Alale is the most powerfull center in medical tourism - All you need to Know about Liver Cancer

Liver cancer, also known as hepatic cancer, is a cancer which starts in the liver, rather than migrating to the liver from another organ or section of the body. In other words, it is a primary liver cancer.

Cancers that originate elsewhere and eventually reach the liver are known as liver metastasis or secondary liver cancers, and are most commonly from cancer of the gastrointestinal (GI) tract (colon cancer), lung cancer, renal cancer (cancer of the kidney), ovarian cancer and prostate cancer.

The liver, which is located below the right lung and under the ribcage is one of the largest organs of the human body. It is divided into the right and left lobes. Nutrient-rich blood is carried by the portal vein from the intestines to the liver, while oxygen-rich blood reaches the liver from the hepatic artery.

• The liver is a large and vital organ in all mammals
• Hepatocellular carcinoma is the most common type of liver cancer
• Liver cancer effects around 30 people per 100,000
• One of the major risk factors is excess alcohol intake
• Symptoms generally do not appear until the cancer is advanced
• Diabetes and hepatitis are risk factors for liver cancer
• Diagnosis can be made in a number of ways, including biopsy and blood tests
• Treatment options for liver cancer include surgery and liver transplant
• Cutting down alcohol intake can help reduce the chances of liver cancer.

Symptom

Most people don't have signs and symptoms in the early stages of primary liver cancer. When signs and symptoms do appear, they may include:

• Losing weight without trying
• Loss of appetite
• Upper abdominal pain
• Nausea and vomiting
• General weakness and fatigue
• Abdominal swelling
• Yellow discoloration of your skin and the whites of your eyes (jaundice)
• White, chalky stools

Associated Factors

In the absence of chronic liver disease liver cancer is rare. However, in patients with underlying liver disease, liver cancer may be quite common. The exact cause of liver cancer is not known. Scientists have identified many risk factors that can make someone more likely to develop liver cancer:  

• Among those with chronic liver disease, men are more likely to develop liver cancer than are women. The reason for this is unknown.
• Viral infection of the liver: Chronic infection with either hepatitis B or hepatitis C may lead to the development of cancer.
• Certain types of inherited liver disease such as hemochromatosis, which results in accumulation of too much iron in the liver, as well as alpha-1 antitrypsin deficiency, and tyrosinemia can lead to the development of liver cancer later in life.
• Cirrhosis is the formation of scar tissue in the liver. This can often lead to cancer. Major causes of liver cirrhosis are alcohol use, chronic hepatitis B and C, and non-alcoholic steatohepatitis (NASH). Most causes of cirrhosis are also associated with the development of liver cancer.
• Alcohol: excessive alcohol use is a known risk factor for development of alcoholic cirrhosis and liver cancer.
• Obesity increases the risk of liver cancer in those patients in whom it causes liver disease.
• Tobacco use increases the risk of liver cancer if you already have chronic liver disease.
• Anabolic steroids: long-term use of anabolic steroids can increase the risk of liver cancer.

Diagnosis

Tests and procedures used to diagnose liver cancer include:

• Blood tests. Blood tests may reveal liver function abnormalities.
• Imaging tests. Your doctor may recommend imaging tests, such as an ultrasound, computerized tomography (CT) scan and magnetic resonance imaging (MRI).

• Removing a sample of liver tissue for testing. Your doctor may recommend removing a piece of liver tissue for laboratory testing in order to make a definitive diagnosis of liver cancer.

During a liver biopsy, your doctor inserts a thin needle through your skin and into your liver to obtain a tissue sample. In the lab, doctors examine the tissue under a microscope to look for cancer cells. Liver biopsy carries a risk of bleeding, bruising and infection.

Determining the extent of the liver cancer

Once liver cancer is diagnosed, your doctor will work to determine the extent (stage) of the cancer. Staging tests help determine the size and location of cancer and whether it has spread. Imaging tests used to stage liver cancer include CTs, MRIs and bone scans.

There are different methods of staging liver cancer. One method uses Roman numerals I through IV, and another uses letters A through D. Your doctor uses your cancer's stage to determine your treatment options and your prognosis. Stage IV and stage D indicate the most advanced liver cancer with the worst prognosis.

Treatment depending on stage

If surgery is possible

Surgery is the best treatment if the cancer hasn't spread.
 

Surgery to remove the cancer

Surgery to remove the cancer might be an option if your cancer is only in your liver and the rest of your liver is healthy. Your surgeon can remove anything from a small wedge to up to 80% of your liver. You are more likely to have this type of surgery if you don't have cirrhosis. 

Fibrolamellar hepatocellular cancer develops more often in people who do not have cirrhosis. It is often possible to remove these cancers with surgery.

Liver transplant

People who have cirrhosis usually can't have a liver resection because the rest of the liver isn't healthy enough. So, your specialist may suggest a liver transplant if you have cirrhosis of the liver and you have: 

• a single liver tumor that is 5cm across or less
• up to 5 tumors that are all 3cm across or less
• a single tumor 5 to 7cm in size that has not grown for at least 6 months

Finding a donor is difficult and can take months. You may need other treatments while you are waiting for the transplant to control the growth of the cancer. Severe cirrhosis of the liver can mean you aren't fit enough for a transplant. Assessing your fitness will be part of the process of deciding whether you can have the operation. It is a very big operation and if you are already ill you may not survive it.  

Children

Children who have a type of liver cancer called hepatoblastoma are more likely to have a combination of surgery to remove the tumor and chemotherapy. 

If surgery is not possible

Surgery may not be possible because:

• the tumor is too large
• the tumor is in a part of the liver that makes it hard to remove, such as being near a blood vessel
• you have several tumors spread through the liver
• you aren't well enough for surgery

You might have more local treatments to the liver including:

• chemoembolisation
• radiofrequency ablation (RFA)
• alcohol (ethanol) injections into the tumor
• radioembolisation 
• microwave ablation

You might also have: 

• biological therapy such as sorafenib
• chemotherapy
• radiotherapy
   

Advanced cancer

Advanced liver cancer means that the cancer has spread beyond the liver to other parts of your body. Treatment aims to help you live longer and to maintain a good quality of life by controlling the growth of your cancer and treating symptoms. 

You might have: 

• biological therapy such as sorafenib
• chemotherapy
• radiotherapy

Your doctor may offer treatment to help control symptoms such as pain, breathing problems, weight loss and jaundice. Sometimes people with liver cancer and cirrhosis may get a build up of fluid in the abdomen (ascites). Your doctor may drain some of the fluid away or prescribe water tablets (diuretics). 

Tell your doctor and nurses about any symptoms you have so they can treat them. 

Sources: medicinene, cancerresearchuk.org, mayoclinic.org, liver.ca, medicalnewstoday