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Jaundice, a yellowish tinge to the skin and whites of the eye, is caused by an excess of bilirubin. Cancer can cause jaundice by disrupting the bilirubin excretion system or blocking the pathway used by the liver to shunt bilirubin to the intestines.
Jaundice is a medical sign characterized by a yellowish tinge to the skin and whites of the eye. The discoloration of the skin and whites of the eyes is secondary to an excess of bilirubin, a product that results from the breakdown of red blood cells. In a healthy person, red blood cells develop, live, and then die in cycles that avoid overloading the body’s normal three-stage excretion system in which the liver filters bilirubin and sends it to the intestines for excretion. During illness or injury, however, excess bilirubin can build up in tissues when its excretion is delayed, slowed, or stopped. Cancer and jaundice are often closely associated due to the disease’s ability to disrupt the bilirubin excretion system at any of its three major steps.
There can be many associations between cancer and jaundice. A malignant tumor of the blood or bone marrow could cause increased hemolysis, excessive bilirubin and subsequent jaundice. In this scenario, the massive amount of bilirubin in the system exceeds the organ’s ability to filter the substance. If the rate of red blood cell destruction can be slowed and the patient’s liver function is normal, jaundice may slowly subside in severity. In this case, the association between jaundice and cancer is directly causative.
The relationship between cancer and jaundice may also be indirectly causative. If cancer treatments such as chemotherapy or radiation cause increased red blood cell hemolysis as a side effect of treatment, excessive bilirubin can still overwhelm the liver’s capacity and lead to jaundice. This can reduce or disappear altogether between treatments if treatment sessions are spaced far enough apart.
When a patient suffers from liver cancer, either as a primary malignancy or as a result of metastases, the cancer and jaundice are again associated. Under these circumstances, the body’s hemolysis rate may be completely normal, however, liver function is impaired and jaundice may occur as bilirubin accumulates in the tissues and sclera. This type of jaundice is essentially irreversible. Steps can be taken, if possible, to reduce the workload of the liver by avoiding drugs that do not put stress on the liver.
Another way cancer and jaundice can be associated is if a tumor blocks the pathway used by the liver to shunt bilirubin to the intestines for excretion. Despite normal liver function and a normal rate of red blood cell hemolysis, jaundice can still occur because bilirubin, built up at a normal rate, is unable to drain into the intestines. This type of jaundice can be treated with removal of the blockage, depending on the patient’s condition and prognosis.
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