells. The immune system fights off diseases by attacking germs and other cells that shouldn't be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells.
Immunotherapy may be used after surgery to kill any remaining cancer cells. For those with advanced hepatocellular carcinoma that can't be removed with surgery, immunotherapy may be an option.
Immunotherapy side effects depend on which medicine you take. Side effects may include high blood pressure, nausea, cough and feeling very tired.
Targeted therapy
Targeted therapy for cancer is a treatment that uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die.
Targeted therapy may be used after surgery to kill any remaining cancer cells. For those with advanced hepatocellular carcinoma that can't be removed with surgery, targeted therapy may be an option.
Targeted therapy side effects depend on which medicine you take. Side effects may include high blood pressure, feeling very tired, diarrhea and joint pain.
Palliative care
Palliative care is a special type of healthcare that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve pain and other symptoms. A healthcare team that may include doctors, nurses and other specially trained health professionals provides palliative care. The care team's goal is to improve quality of life for you and your family.
Palliative care specialists work with you, your family and your care team. They provide an extra layer of support while you have cancer treatment. You can have palliative care at the same time you're getting strong cancer treatments, such as surgery, chemotherapy, immunotherapy, targeted therapy or radiation therapy.
The use of palliative care with other treatments can help people with cancer feel better and live longer.
للمزيد من المعلومات
نمط الحياة والعلاجات المنزلية
If you've been diagnosed with hepatocellular carcinoma, take care of your body by helping it feel as good as possible during treatment. Be active when you can, get enough rest, and choose a healthy diet.
Stay active
Physical activity is often the best treatment to manage fatigue. To give yourself more physical energy, exercise every day. Exercise prevents muscle loss and helps manage fatigue. Ask your healthcare team about programs in your community. Choose activities you enjoy and can easily do:
- Take a walk around the block. Exercise outside if it is safe for you.
- Do aerobic exercise to lessen cancer-related fatigue. Stick with a regular program. This is more important than how hard or how long you exercise. Aerobic exercise includes walking or using gym equipment, such as an exercise bike. Save energy for daily aerobic exercise.
- Try strengthening exercises. Exercising with weights, bands or even your body weight also can fight fatigue.
- Pace yourself. On days when you have more energy, do not push it. Stick to your routine to help manage your fatigue.
- Explore low-impact exercises. Yoga, tai chi and Pilates can help fatigue that comes from the cancer.
Get the rest you need
Difficult symptoms can affect how you sleep. But your body needs restful sleep to work well. Lack of sleep can make you more easily irritated and less able to cope with pain and stress. Talk to your care team if you have sleep problems.
Eat a healthy diet
A healthy diet rich in fruits, vegetables, whole grains and lean protein can help you:
- Keep up your energy so that you can exercise and be active.
- Manage your symptoms.
- Improve your overall well-being.
التأقلم والدعم
ولكنك ستجد مع مرور الوقت طرقًا للتعامل مع المشاعر التي تنشأ بعد تشخيص الإصابة بالسرطان. وإلى أن يحدث ذلك، إليك بعض الأفكار التي ستساعدك على التأقلم مع سرطانة الخلايا الكبدية.
Learn enough about cancer to make decisions about your care
Ask your healthcare team about your cancer, including your test results, treatment options and, if you like, your prognosis. As you learn more about hepatocellular carcinoma, you may become more confident in making treatment decisions.
Keep friends and family close
Keeping your close relationships strong can help you deal with hepatocellular carcinoma. Friends and family can provide the practical support you may need, such as helping take care of your home if you're in the hospital. And they can serve as emotional support when you feel overwhelmed by having cancer.
Find someone to talk with
Find someone who is willing to listen to you talk about your hopes and worries. This may be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group also may be helpful.
Ask your healthcare team about support groups in your area or contact the American Cancer Society. Find support online through Mayo Clinic Connect, which is a community where you can connect with others for support, practical information and answers to everyday questions.
الاستعداد لموعدك
احجز موعدًا لزيارة الطبيب أو غيره من اختصاصيِّي الرعاية الصحية إذا ظهرت عليك أي أعراض تثير قلقك.
إذا اشتبه الطبيب في إصابتك بسرطانة الخلايا الكبدية، فقد تُحال إلى طبيب مختص في أمراض الكبد، يسمى طبيب الكبد. وقد تُحال أيضًا إلى طبيب متخصص في علاج السرطان، يُسمى اختصاصي الأورام، في حال تشخيص إصابتك بالسرطان.
نظرًا إلى قصر مدة المواعيد الطبية، فمن المستحسن أن تكون مستعدًا جيدًا. وإليك بعض المعلومات التي ستساعدك على الاستعداد للموعد الطبي.
What you can do
- Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.
- Write down symptoms you have, including any that may not seem related to the reason for which you scheduled the appointment.
- Write down important personal information, including major stresses or recent life changes.
- Make a list of all medicines, vitamins or supplements you're taking and the doses.
- Take a family member or friend along. Sometimes it can be very hard to remember all the information provided during an appointment. Someone who goes with you may remember something that you missed or forgot.
- Write down questions to ask your healthcare team.
Your time with your healthcare team is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For hepatocellular carcinoma, some basic questions to ask include:
- Do I have hepatocellular carcinoma?
- What is the stage of my hepatocellular carcinoma?
- Has my hepatocellular carcinoma spread to other parts of my body?
- Will I need more tests?
- What are the treatment options?
- How much does each treatment increase my chances of a cure or prolong my life?
- What are the potential side effects of each treatment?
- How will each treatment affect my daily life?
- Is there one treatment option you believe is the best?
- What would you recommend to a friend or family member in my situation?
- Should I see a specialist?
- Are there any brochures or other printed material that I can take with me? What websites do you recommend?
- What will determine whether I should plan for a follow-up visit?
Don't hesitate to ask other questions.
What to expect from your doctor
Be prepared to answer questions, such as:
- When did your symptoms begin?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
التجارب السريرية
استكشِف دراسات مايو كلينك حول التطورات الجديدة في مجال العلاجات والتدخلات الطبية والاختبارات المستخدمة للوقاية من هذه الحالة الصحية وعلاجها وإدارتها.