Liver Cancer

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Liver Cancer

Overview

Unrestrained growth and spread of unhealthy cells in the liver is called Liver cancer. If Cancer begins in the liver, it is called primary liver cancer. However, if Cancer spreads to the liver from other organs like colon, stomach, pancreas, breast cancer, etc. is called metastatic or secondary liver cancer.

Is liver tumor different from liver cancer?

Any node or mass inside the liver is called a liver tumor. Liver tumors can be non-cancerous (benign) or cancerous (malignant). The most common type of cancer that originates in the liver is known as Hepatocellular Carcinoma (HCC).

Causes

There are several causes of primary liver cancer. Risk factors for liver cancer include:

  • Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections cause chronic damage to the liver and are a major cause for liver cancer. About 5-10% of patients with these viruses develop liver cancer.
  • Cirrhosis is a progressive illness that causes scarring of the liver. Cirrhosis is the end result of the outcome of all types of long-standing liver damage. About 5-10% of patients with cirrhosis develop liver cancer.
  • Toxins like Arsenic: Drinking water polluted with arsenic (generally groundwater), also raises the risk for developing liver cancer.
  • Obesity increases the risk of liver cancer.
  • Diabetes increases the risk of liver cancer, especially in those who also drink alcohol heavily or suffer from superimposed Hepatitis B or C infection.

Symptoms

In the initial stages, Liver Cancer usually has no apparent symptoms. Only when the tumor becomes large, it causes symptoms. Certain symptoms are related to liver failure, which develops when cancer spreads within the liver. The following symptoms can occur:

  • Unexplained weight loss
  • Lack of appetite
  • Abdominal pain
  • Swelling of the belly due to the accumulation of fluid
  • Jaundice
  • Enlargement of the liver or a mass that can be felt in the abdominal area
  • Sudden deterioration in the overall condition of a patient with cirrhosis.

Risk factors

If liver cancer is suspected, you will need a CT or MRI scan for confirmation. Unlike other cancers, a biopsy is not always required for the diagnosis of liver cancer. Special blood tests called ‘Tumour Markers’ also aid in the diagnosis. It is very important to detect liver cancers in early stages for good clinical outcomes.

What is liver cancer screening?

Liver cancer screening is the best way to detect liver cancer when it is in early stages and is easily treatable. Patients who have Hepatitis B, Hepatitis C or liver cirrhosis and are at high risk of developing liver cancer should undergo periodic screening tests. This usually involves a blood test to look for a cancer marker (AFP – Alpha Feto Protein test) and an ultrasound scan of the liver to look for small nodules in the liver that may be cancer. If the AFP value is high or a nodule is detected in an ultrasound, further tests like a CT or MRI scan, are advised. The screening tests are usually advised once every six months.

Diagnosis

You and your family should have a clear understanding of the disease and the treatment plan.

  • What is the stage of the disease?
  • What are the various treatment choices?
  • Are there any chances for a successful treatment?
  • Are there any risks and possible side effects of each treatment?
  • How long will the treatment last?
  • What is the treatment likely to cost?
  • What are the prospects for liver transplantation?
  • Are there any chances of cancer coming back after treatment?

Treatment

The treatment of liver cancer treatment depends on:

  • The liver’s condition
  • The size, location, and number of tumors
  • The person’s age and overall health

Different ways of treating liver cancer are:

  • Surgery: If cancer has been diagnosed early, and the tumor is confined in a smaller part of the organ, and the rest of the liver is healthy, surgery may be performed to remove cancer from the liver.
  • Radiofrequency Ablation: Small cancers can also be burned using the heat generated through high-energy radiofrequency waves. This is a non-surgical technique that uses ultrasound or CT scan to localize cancer and a special needle that is inserted into the tumor to ablate it.
  • Chemotherapy or chemoembolization: In chemotherapy, anti-cancer drugs are used to destroy cancer cells. The chemotherapeutic agent is injected directly into the blood vessels supplying the tumor so that the effect is maximum in the area where the tumor is localized, and there are no side effects on the rest of the body. This is usually done for advanced stages of cancer where surgery or liver transplant is not possible.
  • Radiation Therapy: Radiation therapy uses focused, high-energy x-rays to destroy the cancerous cells.
  • Sorafenib: This is an anti-cancer medication for use in advanced cases of liver cancer where no other treatment is possible.

Is liver transplant effective for liver cancer?

The most effective treatment for liver cancer is to remove the affected part or the complete organ (Liver Transplant) by surgery. However, surgery may not be possible if there are sign & symptoms of liver failure or if the tumor is large in size. In this situation, it is possible to perform liver transplantation during which the entire liver along with the tumor is removed and replaced by a liver organ harvested from the donor.