Liver Cancer

Introduction

Liver cancer is a condition where liver cells multiply uncontrollably. The liver is located in the upper abdomen close to the stomach, intestines, gallbladder, and pancreas.

Liver cancer starts in the liver, either as a primary cancer (originating there) or secondary (spreading from elsewhere), often developing from long-term liver diseases like hepatitis or cirrhosis. The most prevalent form of liver cancer is hepatocellular carcinoma (HCC).

Symptoms

In the beginning phases, liver cancer might not exhibit visible or palpable symptoms. Nevertheless, as the cancer progresses, individuals may detect one or more of these typical symptoms. Please keep in mind that these symptoms may also be attributed to other medical conditions. If you experience any of these symptoms, consult your physician.

Liver cancer symptoms may include:

• Discomfort in the upper right abdomen.
• Abdominal swelling.
• Firm lump beneath the rib cage on the right side.
• Pain near the right shoulder blade or back.
• Yellowish discolouration of eyes and skin
• Easy bruising or bleeding.
• Unusual fatigue.
• Nausea and vomiting.
• Loss of appetite.
• Unexplained weight loss.

Risk factors

Following are the risk factors for liver cancer:

• Obesity
• Family history
• Older age
• Hepatitis B or hepatitis C infection.
• Tobacco consumption
• Alcohol consumption.
• Cirrhosis
• Fatty liver
• Diabetes
• Other disease like hemochromatosis, (Excessive iron uptake and storage)
• Eating foods contaminated with aflatoxin, a fungus that can develop on improperly stored grains and nuts.

Diagnosis of Liver Cancer

• Physical examination by a hepatologist
• Blood Tests: To check liver function and tumor markers. (Tumor markers are specific substances created by cancerous or non-cancerous cells when disease is present. Alpha-fetoprotein is a protein often found at elevated levels in individuals with liver cancer, serving as a tumor marker)
• Imaging: Ultrasound, CT scans, or MRI to visualize tumor.
• Angiogram : This test provides information about your liver’s blood vessels
• ERCP: Endoscopic Retrograde Cholangiopancreatography (ERCP) helps doctors determine the size of liver tumor and get biopsy tissue samples for a definitive diagnosis
• Liver Biopsy: A tissue sample from liver is taken and examined under a microscope.

Treatment Options

Treatment options vary by Stage of liver cancer

• 1. Chemotherapy: Chemotherapy is frequently used to treat cancer. It uses medications to stop tumor development and kill cancer cells. It could be used in conjunction with other cancer treatments including surgery or radiation therapy.
• 2. Surgery: The goal is to either transplant the liver or remove the tumor (resection). Your liver may be removed whole or in part. Your liver can regrow to its normal size if a portion of it is removed. You will require a liver transplant if you have a total hepatectomy, which involves removing your entire liver.
• 3. Radiation therapy: It kills cancer cells with high-energy beams. One of the most effective treatments for cancer is radiation therapy, which is used in conjunction with chemotherapy and surgery.
• 4. Immunotherapy and targeted therapy: medications that strengthen the immune system or target particular cancer cells are given. It focuses on the mutations or genetic alterations that cause healthy cells to become cancerous. It aids in the treatment of cancer cells while sparing healthy cells.
• 5. Additional Local Therapies: These involve embolization or ablation to eliminate liver tumor directly. These include Transarterial chemoembolization, Transarterial radioembolization, microwave ablation therapy etc.

How can you reduce the risk of getting Liver Cancer?

The following behaviour lowers the risk of liver cancer:

• Maintain healthy weight
• Physical activity.
• Get vaccinated against hepatitis B.
• Complete treatment of hepatitis C,
• Avoid smoking and alcohol.
• Ensure liver cancer screening. Regular blood tests and liver ultrasounds may be advised by your hepatologist, if you have liver disease, diabetes, obesity, family history or excessive alcohol consumption.

Why is early detection important in liver cancer?

Early detection in liver cancer is crucial because it allows for curative treatments like surgery or transplant when tumors are small, significantly improving survival rates, as the disease often shows few symptoms until advanced stages when options are limited. Catching it early means less spread and better liver function, making interventions more effective and potentially reversible before irreversible damage occurs.

Key reasons for early detection

• 1. Early-stage cancers can often be surgically removed (resection) or destroyed with heat (ablation), leading to higher cure rates.
• 2. The prognosis is strongly tied to the tumor's stage at diagnosis; early detection dramatically increases the chance of long-term survival.
• 3. Late-stage diagnosis often means the cancer has spread, limiting treatment to palliative care and making a cure unlikely.
• 4. Early detection allows for intervention before severe cirrhosis (scarring) becomes widespread, preserving the liver's ability to function.
• 5. Liver cancer is a "silent killer" as it typically doesn't cause noticeable symptoms (like pain, weight loss, or jaundice) until it's advanced, making screening vital for high-risk individuals.

Who should be screened?

People with risk factors like

• Chronic hepatitis (B or C)
• Cirrhosis
• Fatty liver disease (NAFLD)
• Hemochromatosis

It is recommended to have regular screening (like AFP, blood tests and ultrasounds) every 6-12 months for early detection of liver cancer, if a person is at risk of getting liver cancer.

Disclaimer:

This information is provided for educational purposes only. Some of the content is derived from data found at www.cdc.gov, my.clevelandclinic.org, www.cancerresearchuk.org,www.coursehero.com and www.oncolink.org