Liver cancer is a type of cancer in which there is an abnormal and uncontrolled growth of liver cells. It is classified into two main types: primary liver cancer (cancer that develops within the liver tissue) or secondary liver cancer (cancer that spreads to the liver tissue after developing in some other part of the body). Liver cancer affects men two times more often than women.
The exact cause of liver cancer is not known. But, changes in the DNA of the liver cells are more likely to cause liver cancer.
DNA is an essential component in our cells, which carries specific genes that regulate the cell functions (cell growth, division, and cell death). Any mutations or changes in the DNA eventually alters the normal functioning of the cells, which can resultin excessive multiplication of the cells, thereby leading to liver cancer.
Early stages of liver cancer do not have any symptoms. But, if cancer grows, the following symptoms can be seen:
- Discomfort in the right side of the upper abdomen
- Abdominal swelling
- A hard lump under the rib cage on the right side
- Pain in the back or at the right shoulder blade
- Easy bleeding or bruising
- Unusual fatigue
- Nausea or vomiting
- Loss of appetite
- Unexplained weight loss
When liver cancer is suspected, information regarding the symptoms, health, past illnesses and treatment will be collected. Followed by this, a physical examination will be performed to check for the presence of lumps or unusual signs of the disease.
The following tests may be recommendedto help diagnose liver cancer:
- Blood test: Complete blood count measures the count of different types of blood cells like red blood cells, white blood cells, and platelets.
- Alpha-fetoprotein test. This test measures the levels of alpha-fetoprotein in the blood. A high level of this protein may be a positive sign of liver cancer.
- Ultrasound scan: It uses high-frequency sound waves to create images of the liver. It helps to detect abnormalities in the liver.
If any of the above tests suggest a chance for liver cancer, the following tests can help in the confirmation of cancer.
- Computerizedtomography (CT) scan: This test takes a series of X rays of the liver to provide a three-dimensional image of the liver.
- Magnetic resonance imaging (MRI) scan: This scan makes use of a strong magnetic field and radio waves to give a clear picture of the liver.
- Biopsy: This procedure involves the insertion of a needle into the abdomen to collect a small sample of the liver tissue. The collected sample is viewed under a microscope to check for abnormal or cancer cells.
- Laparoscopy:In this procedure, a small incision is made in the abdomen after administering anesthesia. A thin tube that contains a light and camera isinserted through the incision, to examine the liver and its surrounding areas.
Staging helps to determine the extent of cancer spread. The stages of liver cancer are:
- Stage I: The tumour is confined to the liver.
- Stage II: The tumour has spread to the blood vessels or, there are multiple tumours less than 5 cm.
- Stage III: The tumour has spread to the blood vessels and the outer lining of the liver. The tumours are greater than 5 cm in size.
- Stage IV: Cancer has spread to the lymph nodes and blood vessels near the liver and distant organs such as lungs, bones or brain.
In the initial stages, liver cancer may not show any sign and symptoms. As the cancer advances, symptoms like weight loss, loss of appetite, nausea and vomiting, abdominal swelling, and weakness may be apparent.
The following are the risk factors for liver cancer:
- Aflatoxins: Aflatoxins are the toxins produced by fungi, which contaminate foods such as corn, wheat, soybeans, rice and nuts preserved in hot and humid areas. A high intake of aflatoxin-contaminated foods can damage the DNA of the liver cells and increases the risk of liver cancer.
- Hepatitis infection: Hepatitis virus infection (hepatitis B or hepatitis C) increase the risk of developing liver cancer.
- Cirrhosis:Individuals with cirrhosisare likely to develop liver cancer.
- Alcohol: Excessive consumption of alcohol is linked to liver cancer.
- Smoking: Individuals who smoke oftenare at a high risk of liver cancer.
Additionally, there are some other risk factors which increase the risk of liver cancer. They are:
- Hereditary hemochromatosis (HH)
- Glycogen storage disease
- Alpha-1 antitrypsin (AAT) deficiency
- Wilson disease
- Porphyria cutanea tarda (PCT)
The following tips can help recover after surgery:
- Practice gentle exercises, such as walking
- Go for frequent checkups
- Eat a healthy and protein-rich diet
- Consult a physician if you experience pain or other symptoms
- Avoid driving
- Do not drink alcohol
- Formation of blood clots
- Kidney problems
- Leakage of bile
- Alteration in sleeping habits
Liver cancer can be treated by surgery, radiation, or chemotherapy.
Surgery: Surgery is the best treatment option to cure liver cancer. The surgical options for liver cancer include:
- Partial hepatectomy: This surgery involves the removal of a part of the liver affected by cancer. People who are healthy enough for surgery and those with a single tumour that has not spread to the blood vessels can opt for this surgery.
- Total hepatectomy: This procedure involves the complete removal of the liver.
- Liver transplantation: It is an option for those with tumours, which cannot be removed by surgery. It is generally used to treat the individuals with small tumours that have not spread to the nearby blood vessels. It is rarely used in patients with resectable cancers (tumours that can be deleted). Liver transplantation reduces the risk of spread of cancer.
Radiotherapy: This therapy uses high-energy rays to destroy the cancer cells. It can be given either externally or internally.
Chemotherapy: This therapy uses medications to kill cancer cells. The medicines can be given systemically (as tablets or injections that travel throughout the body) or regionally (as injections that are injected directly into a specific area). In liver cancer, regional therapy is mostly preferred.
Chemoembolization: This is a type of chemotherapy in which the chemo-drugs block the blood supply to the tumour. This eventually starves the cancer cells from blood and kills them.
Duration of the treatment
The duration of surgery depends on the surgical approach used. Radiation therapy is given in small doses for 5 days a week for several weeks. Chemotherapy treatment is given in cycles. Each cycle includes the treatment followed by recovery time. The cycles are usually 2- 3 weeks long.
FACTORS AFFECTING COST
The cost of treatment for liver cancer depends upon:
- the condition of the patient
- the type of treatment modality chosen
- the technology used
- other problems in the patient
Individuals receiving radiotherapy for liver cancer may have the following side effects:
- Skin changes such as redness, blistering and peeling of skin
- Loss of appetite
Most of the people feel depressed, anxious or worried when they have liver cancer. All these symptoms can be alleviated by getting help from their peers, family members, support groups, and professional counsellors.
Getting a vaccination for hepatitis B or hepatitis C,eating well, staying physically active, maintaining a healthy weight, and avoiding activities like smoking, drinking alcohol may lower the risk of cancer recurrence or progression.
So far, no dietary supplements have been proven to be useful in preventing the progression of liver cancer. Before using any dietary supplements, one should consult a physician.
Individuals who have undergone surgery or liver transplantation are usually recommended to have regular follow-ups. During the follow-up, imaging and blood tests are done every 3 to 6 months for the first year and then followed by every 6 to 12 months. Follow-up helps to detect the recurrence or spread of cancer.