Liver cancer or hepatic cancer is cancer that originates in the liver. It is a primary liver cancer as it starts in the liver rather than migrating or spreading to the liver from another organ. Cancer that spreads to the liver from other organ is called as liver metastasis or secondary liver cancer, which is the most common form of liver cancer. The liver is made up of various types of cells and hence several types of tumors are formed. Few of them are non-cancerous and few of them are cancerous which may even spread to other body parts.
About the liver
The liver is the second largest organ in the body which is made up of cells called hepatocytes. It consists of bile ducts that facilitate the flow of bile between liver, gall bladder, and the intestine. The liver store the nutrients absorbed from the intestine, remove toxic and chemical wastes from the body, metabolizes alcohol and drugs, and secretes bile into the intestine to aid in the absorption of nutrients.
If cancer originates in the hepatocytes, then it is called hepatocellular carcinoma. If cancer forms in immature liver cells, then it is called hepatoblastoma; this cancer is commonly seen in children. If cancer occurs in bile ducts, then the condition is cholangiocarcinoma. Hepatocellular carcinoma is common among all the liver cancers, and it tends to affect more men than women.
The exact cause of liver is not known. However, researchers believe primary liver cancer is mainly associated with chronic or long-term liver damage called cirrhosis which is caused by hepatitis B, hepatitis C, hemochromatosis (a hereditary disease associated with increased iron in the liver). Liver cancer is also linked to obesity, heavy alcohol use, and fatty liver disease.
In the early stages, the primary liver cancer does not cause any symptoms. The symptoms of advanced liver cancer include:
- Upper abdominal pain
- Loss of appetite
- Unintentional weight loss
- Nausea and vomiting
- Abdominal swelling
- General weakness
Meet the doctor if any of these symptoms are seen for longer duration.
Various factors increase the risk of liver cancer, which include:
- Chronic hepatitis B or hepatitis C
- Liver diseases like hemochromatosis and Wilson’s disease
- Anabolic steroid use
- Non alcoholic fatty liver disease
- Exposure to aflatoxins, chemicals transmitted through food contamination by fungus
- Excessive alcohol consumption
The doctor assesses the patient’s health history and performs physical examination. If liver cancer or chronic condition of the liver is suspected, the doctor recommends the following tests:
- Blood tests: Liver function tests are performed to detect abnormalities of the liver. Tumor markers such as alpha-fetoprotein (AFP) level in the blood is also determined for treatment decisions.
- Imaging tests: Magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound scans to determine type and stage or extent of the damage.
- Biopsy: A sample of affected liver tissue is sent for laboratory testing to confirm the diagnosis.
The treatment of liver cancer depends on the size, location, age, overall health, type and extent of the liver damage. The various treatment option of early stage liver cancer includes:
- Surgery- to remove the affected portion of the liver
- Liver transplant- to replace the damaged liver with a healthy donor liver
- Radiofrequency ablation – A special probe is used to destroy the cancer cells with the help of heat
- Cryoablation – Cancer cells are destroyed using extreme cold with the help of a special instrument called cryoprobe
- Chemoembolization – Anti-cancer drugs are supplied directly to the liver followed by blockage of blood supply
- Radiation therapy – Destruction of cancer cells or shrinking of tumours with the help of X-rays
- Targeted therapy- These drugs act by interfering specific abnormalities within the tumour, they help to reduce progression and improve survival rate.
- Chemotherapy- Anticancer drugs are given orally or intravenously to prevent the spread of cancer
The symptoms and the treatment of liver cancer may cause some physical changes and lead to stress. Therefore, the patient should be strong and find the ways to cope with the conditions by:
- Learning about the condition and making their own decisions regarding treatment or care
- Keeping close relationships strong
- Talking about the hopes and fears with friends and family members to reduce stress
Following some measures can help to minimize the risk of liver cancer:
- Vaccination against hepatitis B
- Limiting alcohol intake
- Being aware of the ways of hepatitis B transmission (blood transfusion, sharing contaminated needles, and having unprotected sex can cause hepatitis B)
- Avoiding aflatoxin exposure
- Performing regular physical activity