Karaciğer Kanseri Nedir? Belirtileri nelerdir?

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Karaciğer Kanseri

Karaciğer kanseri, karaciğerinizin hücrelerinde ortaya çıkan bir kanserdir. Karaciğeriniz, karın boşluğunuzun sağ üst kısmında, diyaframın altında ve midenin üstünde yer alan futbol topu büyüklüğünde bir organdır.

Karaciğerde Kanser Türleri

  • Karaciğer kanserinin en yaygın görülen türü ana karaciğer hücresinde (hepatosit) başlayan hepatosellüler karsinomadır.
  • İntrahepatik kolanjiyokarsinoma
  • Hepatoblastoma gibi diğer karaciğer kanseri türleri daha az yaygındır.

Karaciğeri etkileyen bütün kanserler karaciğer kanseri olarak kabul edilmez. Kanser, vücudun başka bir bölgesinde başlayıp – kalın bağırsak, akciğer veya meme gibi – ve karaciğere yayılırsa karaciğer kanseri yerine metastatik kanser adını alır. Ve bu kanser türü, başladığı organın adını alır – kalın bağırsakta başlayarak karaciğere yayılmış kanseri tanımlamak için metastatik kalın bağırsak kanseri gibi. Karaciğere yayılan kanser, karaciğer hücrelerinde başlayan kanserden daha yaygındır.

Karaciğer Kanser Taraması

Genel nüfus için karaciğer kanseri taramasının karaciğer kanserinden ölme riskini azalttığı kanıtlanmadığından, genellikle tavsiye edilmez. Amerikan Karaciğer Hastalıkları Araştırmaları Derneği, karaciğer kanseri taramalarını, aşağıdakilere sahip insanlar dahil olmak üzere yüksek riskli olduğu düşünülen kişilerde önermektedir:

  • Hepatit B ve aşağıdakilerden biri veya birkaçı için geçerlidir: Asyalı veya Afrikalı, sirozu olan veya ailesel karaciğer kanseri öyküsü olanlar
  • Hepatit C enfeksiyonu ve karaciğer sirozu
  • Otoimmün hastalık, aşırı alkol kullanımı, alkolik olmayan yağlı karaciğer hastalığı ve kalıtsal hemokromatoz gibi diğer nedenlerden kaynaklanan karaciğer sirozu
  • Primer biliyer siroz

Taramanın artılarını ve eksilerini doktorunuzla görüşün. Riskinize bağlı olarak taramanın sizin için doğru olup olmadığına birlikte karar verebilirsiniz. Tarama tipik olarak altı ayda bir ultrason muayenesini içerir.

Karaciğer Kanseri Testleri

  • Kan testleri. Kan tahlilleri karaciğer fonksiyon anormalliklerini gösterebilir.
  • Görüntüleme Testleri. Doktorunuz, ultrason, bilgisayarlı tomografi (BT) taraması ve manyetik rezonans görüntüleme (MR) gibi görüntüleme testlerini önerebilir.
  • İnceleme için bir karaciğer doku örneği alınması. Doktorunuz karaciğer kanserinin kesin tanısını koyabilmek için laboratuarda incelenmek üzere bir parça karaciğer dokusunun alınmasını önerebilir.
  • Karaciğer biyopsisi sırasında, doktorunuz doku örneği elde etmek için cildinizden karaciğerinizin içine ince bir iğne batırır. Laboratuarda, doktorlar kanser hücrelerini aramak için dokuyu mikroskop altında inceler. Karaciğer biyopsisi kanama, morarma ve enfeksiyon riski taşır.

Karaciğer Kanseri Evreleri

Kanser teşhis edildikten sonra, doktorunuz kanserin yayılımını (evresini) belirlemeye çalışacaktır. Evreleme testleri kanserin boyutunun ve yerinin ve yayılıp yayılmadığının belirlenmesine yardım eder. Karaciğer kanserinin evrelenmesinde kullanılan görüntüleme testleri arasında BT’ler, MR’lar ve kemik taramaları bulunur.

Karaciğer kanserinin evrelenmesinde kullanılabilecek farklı yöntemler mevcuttur. Bir yöntem IV ila IV arasındaki Roma rakamlarını kullanırken, bir diğeri A’dan D’ye kadar olan harfleri kullanır. Doktorunuz tedavi seçeneklerinizi ve prognozunuzu belirlemek için kanserinizin evresini kullanır. Evre IV ve evre D, en kötü prognoza sahip en ileri evre karaciğer kanserini gösterir.

Karaciğer Kanseri Tedavi Yöntemleri

Primer karaciğer kanserinin tedavisi, hastalığınızın yayılımına (evreye) olduğu kadar yaşınıza, genel sağlık durumunuza ve kişisel tercihlerinize bağlıdır.

Karaciğer Kanseri Ameliyat

Tümörün Alınması İçin Yapılan Ameliyat.

Belirli durumlarda, doktorunuz, karaciğer kanserinin ve tümörünüz küçükse ve karaciğer fonksiyonunuz iyi ise onu çevreleyen sağlıklı karaciğer dokusunun küçük bir bölümünün alınması için bir ameliyat önerebilir.
Bunun sizin için bir seçenek olup olmadığı kanserin karaciğerinizdeki konumuna, karaciğer fonksiyonlarınızın ne kadar iyi olduğuna ve genel sağlık durumunuza bağlıdır.

