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5-FU: See Fluorouracil.
A
Abdominal CAT scan: Used to evaluate abdominal trauma, the abdominal computerized axial tomography scan can show internal bleeding and organ injuries, lesions, and tumors. The machine holds a rotating X-ray tube and X-ray receptors, and the patient is required to ingest a small dose of barium or other contrast liquid before the procedure. An intravenous line is required for further contrast material to be introduced into the body.
Adenocarcinoma: When pertaining to liver cancer, these tumors usually arise in the glands of the liver. Breast cancer is a well-known adenocarcinoma.
Adriamycin: See Doxorubicin Hydrochloride.
Aflatoxin: A fungal toxin produced by mold that is a powerful liver carcinogen and may possibly lead to liver cancer.
AFP: See Alpha-fetoprotein.
Alanine aminotransferase: (Also called ALT, serum glutamic pyruvic transaminase, and SGPT) A liver enzyme that is usually present in liver and heart cells and plays a distinct role in protein metabolism. Alanine aminotransferase is released into blood when the liver or heart is damaged, and an elevated serum level is a sign of liver or heart damage. Medications can also raise alanine aminotransferase levels.
Albumin: A significant protein in the serum that transports substances, such as drugs, and prevents fluid leakage into the surrounding tissues.
Alkaline phosphatase: A protein found in bile duct cell membranes; blood levels may be increased in any liver disease, but more markedly with cholestasis.
Alkaloid: Any organic compound part of the large group of nitrogenous substances that is composed of carbon, hydrogen, nitrogen, and usually oxygen, that are found naturally in plants. Some of these plants have extracts that are considered pharmacologically active. As a medication, it is in the class of anticancer drugs that inhibit cancer cell growth by stopping cell division in mitosis. Specifically, they prevent the creation of chromosome spindles needed for the duplication of cells.
Alkylating agent: A family of cytotoxic drugs that depurinate DNA, which prevents normal cell division. Alkylating agents kill cells when they are either resting or dividing. The reagent replaces a specific group in a molecule with an alkyl group.
Alhph 1 - antitrypsin: A plasma protein produced by the liver that inhibits the activity of trypsin and other proteolytic enzymes. Its inherited deficiency leads to emphysema and sometimes cirrhosis.
Alpha-fetoprotein: (Also called AFP.) The liver of the fetus usually produces this plasma protein. Alpha-fetoprotein levels in the blood typically go down after birth, and by year one, the serum is virtually undetectable. The protein can reappear in the adult during some pathological stages. The alpha-fetoprotein level in the blood can be used as early detection for some cancer forms, most prominently hepatocellular carcinoma. It is elevated in liver tumors, hepatoblastoma, hemangioendothelioma, and hepatocellular carcinoma. The level produced by liver tumors allows for the response of the treatment of the tumors to be monitored.
ALT: See Alanine Aminotransferase.
Aminotransferase: A hepatocyte enzyme that modifies proteins; blood levels increase in the setting of hepatocellular necrosis (hepatocyte death). The two aminotransferases important in liver disease are aspartate aminotransferase (AST) and alanine aminotransferase (ALT).
Angiosarcoma: A type of cancer that begins in the lining of blood vessels.
Antibody: A Y-shaped immunoglobulin protein on the surface of B cells produced by the body and secreted into the blood or lymph in response to a specific antigen. They can then combine with the antigen and neutralize it.
Antigen: A molecule with a configuration that is recognized by the immune system and is usually a part of a protein or sugar. They stimulate the formation of a specific antibody and trigger an immune response. Antigens can include toxins, bacteria, foreign blood cells, and the cells of transplanted organs.
Antimetabolites: Anticancer drugs that block the chemical reactions necessary for the cell to produce DNA. Antimetabolites act as normal cell nutrients and the cancer cells "consume" the drug as food and then it dies.
Antitumor antibiotic: Anticancer drug that interferes with DNA by interweaving themselves into the DNA and either cut up the chromosomes or restrain the synthesis of RNA, preventing the cell from growing.
Ascites: The accumulation of fluid in the abdominal cavity, usually secondary to liver scarring and increased sinusoidal pressure.
Aspartate aminotransferase: (Also known as AST, glutamic oxaloacetic transaminase, and SGOT.) A liver enzyme that is usually present in liver and heart cells and plays a distinct role in protein metabolism. Aspartate aminotransferase is released into blood when the liver or heart is damaged, and an elevated serum level is a sign of liver or heart damage. Medications can also raise alanine aminotransferase levels.
