Liver Cancer

Liver Cancer

Liver Cancer

What is Liver Cancer?

An abnormal growth of cells that starts invading the normal cells around it is called Cancer. When these abnormal tumor cells are present in the livers, they lead to liver cancer. These are malignant tumours. Cancer cells can also cause benign tumors sometimes grow large enough to cause problems, but they do not grow into nearby tissues or spread to distant parts of the body. The patient can usually be cured with surgery.

Anatomy of Liver

liver cancer

Copyright © Terese Winslow, U.S. Govt, The above image is used for educational purpose only.

What are the general symptoms of Liver Cancer?

Though the symptoms for Liver Cancer usually don’t appear before a later stage, sometimes they may show up earlier. This would help in early diagnosis, when treatment is most likely to be helpful.

SYMPTOMS

  • Unintentional weight loss
  • Loss of appetite
  • Feeling very full after a small meal
  • Nausea or vomiting
  • An enlarged liver
  • An enlarged spleen
  • Pain in the abdomen or near the right shoulder blade
  • Swelling or fluid build-up in the abdomen
  • Itching
  • Yellowing of the skin and eyes (jaundice)

OTHER SYMPTOMS

  • Fever
  • Enlarged veins on the stomach that can be seen through the skin
  • Abnormal bruising or bleeding.

These signs and symptoms of liver cancer can also be caused by other conditions, including other liver problems. However, it's important to get it checked so that the cause can be treated!

What are the general causes of Liver cancer?

Some of the causes and risk-factors for liver Cancer include:

  • Gender: Hepato-cellular carcinoma is much more common in males than in females.
  • Race/ethnicity
  • Chronic viral hepatitis : The most common risk factor for liver cancer is chronic (long-term) infection with hepatitis B virus (HBV) or hepatitis C virus (HCV).
  • Cirrhosis: Cirrhosis is a disease in which liver cells become damaged and are replaced by scar tissue.
  • Heavy alcohol use
  • Obesity
  • Type 2 diabetes
  • Inherited metabolic diseases
  • Aflatoxins
  • Anabolic steroids
  • Arsenic in water
  • Infection with parasites
  • Tobacco use
Can Liver Cancer be prevented?

Most liver cancers can be prevented by decreasing a person’s exposure to the risk factors listed under the “Causes” section.

  • Avoiding and treating hepatitis infections – Having sex with someone who already has it, having multiple sex partners, visiting a country where Hepatitis is common, being born to a mother who has HBV can make you prone to the Hepatitis virus and hence, Liver Cancer.
  • Limiting alcohol and tobacco use
  • Getting to and staying at a healthy weight
  • Limiting exposure to cancer-causing chemicals- Such as aflatoxins, arsenic and so on.

Also,  inherited diseases can cause cirrhosis of the liver, increasing a person’s risk for liver cancer. It’s always best to see if you have a natural risk factor for liver cancer in your genes.

What are the stages of liver cancer?

Cancer has different stages, each depicted by a Roman numeral from 1 to 4 (I, II, III and IV). Stage I is the first stage where the tumor is still small while at Stage IV, the patient’s condition is said to be critical because the tumor has spread to other organs of the body. Hence, a cancer’s stage refers to the tumor’s size and extent of spread. This is the simplest form of staging.

In liver cancer, the stage depends on whether it is confined to livers (localized cancer, Stage I) or whether it has spread to other organs (metastatic cancer).

The stage decides the kind of treatment you need to get. The greater the stage number, the more complex the treatment.

 

Survival rates of Liver Cancer?

Needless to say, if the liver cancer is detected while it is still in Stage I, survival rate is higher. The rate decreases progressively with the increase in stage. Stage III is considered critical, while stage IV is, more often than not, fatal.

“For all stages combined, the relative 5-year survival rate from liver cancer is about 15%. Part of the reason for this low survival rate is that most patients with liver cancer also have other liver problems such as cirrhosis, which itself can be fatal.

In general, survival rates are higher for people who can have surgery to remove their cancer, regardless of the stage.” – cancer.org

Can liver Cancer be detected early?

Your medical history and a physical exam to check for risk factors can help determine, to some extent, whether you have or are prone to liver cancer.

If symptoms and/or the results of the physical exam suggest you might have liver cancer, other tests will probably be done.

IMAGING TESTS

These include:

  • Ultrasound
  • CT Scan
  • Magnetic resonance imaging (MRI)
  • Angiography
  • Bone scan

OTHER TESTS AND PROCEDURES

If the medical professional believes that you have cancer but the Imaging tests have proved to be inconclusive, he or she may suggest other tests as well:

  • Laparoscopy
  • Biopsy

LAB TESTS

These may be done to detect cancer, review your health during and post-treatment and so on.

  • Alpha-fetoprotein blood (AFP) test -Levels in the blood of adults can signify liver disease, liver cancer, or other cancers.
  • Other blood tests
  • Liver function tests (LFTs)
  • Blood clotting tests
  • Tests for viral hepatitis
  • Kidney function tests
  • Complete blood count (CBC)
  • Blood chemistry tests and other tests
What are the Treatments available?

Liver cancers may be categorized as: potentially resectable or transplantable, unresectable, inoperable with only local disease, and advanced. There are different treatments for different stages.

POTENTIALLY RESECTABLE OR TRANSPLANTABLE LIVER CANCER

Potentially resectable: If a cancer is at an early stage (stage I and some stage II) and the rest of the liver is healthy, Surgery would be good option.
Potentially transplantable: Doctors resort to liver transplants if the cancer is at an early stage but the rest of the liver is not healthy, or if the tumour is embedded deep in the liver.

UNRESECTABLE LIVER CANCER

These haven’t extended to lymph nodes or distant sites. However, they can’t be removed safely by surgery because

  • The tumor is too large
  • The tumor is in a part of the liver that makes it hard to remove
  • There are several tumors or the cancer has spread throughout the liver

Treatment options include

  • Ablation,
  • Embolization
  • Targeted therapy
  • Chemotherapy
  • Radiation therapy

Sometimes, the treatment may shrink the tumor enough so that surgery is possible again.
These treatments won’t cure the cancer, but they can reduce symptoms and may even help you live longer.

INOPERABLE WITH ONLY LOCAL DISEASE

Sometimes, the patient isn’t healthy enough to be operated on. In such cases there are other treatments available:

  • Ablation,
  • Embolization
  • Targeted therapy
  • Chemotherapy
  • Radiation therapy

ADVANCED (METASTATIC) LIVER CANCERS

These cannot be treated with surgery due to the extent to which they have spread.
Clinical trials of targeted therapies, chemotherapy , radiation therapy, and other new treatments may help.

Recurrent liver cancer

Cancer that comes back after treatment is called recurrent. These can be small, localized ones or widespread. Treatment will depend on the state and stage of the recurring cancer.

How frequently should one visit doctor for early diagnosis?

If you have any of the symptoms, please do visit the doctor.

How can I as a patient know it early?

If you feel any of the symptoms mentioned in the Symptoms section , you should probably visit a doctor. You can also get your genetic make-up checked to see if you are prone to liver cancer or not.

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