Karaciğer Nakli Ameliyatı.

Karaciğer nakli ameliyatı esnasında, hastalıklı karaciğeriniz alınır ve vericiden alınan sağlıklı karaciğerle değiştirilir. Karaciğer nakli ameliyatı, yalnızca erken dönem karaciğer kanseri olan az sayıdaki hasta için bir seçenektir.

Lokal tedaviler

Karaciğer kanseri için lokal tedaviler doğrudan kanser hücrelerine veya kanser hücrelerini çevreleyen bölgeye uygulanan tedavilerdir. Karaciğer kanseri için lokal tedaviler aşağıdakileri içerir:

Kanser Hücrelerinin Isıtılması.

Radyofrekans ablasyon olarak adlandırılan bir işlemde, elektrik akımı kanser hücrelerini ısıtmak ve yok etmek için kullanılır. Cerrahınız bir ultrason veya BT taraması rehberliğinde karnınızdaki küçük kesilerden bir veya daha fazla ince iğneyi ilerletir. İğneler tümöre ulaştığında, bunlar elektrik akımı ile ısıtılır ve kanser hücreleri yok edilir.

Kanser Hücrelerini Dondurmak.

Kriyoablasyon, kanser hücrelerini yok etmek için aşırı soğuğu kullanır. İşlem sırasında, doktorunuz sıvı azot içeren bir aleti (kriyoprob) doğrudan karaciğer tümörlerinin üstüne yerleştirir. Ultrason görüntüleri kriyoprobu yönlendirmek ve hücrelerin dondurulmasını izlemek için kullanılır.

Tümöre Alkol Enjekte Edilmesi.

Alkol enjeksiyonu esnasında tümörlere doğrudan saf alkol deriden veya ameliyat esnasında enjekte edilir. Alkol tümör hücrelerinin ölmesine sebep olur.

Karaciğere Kemoterapi İlaçlarının Enjekte Edilmesi.

Kemoembolizasyon, karaciğere doğrudan güçlü anti-kanser ilaçlarının verildiği bir kemoterapi tedavisidir.

Radyasyon Dolu Boncukların Karaciğere Yerleştirilmesi.

Radyasyon içeren minik küreler doğrudan tümöre radyasyon sağlayabilecekleri karaciğere doğrudan yerleştirilebilir.

Radyasyon Tedavisi

Bu tedavi kanser hücrelerini öldürmek ve tümörleri küçültmek için X ışını ve protonlar gibi çok güçlü enerji kaynaklarını kullanır. Doktorlar, enerjiyi çevredeki sağlıklı dokuları koruyarak dikkatlice tümöre yönlendirirler.

  • Harici ışınlı radyasyon tedavisi sırasında bir masanın üzerine uzanırsınız ve bir makine enerji ışınlarını vücudunuzdaki kesin bir noktaya yönlendirir.
  • Stereotaktik radyocerrahi adı verilen özel bir radyasyon tedavisi türü, pek çok radyasyon ışınının eşzamanlı olarak vücudunuzdaki bir noktaya odaklanmasını içerir.

Hedefe Yönelik İlaç Tedavisi

Hedefe yönelik ilaçlar, bir tümör içindeki spesifik anormalliklere müdahale ederek çalışırlar. İleri evre hepatoselüler karsinomada, tedavi edilmeyen kansere göre, ilerlemeyi durdurduğu veya yavaşlattığı gösterilmiştir. İlerlemiş karaciğer kanserinin kontrolünde sorafenib (Nexavar) gibi hedefe yönelik tedavilerin nasıl kullanılabileceğini anlamak için daha fazla çalışma yapılması gerekmektedir.

Destekleyici (Palyatif) Bakım

Palyatif bakım, ağrıyı ve ciddi hastalıkların diğer belirtilerini hafifletmeye odaklanan uzmanlaşmış tıbbi bakımdır. Palyatif bakım uzmanları, devam eden bakımınızı tamamlayan ayrı bir destek katmanı sağlamak amacıyla sizinle, ailenizle ve diğer doktorlarla birlikte çalışırlar. Palyatif bakım, ameliyat, kemoterapi veya radyasyon tedavisi gibi diğer agresif tedaviler devam ederken kullanılabilmektedir.
Palyatif bakım diğer bütün uygun tedavilerle birlikte kullanıldığında, kanserli insanlar kendilerini daha iyi hissedebilirler ve daha uzun yaşayabilirler.
Palyatif bakım, içerisinde doktorların, hemşirelerin ve özel eğitim almış diğer sağlık çalışanlarının yer aldığı bir ekip tarafından verilir. Palyatif bakım ekipleri, kanserli insanlar ve ailelerinin hayat kalitesini arttırmayı amaçlarlar. Bu bakım türü, alabileceğiniz iyileştirici tedaviler veya diğer tedavilerin yanı sıra sunulur.

Reklam

663 YORUMLAR

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