Brenda Spriggs, MD, MPH, MBA
The liver is an essential organ responsible for detoxifying the body. Liver cancer is a form of cancer that develops from cells of the liver and the bile duct. According to the National Cancer Institute, 22,620 new cases of liver cancer were diagnosed in the United States in 2009, and liver cancer caused 18,160 deaths. Progression of liver cancer impairs normal liver functioning, and in the end stages of the disease, it leads to acute liver failure and liver breakdown. Liver failure as a result of cancer leads to a number of unpleasant side effects and is ultimately fatal.
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The development of large tumors in the liver eventually block the flow of bile fluids between the liver and the bile duct. As a result of this blockage, bile fluids seep into the bloodstream and lead to jaundice, a yellowing of the skin and eyes. According to the University of Michigan, jaundice occurs in 75 to 85 percent of patients with bile duct tumors, and 80 percent of patients with liver cancer.
In addition to yellowing of the skin, jaundice results in pale stools since the bile salts would normally contribute to darker stools. Patients may also experience dark urine and itching.
Patients with advanced liver cancer may also experience delirium, acute confusion that can be accompanied by behavioral changes. Liver failure, cause by advanced liver cancer, causes delirium. Patients with delirium will often experience changes in sleep patterns, difficulty concentrating or amnesia. In severe cases, delirium can lead to a coma.
According to the University of Michigan, delirium can be treated with a number of medications to regulate chemicals within the brain such as mood stabilizers, dopamine blockers or serotonin-regulating drugs.
End stage liver cancer also leads to abdominal pain. As the tumor grows, tumor cells seek out and actively kill healthy tissue surrounding the tumor to allow for more cancer growth. In the late stages of liver cancer, the tumor invades a number of tissues throughout the abdomen, leading to massive organ damage and abdominal pain. Patients may also experience a distended or swollen abdomen, as the larger tumors take up more space within the abdominal cavity. Stanford Medicine also reports that metastatic liver cancer may lead to a buildup of fluid in the abdomen, causing further swelling and pain. Pain associated with late stage liver disease is usually treated with analgesics such as morphine.