World Liver Day 2015: All you need to know about Liver Cancer

Dr Suresh Singhvi

Primary liver cancer is a serious type of cancer that begins in the liver. Secondary cancer of the liver is one where in the tumor elsewhere (eg. Colon) spreads to the liver.

Signs and symptoms

Symptoms of liver cancer are often vague and don't appear until the cancer is at an advanced stage. They can include:

• unexplained weight loss
• loss of appetite
• feeling very full after eating, even if the meal was small
• feeling sick and vomiting
• pain or swelling in your abdomen.
• jaundice(yellowing of your skin and the whites of your eyes)
• itchy skin
• feeling very tired and weak

Visit your doctor if you notice any of the symptoms listed above. Although they are more likely to be the result of a more common condition, such as       an infection, it's best to have them checked.

You should also contact your doctor if you have previously been diagnosed with a condition known to affect the liver, such as cirrhosis or a hepatitis B   or C infection, and your health suddenly deteriorates.

​What causes liver cancer?

The exact cause of liver cancer is unknown, but most cases are associated with damage and scarring of the liver known as cirrhosis.

Cirrhosis can have a number of different causes, including drinking excessive amounts of alcohol over many years and having a long-term hepatitis B or hepatitis C viral infection.

It is also believed that obesity and an unhealthy diet can increase the risk of liver cancer because this can lead to non-alcoholic fatty liver disease. In some individuals the liver cancer arises without any predisposing risk factors and these patients present at a very late stage. Hence it is important not to ignore early symptoms and to be investigated by a specialist doctor, to give treatment at an early stage.

By avoiding or cutting down on alcohol, eating healthily and exercising regularly, and taking steps to reduce your risk of becoming infected with hepatitis B and C, you may be able to significantly reduce your chances of developing liver cancer.

Who is affected?

Being a common type of cancer in India, the chances of developing the condition is high for people with risk factors for the condition.

The number of people affected by liver cancer rises sharply with age, with around 8 in every 10 cases diagnosed in people aged 60 or older, although it also affects many people younger than this. Around two in every three cases affect men.

Over the past few decades, rates of liver cancer in India have raised considerably, possibly as a result of increased levels of alcohol intake, obesity and Hepatitis B/Hepatitis C infection.

Diagnosis and screening

Liver cancer is usually diagnosed after a consultation with the family physician and a referral to a hospital specialist for further tests, such as scans of your liver.

However, regular check-ups for liver cancer (known as surveillance) are often recommended for people known to have a high risk of developing the condition, such as those with cirrhosis.

Having regular check-ups help ensure the condition is diagnosed early. The earlier liver cancer is diagnosed, the more effective treatment is likely to be.

How liver cancer is treated

Treatment for liver cancer (primary or secondary) depends on the stage the condition is at. If diagnosed and depending on the stage, it may be possible to remove the cancer completely.

Treatment options in the different stages of liver cancer include:

• Surgical resection – surgery to remove a section of liver. The best chance of cure is by removing the tumor completely and gives good survival chances to the patient.
• Liver transplant – where the liver is replaced with a donor liver
• Microwave or radiofrequency ablation – where microwaves or radio waves are used to destroy the cancerous cells
• Targeted Chemotherapy and Radiotherapy

However, only a small proportion of liver cancers are diagnosed at a stage where these treatments are suitable. Most people are diagnosed when the cancer has spread too far to be removed or completely destroyed the liver. Hence, it is important to see a specialist Liver surgeon to get the best results for the patient.

In these cases, treatments such as chemotherapy will be used to slow down the spread of the cancer and relieve symptoms such as pain and discomfort.

The Liver also has other structures close to it and being part of it- that includes Gall bladder and Bile ducts (tubes that drain the bile from the liver into the intestines, which then help the digestion). Primary cancers can also arise from these organs too. The procedure of removing these cancers requires expertise and infrastructure to give good results to the patients.

(Dr Suresh Singhvi is a Senior Consultant Liver transplant Surgeon with Sir Ganga Ram Hospital, New Delhi. Website: www.liverdiseaseindia.com)

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