AST: See Aspartate aminotransferase.
B
Bile Duct: Any of the canals that take bile from the gallbladder and liver to the hepatic duct and the cystic duct, and then to the common bile duct of the duodenum, the first part of the small intestine.
Bile: The fluid produced by the liver and emptied into the small intestine via the bile ducts. It contains bilirubin, bile salts, phospholipids, and cholesterol.
Bilirubin: A bile pigment cleared by the liver. It is formed as a product of old red blood cells. Increased bilirubin levels can lead to jaundice.
Biopsy: The removal of cell or tissue specimens for diagnosis and microscopic examination. The procedure can be performed via an open surgical incision or a biopsy needle. A biopsy is necessary in cancer patients before proper treatment can be determined.
Blood cells: Made in the bone marrow, they are either erythrocytes cells or leukocytes cells that can also include platelets.
C
Camptosar: See Irinotecan Hydrochloride.
Caput medusae: Varicose veins around the middle of the abdomen, which can be seen in patients with cirrhosis of the liver.
Carcinoma: A malignant growth that arises from the epithelium and is found in the lining of organs and skin. They then often metastasize.
CAT scan: See CT scan.
Chemoemobilization: Both chemotherapy and colloid particles are administered into the liver tumor through the hepatic artery. This procedure is usually beneficial in patients that have tumors limited to the liver. Chemoembolization can also be used to decrease the size of tumors to allow for resection.
Chemotherapy: Systematic chemotherapy is administered throughout the entire body, regional chemotherapy is localized treatment, combination chemotherapy involves multiple drugs, neoadjuvant chemotherapy is used before other treatment, and adjuvant chemotherapy is used after other treatments. Chemotherapy is a cancer treatment designed to stop the production of cancer cells by use of chemicals. Each cancer cell divides into 2 daughter cells, they then grow, rest, and the divide again. Similar to the drugs used to treat HIV/AIDS, chemotherapy uses powerful chemicals to interrupt this cycle and stop the cells from growing. Different drugs kill at different stages of the life cycle of the cell.
Cholangiocarcinoma: Rare malignancies that occur in the cells of the bile ducts. They originate in the liver and terminate at the ampulla of Vater.
Chromosomes: The fundamental self-replicating genetic structures of cells that contain cellular DNA that carry our genes. There are twenty-three pairs of chromosomes in each cell.
Cirrhosis: A chronic and progressive liver disease characterized by the replacement of normal liver tissue with scar tissue.
Colloid particles: Small units that are dispersed throughout another substance which are too small for resolution with an ordinary light microscope but are incapable of passing through a semipermeable membrane.
CPT-11: See Irinotecan Hydrochloride.
Cryosurgery: A surgical technique that utilizes freezing tumor tissue using liquid nitrogen to remove unwanted portions. Cryosurgery is often used when the tumor cannot be removed using surgery, however it is most useful in smaller tumors.
CT scan: A computerized tomography scan that can take a series of detailed pictures of organs and other areas inside of the body. These pictures are created by use of a computer connected to an X-ray machine. This type of machine can show cancer and metastases earlier and more accurately than other methods.
D
Decompensation: The failure of the liver to compensate for damage or injury. This results in a decrease in liver functions.
DNA: Nucleic acids that are the molecular basis of heredity, are localized especially in cell nuclei, and are constructed of a double helix. DNA determines the structure, function, and behavior of the cell. DNA is held together by weak hydrogen bonds between purine and pyrimidine bases. These bases are adenine, guanine, cytosine, and thymine.
Doxorubicin hydrochloride: An intravenous cytotoxic anthracycline antibiotic drug, doxorubicin hydrochloride has a toxic effect on malignant cells. Chemically, it is 5,12-Naphthacenedione, 10-[(3-amino-2,3,6-trideoxy-a-L-lyxo-hexopyranosyl)oxy] -7,8,9,10-tetrahydro-6,8,11-trihydroxy-8-(hydroxylacetyl)-1-methoxy-, hydrochloride (8S-cis)-. Of the cancers commonly listed to respond well to doxorubicin, liver cancer is not found although it is commonly part of liver cancer treatment. Possible side effects include: nausea, hair loss, ulcers, mouth sores, difficulty swallowing, anemia, discolored (usually red) urine, sensitivity to the sun, and diarrhea.
Dysplasia: The alteration in size, shape, and organization of cells. Dysplasia may be a precursor of cancer.
