Liver Cancer: A Comprehensive Guide to Understanding the Disease

What is Liver Cancer?

A cancer that affects the liver is called liver cancer, sometimes referred to as hepatic cancer. Cancer in the liver destroys liver cells & interferes with its ability to function normally.

Cancer is when unhealthy cells begin to divide and grow uncontrollably to form a malignant growth or tumour. These cells can metastasise and spread to other body parts.

What are the functions of the liver?

The liver is a significant organ that performs several significant functions in the human body, including:

• It metabolises carbohydrates, proteins, and fats, regulating blood sugar levels and energy storage.
• The liver detoxifies the bloodstream by processing and eliminating toxins and drugs.
• The liver produces bile juice, which aids in fat digestion and waste removal.
• It stores essential nutrients, vitamins, and glycogen. The liver synthesises clotting factors, preventing excessive bleeding, and supports the immune system by removing bacteria and toxins.
• It regulates hormones, cholesterol, and blood sugar levels, impacting overall health. In summary, the liver’s diverse functions are essential for general well-being.

Types of liver cancer:

Liver cancer may be primary or secondary. Primary cancer originates in the liver cells, and secondary cancer is transmitted to the liver from another organ.

There are various types of liver cancer:

• Hepatocellular Carcinoma (HCC) is a prevalent liver cancer, with almost 75% of all liver cancer cases. HCC is also known as Hepatoma & it is common in individuals with severe liver damage due to excessive alcohol consumption.
• Bile Duct Cancer or Cholangiocarcinoma develops in the bile ducts in the liver. Approximately 10-20% of all liver cancers are Bile Duct Cancer.
• Angiosarcoma is a cancer that occurs in the inner layer of blood vessels and lymph vessels.
• Hepatoblastoma is a very rare form of liver cancer primarily found in children below the age of 3. If detected early, the chances of survival are very high.

What are the symptoms and signs that indicate liver cancer?

Liver cancer manifests the following symptoms:

• Jaundice
• Fatigue
• Fever
• Abdominal Pain
• Nausea and vomiting
• Loss of appetite
• Abdominal swelling
• Weight loss
• Enlarged liver, spleen, or both
• Fluid buildup on the abdomen
• A lump down the rib cage on the right side
• Discomfort in the back or close to the right shoulder blade

When should I see a doctor?

Schedule an appointment with your general practitioner if you have any bothersome, unexplained symptoms. The physician might suggest a few diagnostic tests to rule out liver cancer in addition to other medical issues. If the tumour is confirmed, you will be referred to an oncologist for liver cancer treatment.

What causes liver cancer?

Liver cancer occurs when the DNA present in the liver cells goes through changes or mutations. Occasionally, it occurs due to chronic hepatitis infections. Liver cancer can also happen without underlying diseases and an unknown cause.

What are liver cancer risk factors?

These are the common risk factors for liver cancer:

• Prolonged hepatitis B or C infection
• Smoking tobacco
• Type 2 diabetes
• Genetic factors
• Exposure to harmful chemicals
• Excess alcohol consumption
• Obesity
• Liver Cirrhosis
• Nonalcoholic fatty liver disease
• Consuming foods that have aflatoxin

How to prevent liver cancer?

The preventive measures for liver cancer are:

• Healthy weight
• Hepatitis B vaccination
• Test yourself for hepatitis C and get treated for it.
• Stop smoking
• Avoid drinking excess alcohol
• Eat a nutritious food

How is liver cancer diagnosed?

Liver cancer is diagnosed through various methods, including:

• Physical examination and medical history: A patient’s medical history and physical exam check, such as signs of disease, lumps, or anything unusual.
• Blood tests: Liver function abnormalities can be detected through blood tests, e.g., liver function tests.
• Imaging tests:
• Ultrasound scan- An ultrasound helps to diagnose primary liver cancer. It can locate abnormal tissue in your liver.
• Computed tomography (CT) – If an ultrasound reveals any liver abnormality, your doctor may recommend a CT scan. An abdominal CT scan can detect many types of liver tumours and find out if it has spread to other organs.
• Magnetic resonance imaging (MRI) – MRI scans help inspect liver tumours. Additionally, MRI can be used to look for obstructions in the blood vessels in and around the liver and determine whether liver cancer has spread to other areas of the body.
• PET-CT scan – This diagnostic imaging test plays a vital role in detecting and monitoring liver cancer. It assists in detecting and identifying the type and stage of liver cancer.
• Liver Biopsy – During a biopsy, tissues or cells are taken out to be examined under a microscope for cancer indications.

For liver cancer diagnosis, a liver biopsy is not always necessary. Based on the findings of imaging tests like CT and MRI scans, physicians can make the diagnosis of liver cancer.

