Liver cancer

The Function of the Liver and Complications Associated with Liver Cancer

The liver is one of the body’s largest internal organs and performs over 500 essential functions. When cancer affects the liver, these vital functions begin to fail, causing complications such as liver failure, bleeding disorders, and metabolic disturbances.

Liver Cancer Causes

Liver cancer develops when liver cells undergo genetic mutations and grow uncontrollably. Chronic liver disease, inflammation, and viral infections such as hepatitis B and C increase the risk.

Categories of Liver Tumors

• Primary Liver Cancer: Includes hepatocellular carcinoma (HCC), cholangiocarcinoma, and rare tumors like angiosarcoma.
• Secondary (Metastatic) Liver Cancer: Cancer that spreads from other organs such as breast, colon, or lung.

Liver Cancer Symptoms

• Abdominal pain
• Weight loss
• Fatigue
• Jaundice
• Nausea and vomiting
• Dark urine and pale stools
• Swelling in legs or abdomen

Diagnosis

• Blood Tests: Includes liver function tests, AFP testing.
• Imaging: Ultrasound, CT, MRI.
• Biopsy: Tissue sampling to confirm malignancy.
• Staging: Determines cancer spread.

Is Liver Cancer Curable?

• Early-stage cancers have better outcomes.
• Success depends on treatment type and timing.
• Advanced therapies improve survival.

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Understanding Cryosurgery & Mechanisms of Tissue Damage

To control the outcome of cryosurgery, it’s essential to understand the mechanisms of damage. During cryosurgery, a cryogenic probe freezes undesirable tissue, forming an ice-ball that destroys cancerous cells through extreme temperatures.

Effects of Cooling

Mammalian cells tolerate low non-freezing temperatures for short periods, but cooling affects cell membranes, ionic balance, and protein structure. Platelets and muscle cells (especially cardiac) are more vulnerable due to their sensitivity to ionic shifts.

Effects of Freezing

Freezing causes extracellular ice formation, leading to dehydration and harmful hypertonic environments. Rapid freezing can result in intracellular ice, which is almost always fatal to cells.

Tissue-Specific Freezing Behavior

Freezing spreads along natural tissue structures such as ducts, vasculature, and connective tissue. Both cellular dehydration and intracellular ice formation occur in frozen regions.

Thawing & Warming

Thawing can cause recrystallization, membrane rupture, and metabolic disturbances due to rapid osmotic shifts, contributing further to tissue destruction.

Multiple Freeze–Thaw Cycles

Using double or triple cycles increases damage and improves treatment success.

Vascular Damage

Freezing causes blood vessel occlusion, endothelial injury, and ischemia. This secondary vascular damage kills cancer cells even in areas not directly frozen.

Immunological Effects

Cryosurgery may provoke beneficial systemic immune responses that help target metastatic tumors.

Antifreeze Proteins

These proteins create needle-like ice crystals that increase tumor destruction, potentially making cryosurgery more effective.

Procedure

The technique uses argon gas or liquid nitrogen. Tumors are visualized using ultrasound or CT, and cryoprobes are inserted strategically to form an ice-ball covering the tumor plus a margin.

Monitoring Cryosurgery

• Local Monitoring: Using thermometry or electrical impedance.
• Ultrasound Imaging: Dark ice-ball area with hyperechoic rim.
• MRI Monitoring: High accuracy 3D imaging without shadowing.
• Optical Imaging and EIT: Modern experimental techniques.

Indications

Cryosurgery is effective for many cancers:

• Liver cancer
• Lung cancer
• Kidney tumors
• Breast cancer
• Bone and soft-tissue sarcomas
• Prostate cancer
• Skin cancers & precancerous lesions

Specific Advantages

• Spares healthy tissue
• Suitable for tumors near major blood vessels
• Allows treatment of large tumors (>10 cm)
• Can be repeated safely
• Does not stimulate residual tumor growth

Adverse Effects

• Risk of bleeding or infection
• Pneumothorax (lung procedures)
• Temporary urinary/sexual dysfunction in prostate cryoablation
• Skin discoloration or numbness
• Possible bone fractures in bone tumor cryosurgery

Summary

Cryosurgery is a powerful minimally invasive method effective across multiple cancer types. With modern imaging and advanced cryoprobes, it continues to grow as a leading option in oncology.