The incidence of liver cancer is rising at an alarming rate in India. Read on to learn about its risk factors, prevention, symptoms, diagnosis, and treatment.
What is liver cancer?
The liver is the largest organ in your body and is situated on the right side of your belly underneath the ribs. Cancer affecting any part of the liver is called liver cancer.
Why is the liver important?
The liver takes part in many critical functions of the body. These include –
- Filtering blood and removing toxins
- Breaking down medicines and alcohol
- Helping in the digestion, absorption and storage of nutrients
- Helping in blood clotting
- Protecting the body from infections
Can I live without my liver?
Since the liver is involved in many vital functions of the body, you can not live without it. You may require a liver transplant to survive if your liver doesn’t function properly.
What are the types of liver cancer?
Liver cancer is classified based on the origin of the cancerous cells.
- Primary liver cancer – Cancer starts in the liver
– Hepatocellular carcinoma
– Intrahepatic cholangiocarcinoma (Bile duct cancer)
– Angiosarcoma (begins in the cells lining the blood vessels of the liver)
– Hepatoblastoma (occurs in children) - Secondary liver cancer – Cancer originated in another organ such as the pancreas or stomach and spreads (metastasises) to the liver
What are the risk factors for liver cancer?
- Chronic viral hepatitis (hepatitis B or C infections)
- Liver cirrhosis
- Heavy alcoholism
- Smoking
- Non-alcoholic fatty liver disease (for example, hemochromatosis)
- Long-term exposure to aflatoxins (produced by moulds that grow on crops such as peanuts, soybeans and wheat when they are improperly stored in moist and warm environments)
- Being exposed to toxins like vinyl chloride and thorium dioxide
- Certain inherited liver diseases
- Anabolic steroids (a synthetic version of testosterone sometimes used by athletes to improve performance and build muscles)
What are the ways to minimise the risk of liver cancer?
You can minimise the risk of liver cancer by –
- Testing and treating hepatitis B and C infections
- Hepatitis B vaccination (prevents long-standing hepatitis B viral infections)
- Limiting alcohol intake
- Avoiding smoking
- Maintaining a healthy weight
- Storing food grains and crops in dry and cool areas to limit exposure to aflatoxin and discarding food grains with mould
- Limiting exposure to cancer-causing chemicals
What are the symptoms of liver cancer?
In the early stages symptoms may be absent but, in later stages patients may present with the following symptoms –
- Weight loss
- Loss of appetite
- Nausea and vomiting
- Bloating
- Feeling full after small meals
- Stomach pain
- Fluid accumulation in the belly
- Yellowing of the skin (jaundice)
Why is the early diagnosis of liver cancer important?
Early diagnosis helps in treating liver cancer at early stages and the outcome of the treatment improves as a result. If the cancer is left undetected or untreated, it can affect major portions of the organ or spread to other parts of the body.
How is liver cancer diagnosed?
If you report to your physician with symptoms of liver cancer, you will be taken through the following steps to diagnose the condition –
- Health history and physical examination – Patient’s history of habits and past illnesses; a physical examination to evaluate the patient’s health status and signs of disease
- Blood tests – To evaluate the general health status and detect tumour markers
- Liver function tests – To know the status of liver functions
- Imaging (Ultrasound, CT, MRI, PET scans) – To evaluate the site and spread of cancer
- Biopsy – To obtain liver cells to confirm liver cancer and identify its type
What is staging of liver cancer and why is it done?
After diagnosis, liver cancer is staged according to the site of involvement, the size of cancer and its spread to nearby or distant sites in the body.
The most commonly followed staging system is called ‘TNM staging’ –
- T stands for the size of the cancerous growth
- N stands for the involvement of lymph nodes
- M stands for distant spread (metastasis)
Based on the T, N and M status, the liver cancer is staged from Stage I to Stage IV.Higher stages denote a more advanced disease. Staging is done to help plan the treatment and to predict patient outcomes.
What is the treatment for liver cancer?
The treatment of liver cancer is determined by the health status of the patient, the stage of the cancer, and the extent of its spread. The treatment options available include –
- Surgery
- Chemotherapy
- Radiotherapy
- Thermal ablation
- Targeted medicines
Can my liver cancer be cured by a liver transplant?
Liver transplantation as an option for treatment is considered if the cancer is detected early. This means that the tumour should be small and should not have spread to other parts of the body. In addition, the patient should be healthy without any significant heart or lung disease.
Can liver cancer recur after treatment?
Depending on the stage and extent of the liver cancer at the time of diagnosis and treatment, there are some chances of recurrence. Hence, it is important to continue with regular follow-ups, especially during the first two years. This helps in the early identification of any signs of recurrence so that your doctors can plan the further course of your treatment.
How long do I have to be under follow-up after my treatment for liver cancer?
Follow-up after treatment is necessary for monitoring the recurrence or spread of cancer and for assessing if there are any side effects to the treatment. Most doctors advise following up with imaging scans and blood tests every 3 to 6 months for the first 2 years, then every 6 to 12 months, if you have undergone surgery, a liver transplant, or ablation/embolization and there are no symptoms of cancer still present.