Liver Cancer: Signs and Symptoms, Causes, Risks. Diagnosis, Treatment, Outlook and Prevention

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a illustration‬‏ of a man with Liver Cancer

1Overview

The body has vital organs that work together to have equilibrium in the body. Without one of these organs, the body will malfunction. The liver is responsible for detoxifying chemicals and metabolizing drugs. Moreover, it produces bile, which aids in the digestion of fats and liver proteins that are essential for blood clotting.

The liver is one of the most important organs in the body. However, it acquires abnormalities or diseases. One of the illnesses that target this organ is cancer.

Cancer develops when the normal cells of the body evolve into cancerous ones, dividing until they form a tumor. Cancer is one of the leading causes of deaths worldwide,
which accounted for 8.8 million deaths in 2015.

Liver cancer is an aggressive type of cancer. According to the World Cancer Research Fund International, liver cancer is considered the sixth most common cancer in the world,
with more than 782,000 cases diagnosed in 2012.

The incidence of liver cancer has tripled in the last three decades. Men are three times more likely than women to acquire the disease.

Several types of cancer can form in the liver. The most common type of liver cancer is hepatocellular carcinoma that usually begins in the hepatocytes, the main type of cells in the liver. The other types of liver cancer include hepatoblastoma and intrahepatic cholangiocarcinoma.

2Signs and Symptoms

The signs and symptoms of the liver are sometimes not noticed until the cancer has spread to the other parts of the body. The signs and symptoms include:

  • Jaundice on the skin, tongue, and whites of the eyes
  • Abdominal pain focused on the right side
  • Unexplained weight loss
  • Fever
  • Fatigue
  • Nausea
  • Vomiting
  • Enlargement of the liver (hepatomegaly)
  • Ascites or fluid accumulation in the abdomen
  • Back pain
  • General itching

3Causes

Many doctors are still baffled on the exact cause of liver cancer. However, some factors may increase the tendencies of people to develop this type of cancer.

Some experts have linked various possible causes of liver cancer like chronic infection with hepatitis viruses. In liver cancer, however, the liver cells have mutations in their DNA.
The DNA provides the instructions for the various chemical processes in the body.

When there are mutations in the cell’s DNA, the cells may begin to grow and divide uncontrollably. They will eventually form a tumor, which can be cancerous.

4Risk Factors

Many factors and culprits cause cancer. Some people are more predisposed to developing cancer than others.

In liver cancer, on the other hand, people who drink alcohol uncontrollably may become more susceptible to developing cancer than those who do not. There are also many risk factors for both liver and lung cancers.

Cirrhosis

People with liver cirrhosis, a condition wherein the liver cells are damaged and replaced with scar tissue, are at a higher danger of developing liver cancer.

Anabolic Steroids

Athletes, weight lifters, and body builders use these male hormones to boost energy, endurance, and muscle strength. Long-term use may heighten the risk of developing liver cancer, and other types of cancer as well.

Diabetes

Patients who have diabetes are more likely to develop liver cancer, especially if they also have hepatitis B, a kind of liver infection, and they consume too much alcohol.

L-carnitine Deficiency

Recent studies have shown that low levels of L-carnitine may increase the likelihood of developing cancer.

Aflatoxins

A fungus found in moldy wheat, corn, nuts, and peanuts produces a substance called aflatoxins. Exposure to this chemical for a long time may lead to higher liver cancer risk.

Genetics

People who have relatives, especially immediate family members, who had liver cancer are at a higher risk of having it themselves.

Inherited Liver Disease

People who have other liver diseases such as Hepatitis B and Hepatitis C have a markedly higher risk of developing liver cancer, compared to others.

Obesity

People who are overweight or obese have a higher risk of developing many cancers, including liver cancer.

Immunocompromised Individuals

People with low and weakened immune systems, like those who have HIV or AIDS, have a higher risk of having liver cancer.

Gender

Men are at a higher risk of getting liver cancer than females. Some medical experts believe that this risk is not because of the gender but of lifestyle practices. Men tend to smoke and abuse alcohol more than women.

5Diagnosis

Early detection and diagnosis play a crucial role in the prognosis of patients with liver cancer. When the tumor is removed before it began to spread to the other parts of the body, the prognosis is higher.

