Jaundice is a medical sign characterized by a yellowish tinge to the skin and the sclera 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 usual three-step excretion system wherein the liver filters out bilirubin and shunts it to the intestines for excretion. During disease or injury, however, excess bilirubin can build up in the tissues when its excretion is delayed, slowed or discontinued. Cancer and jaundice are often closely associated due to the disease's ability to interrupt the bilirubin excretion system at any of its three major steps.
There can be many associations between cancer and jaundice. A malignancy of the blood or bone marrow might cause increased hemolysis, excessive bilirubin and resultant jaundice. In this scenario, the sheer amount of bilirubin in the system overwhelms the ability of the organ to filter out the substance. If the rate of red blood cell destruction can be slowed and the patient's liver function is normal, the jaundice may slowly decrease in severity. In this case, the association between jaundice and cancer is a directly causative one.
The relationship between cancer and jaundice can 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 may still overwhelm the capacity of the liver and result in jaundice. This may subside or disappear entirely between treatments if the treatment sessions are spaced far enough apart.
When a patient suffers from liver cancer — either as the primary malignancy or as the result of metastasis — cancer and jaundice are again associated. Under these circumstances, the rate of the body's hemolysis may be entirely normal, however, the liver's function is impaired and jaundice can occur as bilirubin accumulates in the tissues and sclera. This type of jaundice is essentially irreversible. Steps can be taken, if possible, to decrease the workload of the liver by avoiding medications that are not taxing to the liver.
Another way in which cancer and jaundice can be associated is if a tumor blocks the route the liver utilizes to shunt bilirubin to the intestines for excretion. Despite normal liver function and a normal rate of red cell hemolysis, jaundice can still result as the bilirubin — accumulated at a normal rate — is unable to drain into the intestines. This type of jaundice may be treated with removal of the blockage, depending upon the patient's condition and prognosis.