New cells form when the body doesn't need them and
old or damaged cells don't die as they should.
The buildup of extra cells often forms a mass of
tissue called a growth, nodule, or tumor.
The growth can be benign or malignant.
Benign tumour Malignant tumour
rarely a threat to life may be a threat to life
can be removed and usually don't
sometimes can be removed but can
don't invade the tissues around them can invade and damage nearby
tissues and organs
don't spread to other parts of the body can spread to other parts of the body
What does Liver do???
It removes harmful substances from the blood.
It makes enzymes and bile that help digest food.
It also converts food into substances needed for life
Primarily liver cancer begins in hepatocytes.
Known as hepatocellular carcinoma.
Infection with hepatitis B virus (HBV) or hepatitis C
Heavy alcohol use
Iron storage disease
Obesity and diabetes
Pain in the upper abdomen on the right side
A lump or a feeling of heaviness in the upper
Swollen abdomen (bloating)
Loss of appetite and feelings of fullness
Weakness or feeling very tired
Nausea and vomiting
Yellow skin and eyes, pale stools, and dark urine
Check the liver, spleen and other nearby organs for
any lumps or changes in their shape or size.
Check for ascites, an abnormal buildup of fluid in the
Also, your skin and eyes may be checked for signs of
Blood test detects alpha-fetoprotein (AFP).
High AFP levels could be a sign of liver cancer.
A biopsy usually is not needed to diagnose liver
cancer, but in some cases, the doctor may remove a
sample of tissue.
A pathologist uses a microscope to look for cancer
cells in the tissue.
Tissues are obtained by
1. A needle through the skin
2. Laparoscopic surgery
3. Open surgery
Staging is an attempt to find out whether the cancer
has spread, and if so, to what parts of the body.
When liver cancer spreads, the cancer cells may be
found in the lungs.
Cancer cells also may be found in the bones and in
lymph nodes near the liver.
Metastatic Liver Cancer
Tests done for Diagnosis:
1. CT scan of the chest
2. Bone scan
3. PET scan
Surgery is an option for people with an early stage of
The surgeon may remove the whole liver or only the
part that has cancer.
If the whole liver is removed, it's replaced with
healthy liver tissue from a donor and is known as
Removal of part of the liver is known partial
Done when tumours are small, the disease has not
spread outside the liver, and suitable donor liver
tissue can be found.
Treatments to control liver cancer and extend life.
Surgery to remove the tumor may not be possible
because of cirrhosis or other conditions that cause
poor liver function, the location of the tumor within
the liver, or other health problems.
Use of special probe that contains tiny electrodes to
kill the cancer cells with heat.
Ultrasound, CT, or MRI may be used to guide the
probe to the tumor.
It is a hyperthermia therapy.
Percutaneous ethanol injection
Ultrasound is used to guide a thin needle into the
Alcohol (ethanol) is injected directly into the tumor
and kills cancer cells.
The procedure may be performed once or twice a
For those who can’t have surgery or a liver transplant,
embolization or chemoembolization may be an
A tiny catheter with sponge or other particles is
inserted into an artery in your leg and is moved into
the hepatic artery.
The particles block the flow of blood through the
artery which results in the death of tumour.
People with liver cancer who can’t have surgery or a
liver transplant may receive a drug called targeted
Targeted therapy slows the growth of liver tumors.
It also reduces their blood supply.
The drug is taken by mouth.
Side effects include nausea, vomiting, mouth sores,
and loss of appetite.
Sometimes, a person may have chest pain, bleeding
problems, or blisters on the hands or feet.
The drug can also cause high blood pressure.
Radiation therapy uses high-energy rays to kill cancer
It may be an option for a few people who can’t have
Sometimes it is used with other approaches.
Radiation therapy also may be used to help relieve
pain from liver cancer that has spread to the bones.
Two types: External radiation therapy
Internal radiation therapy
The use of chemicals to kill tumours.
The drugs are given intravenously.
The side effects mainly depend on how much and
what kind of drug is given.
Common side effects include nausea, vomitting, loss
of appetite, fever and chills, and weakness.
Lung cancer is the uncontrolled growth of
abnormal cells in one or both lungs.
Primary and secondary lung cancer
Primary lung cancer starts in lungs.
Lung is the secondary site of infection for some other
Anything that we breathe in can affect the health.
