Are you feeling full even after a small meal? Have swelling in the abdomen?… Get yourself checked for liver cancer!

When Derek lost his appetite and lost weight, he contacted his physician and underwent investigations. Soon, he was diagnosed with liver cancer.

Life can unexpectedly throw any curveball; hence, it is essential to have a basic knowledge about cancers to be detected and treated early for a better outcome. October is a liver cancer awareness month; here is something you need to know about liver cancer.

What is liver cancer¹?

Liver cancer is cancer that begins in the cells of the liver. Liver cancer can be of different types. The most common type of liver cancer is hepatocellular carcinoma, which starts in the main type of liver cell. Other types of liver cancer are intrahepatic cholangiocarcinoma and hepatoblastoma, which are less common. Cancer that spreads to the liver is more common than cancer that begins in the liver.

More than 800,000 people are diagnosed with liver cancer every year worldwide, and it is the leading cause of cancer death worldwide, accounting for more than 700,000 deaths each year.²

Signs and Symptoms³

Having one or more of the following symptoms may not necessarily indicate the presence of liver cancer, but having these symptoms needs to be adequately investigated to rule out liver cancer

The common symptoms are:

• Unexplained weight loss
• Loss of appetite
• Feeling full after a small meal
• Nausea or vomiting
• Fullness under the ribs on the right side (enlarged liver)
• Fullness under the ribs on the left side (enlarged spleen)
• Pain in the abdomen (belly) or near the right shoulder blade
• Swelling or fluid buildup in the abdomen
• Itching
• Yellowing of the skin and eyes
• Fever
• Enlarged veins on the belly that can be seen through the skin
• Abnormal bruising or bleeding

Causes⁴

The exact cause of liver cancer is unknown but is believed to be associated with an abnormal change in the genetic material (mutation). DNA mutations causing the activation of oncogenes and inactivation of tumor suppressor genes can lead to cancer. Also, certain chemicals like aflatoxin can damage the DNA in the liver cells. Hepatitis viruses are also responsible for liver cancer when they get inside the DNA of the cell in the liver and turn on the cell’s oncogenes.

Diagnosis⁵

Liver cancer can be diagnosed by:
Blood tests – Liver function abnormalities can be detected by blood tests.

Imaging tests – Ultrasound and CT scans are recommended.

Biopsy – A sample of liver tissue is removed and sent to the laboratory for testing for a definitive diagnosis of liver cancer. During a liver biopsy, a thin needle is inserted through the skin and into the liver to obtain a tissue sample examined under a microscope for cancer cells. Liver biopsy carries a risk for bleeding, bruising, and infection.

Stages⁶

After a positive diagnosis, the next step is identifying the stages of liver cancer. This is determined based on how far the cancer has spread. Several staging systems are used for liver cancer by different doctors and hospitals such as The Barcelona Clinic Liver Cancer (BCLC). This system is based on the assessing the following factors:

• The spread of cancer – Is it within the liver or has it spread to the other parts of the body.
• The health of the liver – How well is it functioning
• Overall health of the patient – Is the patient otherwise healthy?
• Symptoms – What are the symptoms?

The BCLC staging system has five stages:

• Stage 0 – Very early
• Stage A – Early
• Stage B – Immediate
• Stage C – Advanced
• Stage D – End stage

For liver cancer in adults, stages are also grouped according to how cancer may be treated.

It localized liver cancer that has not spread outside the liver and can be removed by surgery. This includes BCLC stages 0, A, and B.

Locally advanced liver cancer that has not spread from the liver to distant parts of the body but cannot be safely removed by surgery. This includes BCLC stage C.

Metastatic liver cancer has spread from the liver to distant parts of the body. This cannot be entirely removed by surgery and includes BCLC stage D.

Recurrent liver cancer is cancer that reappears after treatment. This cancer can occur in the liver or other parts of the body.

Treatment⁷

Liver cancer can be treated based on the cancer stage and the liver’s health. The treatment options are:

Surgery – These are of two types. Partial hepatectomy involves only a part of the liver, including the tumor and some healthy cells surrounding the tumor. The second type of surgery is a liver transplant.

Ablation is a treatment option wherein tumors are destroyed without removing them. There are different types of ablation, such as Radiofrequency ablation. Microwave ablation, Percutaneous ethanol injection, and Cryoablation.

Embolization involves cutting off blood supply to the tumor in the liver. Without the blood supply, the tumor will slowly die and shrink.

Radiation therapy – In this therapy, high-energy particles are targeted at the cancer cells to kill them. It is a painless and non-invasive procedure similar to an X-ray but more intense.

Targeted drug therapy is a comparatively new form of treatment where medication, such as Kinase inhibitors and monoclonal antibodies, are introduced into the bloodstream.

Immunotherapy involves administering medicine through an IV to help the body recognize and attack cancer cells.

Chemotherapy involves taking medication into the blood vessels to kill cancer cells.

Preventive Measures⁸

It involves taking care of its risk factors such as:

Preventing Hepatitis B and Hepatitis C virus – People who have blood transfusions are at significant risk for contracting the virus.

Avoid alcohol and tobacco use – Alcohol and smoking put the individual at a greater risk for cancer.

Avoid Obesity – Obese people have fatty livers and suffer from diabetes, both of which are linked to liver cancer.

Limit exposure to cancer-causing chemicals – Exposure to cancer-causing chemicals such as aflatoxins puts an individual at a greater risk for cancer.

Quellen:

1. Liver cancer – Symptoms and causes – Mayo Clinic
2. Key Statistics About Liver Cancer
3. Signs and Symptoms of Liver Cancer
4. What Is the Main Cause of Liver Cancer? 10 Risks and 3 Types (medicinenet.com)
5. Liver cancer – Diagnosis and treatment – Mayo Clinic
6. Liver Cancer Stages – NCI
7. Liver cancer treatment options: Types, stages, and more (medicalnewstoday.com)
8. Can Liver Cancer Be Prevented?