Advanced Liver Cancer And Skin Itching: Understanding The Connection

Skin itching in the late stages of liver cancer is primarily caused by a condition known as hyperbilirubinemia. The liver is responsible for the synthesis and metabolism of bilirubin, a yellow pigment formed during the normal breakdown of red blood cells. In patients with advanced liver cancer, especially those who also suffer from cirrhosis, liver function is significantly impaired, which disrupts the normal processing of bilirubin.

When liver function declines, it leads to the accumulation of bilirubin in the bloodstream, causing a condition called hepatocellular jaundice. Additionally, the growth of the tumor can exert pressure on liver tissues, further damaging liver cells and impairing bilirubin metabolism.

In some cases, tumors located in specific areas can directly compress the bile ducts inside or outside the liver. As the cancer progresses, it may invade the bile ducts and form cancerous blockages, known as tumor thrombi, which obstruct the flow of bile. This blockage results in obstructive jaundice, where bile cannot drain properly, leading to a significant rise in blood bilirubin levels. Elevated bilirubin levels cause the buildup of bile salts in the skin, which then stimulate nerve endings, resulting in widespread itching.

Managing itching in such cases involves reducing bilirubin levels in the blood. There are two main approaches to treatment: targeting the tumor itself and facilitating bile drainage. Tumor-targeted treatments may include surgical removal, radiation therapy, interventional procedures, or ablation techniques.

For bile drainage, minimally invasive procedures like percutaneous transhepatic cholangial drainage (PTCD) or stent placement can be used to help remove excess bile and lower bilirubin levels in the blood. These interventions can effectively relieve the uncomfortable symptom of skin itching and improve the patient's quality of life.