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Cancer is a disease caused by unrestrained growth of abnormal cells. There are more than 100 types of cancer, involving various parts of the body. Cancer can affect any part of the body. Liver is the largest and the heaviest organ in the human body. Liver sits in the upper right part of the abdomen below the rib cage. The average weight of the liver is 1.5 kilograms in average adult human. Liver performs many different functions such as- filtration of blood, metabolism of carbohydrates, proteins, fats, hormones and other chemicals, formation of bile and coagulation factors and last but not the least storage of vitamins and iron. Liver Cancer is a type of cancer involving different parts of the liver. It is the second most common cause of death from cancer worldwide. So, one must know about the Liver Cancer.
Liver cancer can be basically of two types. In one type, the origin of cancer is within the liver, known as primary Liver cancer. In the second type, basically it is a cancer involving another part of the body such as lung, breast etc and the spread of the cancer involves the liver secondarily, also known as metastatic cancer. Liver cancer is the fifth most common cancer in men and ninth most common cancer in women worldwide.
Hepatocellular carcinoma is the most common type of liver cancer worldwide. This type of liver cancer involves the main liver cells that is hepatocytes. Other types are less common in occurrence. Liver cancer has a low survival rate and very poor prognosis. To prevent this dangerous disease or to get its treatment at the earliest, let’s take a look at various symptoms, causes, stages and treatment modalities of liver cancer.
Symptoms of Liver Cancer
In the early stages of the liver cancer, most people do not experience problem. When the symptoms appear, it is usually the advance stage of it. The various symptoms of liver cancer are-
Pain in the upper right part of the abdomen is the most common and usually the first complaint. It may be accompanied with swelling of the abdomen.
2. Loss of Appetite
One- quarter to one- third of the patients experience early satiety or loss of appetite with weight loss.
3. Weight Loss
Loss of weight occurs without trying or despite of taking proper food. Weight loss causes weakness and fatigue.
Yellow discoloration of the skin and white portion of the eyes occur in jaundice. It occurs due to increased amounts of bilirubin in the blood due to the disease process. Jaundice is usually slight in early stages and aggravates with progress of the disease.
5. Vomiting of blood
The vomiting of the blood is a serious condition and indicates possible underlying serious illness.
6. Enlargement of Liver
More than 90% of patients experience enlarged liver. Cirrhosis patients usually show enlargement of liver.
Mild to moderate fever can also be a symptom, especially in cirrhosis patients.
Stages of Liver Cancer
Staging of a cancer is determined on the basis of the size of the tumour, involvement of other organs and spread of the tumour. It helps in deciding the treatment modality. It also indicates prognosis to a certain extent. The stages of Liver cancer are as follows:
Stage I- Less than 50% of the liver is involved and the tumour is confined within the liver. The median survival by this stage is 11 months.
Stage II- It is moderately advanced stage of liver cancer. In this stage either the tumour size is large or multiple small sized tumours are present with or without the tumour spread to blood vessel. The median survival by this stage is 3 months.
Stage III- This advance stage of liver cancer involves either a very large tumour or multiple tumours of small size with tumour spread to blood vessel and lymph nodes. The median survival by this stage is approximately 1 month.
Stage IV- It is the very advanced stage of liver cancer. The tumour has already spread to the other parts of the body. Prognosis of this stage is very poor with very less survival time.
The treatment modality is decided after the determination of the stage of cancer.
Causes of Liver Cancer
The exact cause of the liver cancer is unknown. There are many possible risk factors and diseases which lead to development of this cancer. Hepatitis, cirrhosis etc are the common risk factors. These risk factors lead to changes in the liver cells and ultimately uncontrolled growth of these cells occurs. Various risk factors of this cancer are as follows:
1. Hepatitis B virus Infection
Chronic or long term infection with hepatitis B virus has been an established risk factor for primary liver cancer. Persons having long term infection with hepatitis B, are at almost 100 times greater risk of developing this cancer than others. Hepatitis B virus infection causes liver damage. Therefore, those who have this infection are at increased risk of developing this cancer.
