Liver cancer

What is liver cancer?

Liver cancer is an abnormal, uncontrolled growth of cells in the liver.
The liver is the largest internal organ of the body. It helps to regulate and store blood glucose (sugar). It helps get rid of drugs and toxins and produces important proteins. The liver also produces bile, which helps the body process fats and get rid of waste products.

There are two types of liver cancer: primary and secondary.

Primary liver cancer starts from the cells of the liver. The two most common forms of primary liver cancer are:

Hepatoma, which is often associated with cirrhosis and hepatitis B or C infections
Cholangiocarcinoma, a rare tumour developing in bile ducts cells.

Secondary liver cancer occurs when a cancer starts someplace else and spreads to the liver. A secondary liver tumour may not be found until it causes symptoms.

What is the cause?

Although the exact cause of liver cancer is not known, the contributing factors include:

Heavy alcohol drinking
Hepatitis B and C infections, cirrhosis, and other chronic liver ailments
Chronic liver disease
What are the symptoms?

Symptoms of liver cancer are:

Pain, especially in the abdominal area or around the right shoulder blade
Loss of weight
Loss of appetite
Pain or swelling in the abdomen
Jaundice (yellowing of the skin and whites of eyes)
How is the diagnosis made?

To diagnose liver cancer, the physician notes the symptoms, checks for weight loss, malnutrition, weakness, examines for enlargement of the liver and other signs. Certain tests required include:

Blood tests for anaemia and liver functions
Alpha-fetoprotein level (a protein that sometimes occurs in the blood when liver cancer is present)
Ultrasound exam of the liver
CT scan
Hepatic artery angiogram (a process in which a local anaesthetic is given and the person is injected with a dye-like substance; a series of x-ray pictures are then taken and examined for signs of any abnormal growths in the liver)
Biopsy (a procedure in which a local anaesthetic is given and then a small sample of tissue from the liver is obtained through the skin with a hollow needle)
What is the treatment?

The treatment depends on the stage of the disease and whether it is primary or secondary liver cancer.

The following may be recommended:
Surgery to remove all the tumour along with a part of the liver
Anti-cancer drugs (chemotherapy).
If a liver tumour (hepatoma) is detected at an early stage, surgery may result in a cure if there is no cirrhosis. However, surgery may not be a good option if the tumour is large or if the liver is not working well or if there is cirrhosis. Chemotherapy does not cure the cancer, but it may shrink the tumour. This helps prevent some symptoms, including pain. Another possible treatment is hyperthermia therapy, which uses heat to kill cancer cells.

The effects of liver cancer vary depending on the stage at which the tumour is detected and when treatment begins. Age and physical condition of the patient are also important because some treatments are not recommended for the elderly. They may get infections more easily because chemotherapy can lower the body's resistance. The more the cancer has spread before diagnosis, the less are the chances for cure. Survival after diagnosis is often only several months but may be longer.

How can it be prevented from spreading or recurring?

This can be achieved by following these guidelines:

Consult the doctor if a return of any previous symptoms is noticed
Avoid alcoholic drinks
Eat small, frequent, well-balanced meals throughout the day. Take vitamin and mineral supplements with iron, folic acid, and thiamine, if recommended by the doctor
Make sure that restaurants and grocery stores where you buy food, and areas where you prepare food, are safe and clean
Exercise according to your doctor's recommendation and observe good health practices
Do not use illegal drugs
What are the complications?

Gastrointestinal bleeding
Liver failure
Spread (metastasis) of the carcinoma