The most important risk factor for lung cancer is
Other risk factors include:
3. Industrial substances
4. Radiation exposure
5. Air pollution
Symptoms of lung cancer that are in the chest:
Coughing, especially if it persists or becomes intense
Pain in the chest, shoulder, or back unrelated to pain from
A change in color or volume of sputum
Shortness of breath
Changes in the voice or being hoarse
Harsh sounds with each breath (stridor)
Recurrent lung problems, such as bronchitis or
Coughing up phlegm or mucus, especially if it is tinged
Coughing up blood
Symptoms of lung cancer that may occur elsewhere
in the body:
Loss of appetite or unexplained weight loss
Muscle wasting (also known as cachexia)
Headaches, bone or joint pain
Bone fractures not related to accidental injury
Neurological symptoms, such as unsteady gait or
Neck or facial swelling
Diagnosis of lung cancer is usually done by looking
If it is suspected, a biopsy is done to confirm the
A small tube is inserted through the mouth or nose
into the lungs.
The tube, which has a light on the end, allows the
doctor to see inside the lungs and to remove a small
Types and Stages of Lung
Non-Small Cell Lung Cancer
Non-small cell lung cancer accounts for about 85
percent of lung cancers.
Stages of Non-Small Cell Lung Cancer
Stage I: only in the lungs and has not spread to any
Stage II: lung and nearby lymph nodes.
Stage III: lung and in the lymph nodes in the
middle of the chest.
Locally advanced disease.
Stage III has two subtypes:
Stage IIIA: cancer has spread only to lymph nodes
on the same side of the chest where the cancer
Stage IIIB: cancer has spread to the lymph nodes on
the opposite side of the chest, or above the collar
Stage IV: This is the most advanced stage of lung
Cancer has spread to both lungs, to fluid in the area
around the lungs, or to another part of the body.
Small Cell Lung Cancer
SCLC accounts for remaining 15% of lung cancer.
Stages of Small Cell Lung Cancer
Limited stage: In this stage, cancer is found on
one side of the chest, involving just one part
of the lung and nearby lymph nodes.
Extensive stage: In this stage, cancer has spread
to other regions of the chest or other parts of
Non-Small Cell Lung Cancer
3. Chemotherapy, and
4. Targeted treatments
alone or in combination—are used to treat lung
Most stage I and stage II non-small cell lung cancers
are treated with surgery to remove the tumor.
For this procedure, a surgeon removes the lobe, or
section, of the lung containing the tumor.
Chemotherapy and Radiation
Adjuvant Chemotherapy for patients with stage II and
For people with stage III lung cancer that cannot be
removed surgically chemotherapy in combination
with definitive (high-dose) radiation treatments is
In stage IV lung cancer, chemotherapy is typically the
main treatment and radiation is used only for
palliation of symptoms.
Chemotherapy plan consists of combination of
Chemotherapy before radiation or surgery causes
shrinkage of tumor enough to make it easier to
remove with surgery.
This increases the effectiveness of radiation and
destroys hidden cancer cells at the earliest possible
Targeted therapies are designed specifically to attack
cancer cells by attaching to or blocking targets that
appear on the surfaces of those cells.
People who have advanced lung cancer with certain
molecular biomarkers may receive treatment with a
targeted drug alone or in combination with
Erlotinib - blocks Epidermal Growth Factor Receptor
Avastin – blocks Vascular Endothelial Growth Factor
Crizotinib – blocks Anaplastic lymphoma kinase
Small Cell Lung Cancer
Chemotherapy and Radiation Therapy
For small cell lung cancer, regardless of stage,
chemotherapy is an essential part of treatment.
Radiation treatment may be used as well depending
on the stage of cancer.
For limited-stage small cell lung cancer, combination
chemotherapy plus radiation therapy at the same time
is the recommended treatment.
Radiation therapy of the brain may be used before or
after chemotherapy for some people whose cancer
has spread to the brain.
Preventive Radiation Therapy to the Brain
In more than half of the people with small cell lung
cancer, the cancer also spreads to the brain.
Prophylactic Cranial Irradiation (PCI).
This can benefit patient with both limited-stage and
extensive-stage small cell lung cancers.
A very small percentage of people who have limited-
stage small cell lung cancer.
No lymph node tumors may benefit from surgery.
After surgery adjuvant chemotherapy is given.
Treatment Side Effects
Nausea and vomiting
Weight loss or gain