E
Endothelium: The layer of cells that line the blood, lymphatic vessels, and the heart.
Etoposide: A semisynthetic derivative of podophyllotoxin, etoposide can be administered orally or intravenously. It is often used for neoplastic disease. Chemically, etoposide is 4'-demethylepipodophyllotoxin 9-[4,6-0-(R)-ethylidene-(beta)-D-glucopyranoside] and has molecular formula: C 29 H 32 O 13 . Possible side effects include: low blood counts, nerve numbness, shortness of breath, hair loss, nausea, vomiting, mouth sores, and diarrhea.
F
Fibrolamellar: Fibrolamellar hepatocellular carcinoma (FLC) is commonly considered a variation of HCC. However, FLC may be uniquely distinct from HCC in both its epidemiology and prognosis. FLC has an improved prognosis when compared to HCC, and is more commonly found in younger patients with non-cirrhotic livers.
Fluorouracil: An older chemotherapy drug, fluorouracil is used for many types of cancer, including liver cancer, and can be administered intravenously and orally. (In skin cancer it can be used as a crème applied directly to the skin.) The most common cancers that use this drug include colon, rectal, and breast cancer. It is prescribed to liver cancer patients. Fluorouracil is an antineoplastic antimetabolite, and is chemically 5-fluoro-2,4(1H,3H)-pyrimidinedione with molecular formula C4H3FN2O2. Possible side effects of fluorouracil can include: mouth sores, ulcers, diarrhea, blurry vision, skin irregularities and sensitivity, impaired bone marrow function, vomiting, hair loss, brittle nails, and rashes.
Folinic acid: See Leucovorin.
G
H
HCC: See Hepatocellular carcinoma.
Hemochromatosis: The toxic accumulation of iron in organs, which leads to dysfunction in certain organs. These organs can include the liver, bone marrow, pancreas, skin, and testicles. Hemochromatosis is often considered a genetic disorder, with an inherited increase in gut iron absorption, but can also arise as a result of multiple blood transfusions. It affects approximately 1 in 400 individuals of European ancestry.
Hepatic artery: A portion of the coeliac artery that distributes blood to the liver, stomach, pancreas, duodenum, gallbladder, and the greater omentum.
Hepatitis: 1) Inflammation and damage to the liver. It is generally considered acute if duration is less than six months, and chronic if greater than six months. 2) A disease marked by inflammation of the liver.
Hepatitis A: An acute and usually benign viral hepatitis caused by a picornavirus (genus Hepatovirus) that does not persist in the blood serum. It is transmitted through person-to-person contact with oral secretions, sexual fluids, and especially in food and water contaminated with infected fecal matter. The virus can be shed in the stools of an infected individual several weeks before any symptoms appear.
Hepatitis B: A sometimes-fatal form of viral hepatitis caused by a double stranded DNA virus with genus Orthohepadnavirus of the family Hepadnaviridae. Hepatitis tends to persist in the blood serum. It can be transmitted through contact with infected blood products, sexual intercourse, and from mother to infant. The infection from Hepatitis B is much more severe than that of Hepatitis A and can occur as an asymptomatic carrier state, a chronic infection, or as cirrhosis of the liver. This virus can persist for extended periods of time, especially in asymptomatic carriers. The association of this integrated virus with hepatocellular carcinoma is now well established.
Hepatitis C: A form of viral hepatitis caused by a single stranded RNA virus of family Flaviviridae. It is most commonly transmitted through blood transfusions, but can be transmitted through sexual contact or exposure to contaminated blood products.
Hepatitis D: A more rare form of viral hepatitis that occurs only in association with a hepatitis B infection.
Hepatitis E: A form of viral hepatitis caused by a positive stranded RNA virus of the genus calicivirus.
Hepatitis G: A virus first identified in 1995 that is genetically related to the hepatitis C virus, but uniquely is not known to cause hepatitis or any other disease. Infection with the hepatitis G virus seems to be beneficial to HIV-infected patients. These patients have longer survival when they are coinfected with hepatits G and HIV than if they have HIV alone. The hepatitis G virus is also called the GB virus C (GBV-C). This designation is often preferred since the virus is not a cause of hepatitis.