2. Hepatitis C virus Infection
Similar to the hepatitis B virus infection, hepatitis C virus can also lead to long term infection, liver damage and ultimately cancer but the chances are less than that of the hepatitis B virus. From infection with hepatitis C virus to the development of liver cancer, it usually take approximately 30 years. The risk is more in aged persons.
The majority of liver cancer cases associated with Hepatitis B and C virus infection are also associated with liver cirrhosis. Thus, not only one factor alone causes this cancer, but also there are multiple factors which in together causes it.
3. Alcohol and Cirrhosis
Cirrhosis from virus infections or non- viral causes such as- alcohol etc is associated with increased risk of liver cancer. Alcohol consumption, even at moderate levels is associated with increased risk of hepatitis C infection. Damage to liver cells due to alcohol along with concomitant hepatitis C infection causes liver cancer.
4. Iron Overload
As liver is the storage site of iron, iron overload can also occur. Some hereditary diseases such as- Hemochromatosis cause iron overload. This iron overload causes risk of developing liver cancer, if untreated. Iron depletion therapy reduces the iron overload.
Aflatoxins are toxic products of some species of fungi, Aspergillus. Consumption of food contaminated with aflatoxins increase the risk of developing liver cancer. Foods susceptible to this infection are- groundnuts, corn, oil seeds and nuts, such as cottonseed, almonds, and pistachios.
6. Oral Contraceptives
Oral contraceptives also increase the risk of liver cancer.
7. Other Risk factors
Smoking, workers exposed to Arsenic, diabetes, non-alcoholic fatty liver are also the risks to develop liver cancer.
Treatment of Liver Cancer
A well-known proverb “Prevention is better than Cure”, everyone must know and also follow in their life. Prevention of Hepatitis B and C virus infections are the most effective ways of preventing liver cancer. A safe and effective vaccine for preventing Hepatitis B infection is available since 1982. Vaccination in early childhood is helpful in preventing this serious infection. Prevention of hepatitis C infection is more difficult, as no known vaccine is available for it. To prevent hepatitis C infection, one must know the health status of sexual partner and should not use infected needles such as for intravenous drugs, piercing and tattoos.
Early detection and removal of small tumours also lead to better prognosis. Various vitamins such as Vitamin A compounds also reduce the risk of liver cancer. Avoiding alcohol consumption or less consumption will reduce the chances of developing cirrhosis and also liver cancer.
The treatment of liver cancer involves surgery, chemotherapy, radiotherapy and liver transplant etc.
The diseased part along with some healthy margins are removed in surgery. Healthy margins are removed to prevent recurrence of the disease. Surgery depends upon the remaining healthy part of the liver, as its functions are important. Liver cancer associated with cirrhosis has a bad impact on surgery. As because the remaining part which is not involved with cancer is also not healthy. So, after surgery there should be some amount of healthy liver tissue to perform its necessary functions.
Complete removal of the liver with transplantation is another treatment option.
Chemotherapy is an adjuvant therapy to surgery. Anti- cancer drugs kill the cancer cells and prevent their proliferation.
Radiation kills the cancer cells. Due to low liver tolerance, radiation therapy has a limited use.
If the tumour involves most of the liver, then complete liver is removed and liver transplantation is done. Transplantation of liver is also a very risky and complicated procedure. The immune system of the body may reject the new transplanted liver as foreign body. Medicines suppressing the immune system prevent rejection of the new organ.
Liver is a very important organ of human body and involved in many necessary functions. Liver cancer is a very serious disease with very poor prognosis. Viral infections such as Hepatitis B and C, alcohol consumption are some of the important risk factors. So, to avoid this serious disease one must know the risk factors and should take proper preventive measures. Although many treatment modalities are available, but they have their own limitations and various complications. So, one must know about the liver cancer, the causes, symptoms, preventive measures and the various treatment options.