Medical History and Physical Exam

The doctor will conduct a thorough medical history taking and physical examination to determine any abnormalities in the liver. The family history of liver cancer will be noted. If the signs and symptoms point to liver cancer, the doctor will request for further evaluation.

Imaging Tests

Imaging tests such as radiologic exams, CT scans, and MRI aim to help detect cancer or tumors.  These imaging tests utilize x-rays, magnetic fields, and sound waves to create photos of the internal parts of the body.

These tests aim to help find suspicious areas where cancer cells may proliferate, help diagnose liver cancer and guide the doctor who’s doing the needle biopsy. Other uses include determining how far cancer has spread, evaluating if the treatment was effective and to look for possible relapse of recurrence.

Laparoscopy

One of the procedures that can be done is laparoscopy. Usually done in the clinic as an outpatient, this minimally invasive procedure helps doctors confirm a diagnosis of cancer through biopsy, help plan for treatments and confirm the stage of cancer.

Biopsy

Another test to confirm the diagnosis of cancer is through biopsy. A biopsy is the removal of a tissue sample to see if it’s cancer.

Laboratory Tests

Blood tests can help diagnose liver cancer, learn how well the liver is working, get an idea of the patient’s general health and evaluate if the treatment is working.

Some of the blood tests include liver function tests (LFTs), alpha-fetoprotein blood (AFP) test, blood clotting tests, complete blood count (CBC), blood chemistry, and Hepatitis infection tests, among others.

Once the liver cancer is diagnosed, the doctor will determine the severity, extent or stage of cancer. Staging helps determine the location and size of the tumor. Also, it determines if the cancer has spread to neighboring tissues.

6Treatment

After cancer has been diagnosed and staged, treatment comes next. It’s the most important phase because it determines the outcome of the patient’s health status.

Surgery

After diagnosing cancer, the doctor will recommend surgery to remove the tumor or cyst in the liver. It will either involve the removal of the tumor (resection), removal of a part of the liver (hepatectomy), or liver transplant.

Radiation Therapy

Radiation therapy entails the delivery of radiation delivered from outside the body on cancer. There are two types of radiation therapy, external beam radiation therapy, and radioembolization. In radioembolization, small radioactive beads are injected into the hepatic artery.

Chemotherapy

A standard procedure to treat all types of cancer, chemotherapy uses various drugs to target and kill cancer cells. The common side effects include fatigue, nausea, vomiting, and hair loss.

Localized Treatments

Cryoablation

This type of treatment freezes cancer cells. The cancer cells are exposed to extreme cold to kill them. During the procedure, the doctor will use liquid nitrogen to freeze the cells.

Radiofrequency ablation

This procedure uses heat to kill cancer cells. An electric current is used by the doctors.

Alcohol injection into the tumor

The doctor will inject pure alcohol directly into the tumors.

Injecting chemotherapy drugs into the liver

Also called chemoembolization, this procedure involves the injection of anti-cancer drugs directly to the liver.

7Outlook

The main reason why cancer is so serious and deadly is its ability to spread in the body. The cancer cells can spread locally by moving into nearby healthy tissues. They also spread through the bloodstream and the lymphatic system.

The earlier the detection of cancer, the better its prognosis. Stage I and stage II cancers have a better prognosis than the other stages, III and IV.

8Prevention

Liver cancer can be prevented through the following measures.

Avoiding and Treating Hepatitis Infections

The many types of hepatitis infection increase the risk of people in developing liver cancer. It is important to avoid getting the disease through vaccination and abstaining from sexual intercourse with an infected person. For hepatitis infections that can be transmitted through the oral-fecal route, it is important to make sure food handlers are not infected. Hand washing is also important.

Limit Alcohol Intake

Drinking alcohol may lead to liver cirrhosis and then liver cancer. Limiting alcohol intake is important in liver cancer prevention.

Other preventive measures include:

  • Stop smoking
  • Maintain a healthy weight
  • Reduce exposure to cancer-causing chemicals
  • Eat healthy foods
  • Drink plenty of water
  • Have regular check ups

It is important to have regular consultations with your doctor. Early detection is essential because the sooner cancer is detected, the more effective the treatment is. Early treatment is important for a good prognosis.