Hepatocellular carcinoma: (Also called primary liver cancer, hepatoma, and HCC.) Hepatocellular carcinoma is the most common primary malignant liver tumor in which the cancer starts in cells of the liver. Hepatocellular carcinoma is also the fourth most common cancer in the world. Symptoms include: abdominal pain, unexplained weight loss, unexplained fevers, abdominal swelling, appearance of ascites, muscular wasting, bloating, decreased appetite, and nausea. Jaundice and swelling of the legs occur in more advanced liver cancer. Many patients with hepatocellular carcinoma do not develop symptoms until the advanced stages of the tumor. Hepatitis B and C appear to be the most significant causes of hepatocellular carcinoma worldwide.
Hepatocyte: An epithelial parenchymatous cell of the liver.
Hepatoma: See Hepatocellular carcinoma.
Hemangioendothelioma: In liver cancer, it is characterized by tumors that arise from the blood vessels in the liver. It can also occur in other parts of the body, including the spleen and the lungs.
Hemangioendotheloma, epitheliod: This is a rare malignant vascular tumor that arises in the endothelium and can occur in many places in the body including the liver, bones, and the lungs.
I
Injection, ethanol: Ethanol (alcohol) is injected and causes tumor cell death. The injection of ethanol causes cellular proteins to disintegrate and cells to dry out. Injection is for patients that are not candidates for surgery, or chose not to have surgery.
Interstitial laser photocoagulation: An investigational procedure, interstitial laser photocoagulation involves the injection of an optical fiber into the liver tumor. The exposed cells undergo thermal necrosis.
Ionization: The formation of or separation into ions by heat, electrical discharge, radiation, or chemical reaction.
Irinotecan hydrochloride: A topoisomerase I inhibitor anticancer drug, irinotecan hydrochloride is an alkoloid extract. Irinotecan hydrochloride was investigated as CPT-11 and is administered intravenously. Chemically, it is (4S)-4,11-diethyl-4-hydroxy-9-[(4- piperi-dinopiperidino)carbonyloxy]-1H-pyrano[3', 4': 6,7] indolizino[1,2-b] quinoline-3,14(4H, 12H) dione hydrochloride trihydrate with the empirical formula: C33H38N4O6oHClo3H2O. Side effects can include: vomiting, nausea, diarrhea, mouth sores, hair loss, and dizziness.
Irradiation: The exposure to or application of radiation as X-rays or alpha particles.
Isolated liver perfusion: A process where the liver is exposed to high doses of chemotherapy, and the blood supply to the liver is isolated from the systemic circulation so that the rest of the body is not exposed to the high dose of drugs. This procedure is currently used only in clinical trials.
J
Jaundice: Caused by bilirubin (bile pigment), jaundice results in the yellowing of the whites of eyes and the skin and is a major sign of liver dysfunction.
K
L
Leucovorin: This chemically reduced derivative of folic acid is used generally as an antidote to drugs that act as folic acid antagonists. Specifically, it can reverse the toxicity of methotrexate and potentiate and modulate flourouracil. Leucovorin can be administered orally, intramuscularly, or intravenously. Chemically, leucovorin is N[4[[(2amino-5-formyl1,4,5,6,7,8hexahydro4oxo6-pteridinyl)methyl]amino]benzoyl],calcium salt (1:1). Possible side effects can include: increased pernicious anemia symptoms, allergic reactions, nausea, and vomiting.
Liquid nitrogen: The dangerous tissue killing liquid form of the colorless tasteless odorless element that as a diatomic gas is relatively inert.
Liver biopsy: This procedure can be done using fine needle aspiration or with regular needles and is done through the skin. A liver biopsy is usually required in order to begin treatment and to correctly diagnose the cancer. After a liver biopsy, one is able to distinguish between primary liver cancer and cancer that has metastasized to the liver.
Liver: A large glandular solid vertebrate organ located in the upper right quadrant of the abdominal cavity that secretes bile. It is active in the formation of certain blood proteins and in the metabolism of carbohydrates, fats, and proteins. Also plays a major role in digestion, detoxification, and elimination of substances from the body.
Liver function test: This test measures the blood serum level of several enzymes produced by the liver. When a liver function test returns elevated values, it can be a sign of possible liver damage.
Liver scan: Involves a small dose of radioactive substance being injected into the bloodstream so that the liver can be properly visualized during an X-ray.
Liver transplant: Surgery in which a donor provides a new liver or partial liver to replace a diseased liver in another. A complicated procedure, a liver transplant requires both the vessels and biliary tract to be reacttached to a new liver. This is not usually recommended, as tumors will re-grow in the new liver. There has been some success with small hepatocellular tumors, epitheloid hemangioendothioloma, and neuroendocrine carcinoma.