Liver Cancer Staging:

• Very early stage – The tumour is smaller than 2 cm. Bilirubin levels are normal. Surgery is usually recommended.
• Early stage – The tumour measures less than 5cm, and the liver function varies.
• Intermediate stage – There are possibilities of a large tumour or multiple tumours.
• Advanced stage – Other parts of the body, such as lymph nodes, lungs, and bones, have been metastasised by the tumour.

What are the treatments for liver cancer?

The various treatment methods are as follows:

• Ablation Therapy: Radiofrequency ablation (RFA) or microwave ablation employs heat to eliminate cancerous tissue in the liver. These techniques are usually reserved for small tumours or patients who can’t have surgery.
• Radiation therapy: If surgery is not possible, the doctor may recommend selective internal radiation therapy (SIRT) or radio-embolisation.
• TACE – Trans arterial chemoembolisation: The tumour receives chemotherapy drugs and unique materials injected into the blood vessel during the procedure. This helps to block the blood supply to the cancerous tumour and trap the chemotherapy drugs inside it.
• Surgery:
• Surgical resection: A section of the liver containing the tumour may be surgically removed if it is limited to one area and there is enough healthy liver tissue.
• Liver transplant surgery: A liver transplant replaces the patient’s entire liver with a healthy donor liver in certain cases of early-stage liver cancer without cirrhosis.
• Target therapy: Specialised drugs that only target tumours or cancerous cells while leaving healthy cells unaffected are administered to the patient’s body.
• Immunotherapy: Immunotherapy boosts your immune system’s capacity to combat cancer cells, utilising the body’s natural defences against the disease. An immune checkpoint inhibitor is a frequent form of immunotherapy. Immune checkpoint drugs function by obstructing the immune system-evading pathways the malignancy would otherwise use to conceal itself.
• Freezing Cancer Cells: Extreme cold is used in cryoablation, a minimally invasive interventional radiology treatment, to freeze and kill abnormal malignant and precancerous cells. This is a successful cancer outpatient treatment because applying cold to tumour cells stops them from growing or spreading.
• Heating Cancer Cells: Electric current is used to burn and kill cancer cells during a process known as radiofrequency ablation. It’s also known as hyperthermia treatment for cancer.
• Alcohol injection: During an alcohol injection, either intraoperatively or through the skin, pure alcohol is administered directly into tumours. Alcohol causes the tumour’s cells to dry out and ultimately die.

FAQS:

1.Is liver cancer hereditary?

If there is a family history of liver cancer, an individual’s chance of getting liver cancer rises.

2.Is liver cancer painful?

An enlarged stomach can make you feel uncomfortable or painful, cause a loss of appetite, or quickly feel full.

Your right shoulder may hurt if your liver is enlarged and swollen. This occurs due to the enlarged liver stimulating nerves that link to shoulder nerves. It’s known as referred pain.

3.What is hepatitis C infection?

The hepatitis C virus is responsible for the liver-related viral disease known as hepatitis C. It can be a mild illness lasting only a few weeks or a chronic infection lasting longer.

4.Is it mandatory to take a hepatitis B vaccination?

It is recommended to get a hepatitis B vaccination as it will protect you against severe hepatitis B infection.

5.Can one prevent liver cancer?

Taking the hepatitis B vaccine, avoiding excessive alcohol use, eating a healthy diet, staying away from toxins, and scheduling routine liver exams if your liver health is at risk are all preventive measures.

6.Which risk factors are commonly associated with liver cancer?

The prevalent risk factors for liver cancer are excess alcohol consumption, obesity, smoking tobacco, type 2 diabetes, and chronic hepatitis B or C infection.

7.How to diagnose liver cancer?

An abdomen ultrasound scan, CT scan, MRI scan, PET-CT scan, and liver biopsy can diagnose liver cancer.

8.What is the liver cancer prognosis?

The cancer patient’s overall health, the stage of the disease at diagnosis, and other variables all affect the prognosis. Early detection and proper care lead to successful treatment options.

9.Which doctor specialises in liver cancer treatment?

Medical professionals like oncologists, hepatologists, or gastroenterologists treat liver tumours.

10. Cancer care at Omega Hospitals

Omega Hospitals comprises top oncologists, hepatologists, and gastroenterologists in India who are highly experienced and skilled in delivering patients with the best medical care possible, showing empathy and consideration. The specialists treat liver tumours using a multidisciplinary approach that involves active participation from other medical specialists to treat the illness and promote a speedy recovery.

References:

https://www.healthdirect.gov.au/liver-cancer#treated

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561392/

https://www.cancer.org.au/cancer-information/types-of-cancer/liver-cancer

https://www.cancerresearchuk.org/about-cancer/liver-cancer/treatment