1. Liver Cancer  A leading cause of death in the world  Can be primary or a metastatic site  Seen more in other parts of the world  incidence African American males 40 – 60 years old Cirrhosis Hepatitis B and C

2. Causes of Liver Cancer  Primary Trauma Nutritional deficits Carcinogens Hepatotoxins Aspergillus fungus

3. Causes of Liver Cancer  Metastatic Disease Due to the vascularity of the liver  Esophagus  Stomach  Colon and rectum  Breasts  Lungs  Malignant melanoma

4. Early Signs and Symptoms  RUQ pain  Abdominal tenderness  Fatigue, malaise  Anorexia  Weight loss

5. Diagnostic Data  Nuclear scan Determines structural changes  Ultrasound guided liver biopsy Confirms malignancy

6. Late Signs and Symptoms  Looks like cirrhosis Jaundice Ascites Bleeding disorders Encephalopathy

7. Treatment  Surgical Only for single lesion in one lobe Resection of the lobe  Cryoablation Freezing of tumors with liquid nitrogen  Chemotherapy With intravascular infusion pump

8. Prognosis  Usually fatal within 6 months  Single lesion lobectomies can survive up to 5 years