Lymphatic system: The system of tissues and organs that create and store cells that fight infection and the network of lymphatic vessels and channels that carry lymph.
M
Merkel cell carcinoma: See Neuroendocrine carcinoma.
Metastases: Tumors that originated from cancer cells in another part of the body.
Metastasize: To spread to another part of the body via blood vessels, lymph channels, or other means.
Metastatic cancer: Any cancer that has spread from the original site of tumor development to another anatomical site.
Mitomycin-C: An antibiotic that has been shown to have antitumor activity. Mitomycin-C is administered intravenously, and its chemical name is 6-Amino-1,1a,2,8,8a,8b-hexahydro-8-(hydroxymethyl)-8a-methoxy-5-methyl-azirino [2',3':3,4]pyrrolo[1,2-a]indole-4,7-dione carbamate (ester). The chemical formula of Mitomycin-C is C15H18N4O5. Possible side effects can include: weakness, lung scarring, renal failure with sever blood platelet reaction, hair loss, liver toxicity, nausea, vomiting, diarrhea, and mouth sores.
Mitoxantrone hydrochloride: A synthetic antineoplastic anthracenedione that is administered intraveneously. The molecular formula is C22H28N4O6o2HCl. Side effects can include: low blood counts, muscle damage, liver toxicity, nausea, vomiting, diarrhea, urine (usually green) discoloration, and mouth sores.
Mutamycin: See Mitomycin-C.
Mycotoxins: Toxic compounds produced by certain molds and fungi. Some have medicinal uses.
N
Necrosis: The localized death of living tissue.
Necrosis, thermal: The localized death of living tissue using heat.
Neoplasms: A new abnormal tissue growth that can be malignant or benign. Malignant neoplasms are less differentiated than benign neoplasms.
Neuroendocrine carcinoma: A rare yet extremely malignant form of skin cancer. These tumors initially appear on areas of the body exposed to the sun, grow rapidly, and often metastasize. Neuroendocrine carcinoma has a predilection to spread to the liver, bone, brain, and lungs.
O
Optical fiber: A flexible visually transparent slender object, usually made of glass or plastic, through which light can be transmitted by successive internal reflections.
Ovantrone: See Mitoxantrone hydrochloride.
P
Palliative treatment: A treatment not expected to provide a cure. Palliative treatments focus on the comfort of the patient and relief of symptoms.
Primary liver cancer: See Hepatocellular carcinoma.
Primary liver cell carcinoma: See Hepatocellular carcinoma.
Q
R
Radiation: Uses high-energy X-rays, electron beams, or radioactive isotopes to kill cancer cells without exceeding safe doses to normal tissue. It does this by ionization. Some cells die immediately after the radiation due to direct effect, but most die because the radiation damages the chromosomes and DNA so that they can no longer divide. There is limited usefulness for radiation in liver cancer patients. It is usually used in combination with surgery, if at all, and can treat the liver area after a tumor has been removed. Currently, radiation is used as a way to decrease the pain associated with larger liver masses and metastases.
Radioactive isotopes: The property possessed by atoms having the same atomic number but different mass numbers where they spontaneously emit energetic particles as electrons or alpha particles by the disintegration of their atomic nuclei.
Radio frequency ablation: This new procedure destroys liver cells 4 cm and smaller by heating them, using a needle and electrical current, to temperatures between 80 and 100 degrees C. This is currently still a palliative treatment.
Resection: Excision of tissue or organ. In primary liver cancer, the cancer must not have metastasized to any other part of the body in order to be a candidate for resection.
S
Sarcoma: This cancer occurs in the supportive tissues of the body. In liver cancer, it amasses in the connective tissue in the liver.
Serum glutamic oxaloacetic transaminase: See Aspartate aminotransferase.
Serum glutamic pyruvic transaminase: See Alanine Aminotransferase.
SGOT: See Aspartate aminotransferase.
SGPT: See Alanine Aminotransferase.
T
Toposar: See Etoposide.
Toxins: Poisons produced by animals and plants.
U
Unresectable: Unable to be removed by excision.
V
Vepesid: See Etoposide.
VP-16: See Etoposide.
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Definitions written by the Medical Research Committee; many were modified and adapted from: www.dictionary.com, Everyone's Guide to Cancer Therapy (Revised Third Edition) by Malin Dollinger, M.D., Ernest H. Rosenbaum, M.D., and Greg Cable, hepnet.com, medterms.com, cancerweb.ncl.ac.uk, emedicine.com, rxlist.com, cancer.gov, m-w.com.
