The Liver is the largest internal organ, weighing about 1.3 kg and is located on the right side of the belly. It is reddish-brown in color and feels rubbery when touched. Normally, we cannot feel the Liver as it is located deep inside the body and is protected by the rib cage. The Liver , gall bladder, pancreas and the intestine together process the food for digestion and absorption. Furthermore, the Liver is the most important organ for detoxification of toxins (chemicals) and for metabolism of drugs. The Liver secrets bile juice and is also responsible for the production of proteins responsible for clotting. Liver is sectioned into two large portions, the right and the left lobes.
The Liver is one of the vital organs of the body, responsible for hundreds of chemical actions necessary for life. It is also cited as a gland since it secretes digestive enzymes.
Liver Cancer is a condition that happens when the normal life cycle of the cell is interrupted and instead of dying they keep growing uncontrollably and forms a tumor. This tumor may be restricted only to the Liver (benign tumor) or the Cancer cells may spread to other parts of the body (malignant tumor).
Liver Cancer is the third most frequent cause of Cancer death.
Benign tumors are usually small, however sometimes they may grow large enough to cause problems, but they do not spread to nearby tissues or distant parts of the body. Surgery is the most preferred treatment option for such type of Cancer.
Fibrolamellar It is a rare type, making up less than 1% of HCCs. This type is most often seen in women younger than age 35, and often the rest of the Liver is not diseased. This subtype generally has a better outlook than other forms of HCC.
Cancer that has originated in some other part of the body and has spread to the Liver is called metastatic Liver Cancer. Liver metastases are very common in many types of Cancers, especially in case of GI tract Cancer, breast, lung and pancreas. Though, theoretically, any Cancer can spread to the Liver .
India accounts for the country with lowest Cancer incidence rates in males among all the Asian countries. Among the 9,48,858 total number of Cancer cases registered in India, 20,144 cases contributed to Liver Cancer. The mean incidence of Liver Cancer is 2.77% for males and 1.38% for females. The prevalence of Liver Cancer in India varies from 0.2% to 1.6%. Hepatitis B virus (HBV) infection is the most prevalent etiologic factor in high incidence areas, while hepatitis C (HCV) infection is the most common in the low incidence areas
Liver is located deep inside the body and hence usually the signs and symptoms of Liver Cancer can’t be felt until the later stages of the disease. However, in some cases it can be detected earlier. Some of the most common symptoms of Liver Cancer are:
Some other symptoms include fever, enlarged veins on the belly that can be seen through the skin, and abnormal bruising or bleeding. But many of the signs and symptoms of Liver Cancer can also be caused by other conditions and experiencing any of these do not ascertain Liver Cancer. Still, if any of these problems is spotted it’s important to consult a doctor right away so the cause can be found and treated if needed.
There are several factors that might be responsible for the development of Cancer. Since the Liver filters blood from all parts of the body, Cancer cells from elsewhere can lodge in the Liver and start to grow. The causes of Liver Cancer may also be linked to environmental, dietary, or lifestyle factors.
A recent study involving 140 patients, hepatitis B was the most common cause of Liver Cancer affecting as many as 56 (39%) patients, followed by alcohol which affected 31 (22%) patients. T he prevalence of diabetes was found to be 25% in Liver Cancer patients.
Most cases of Liver Cancer could be prevented with simple lifestyle changes such as avoiding excess alcohol, having protected sex and getting vaccinated against the hepatitis B virus. A few measures to prevent Liver Cancer are:
Staging is important to understand the severity, spread and probability of cure of the disease. Once the type of Cancer is diagnosed, a stage is assigned that helps in planning the treatment for the disease.
Liver Cancer is categorized into four stages:
Survival rate of Liver Cancer is determined by analyzing and studying the cases of patient’s having the same disease at the same stage. However, these rates cannot predict precisely the probability of cure or survival of any patient, as each patient is unique and their survival depends on a lot of other factors like immunity, response to treatment, health record etc. These statistics of survival rate is just a reference to understand the severity and criticality of the disease. Below are some details on the survival rate for 5 years:
|Stage||5 year Survival Rate|
It is often hard to find Liver Cancer early because signs and symptoms often do not appear until it is in its later stages. Small Liver tumors are hard to detect on a physical exam because most of the Liver is covered by the right rib cage. By the time a tumor can be felt, it might already be quite large.
For people at higher risk of Liver Cancer due to cirrhosis or chronic hepatitis B infection, some experts recommend screening for Liver Cancer with alpha-fetoprotein (AFP) blood tests and ultrasound exams every 6 to 12 months. Ultrasound uses sound waves to take pictures of internal organs.
Once a suspicion of Liver Cancer arises, a physician will order one the following to confirm a diagnosis:
The medical treatment chosen depends on how much Cancer has spread and the general health of the Liver .
Surgery is one of the most common treatment options if the Cancer is small and is limited to some part of the Liver .
In this procedure, the Cancerous Liver of the patient is removed and is replaced with a healthy Liver from another person. It is usually used in cases where the Cancer cells are unresectable.
In this procedure the Cancer cells in the Liver are killed without any surgery. Heat, laser, or injecting a special alcohol or acid directly into the Cancer are used to kill the Cancer cells. This technique may be used in palliative care when Cancer is unresectable.
Blocking the blood supply to Cancer can be done using a procedure called embolization. This technique uses a catheter to inject particles or beads that can block blood vessels that feed Cancer. Starving the Cancer of the blood supply prevents the growth of the Cancer. This technique is usually used on patients with large Liver Cancer for palliation.
Radiation uses high-energy rays directed to the Cancer to kill Cancer cells. Normal Liver cells are also very sensitive to radiation. Complications of radiation therapy include skin irritation near the treatment site, fatigue, nausea, and vomiting.
Chemotherapy is a technique that kills Cancer cells by the use of drugs given either orally or by injections. Complications of chemotherapy include fatigue, easy bruising, hair loss, nausea and vomiting, swollen legs, diarrhea, and mouth sores. These side effects are usually temporary.
Sorafenib (Nexavar) is an oral medication that can prolong survival (up to 3 months) in patients with advanced Liver Cancer. Side effects include fatigue, rash, high blood pressure, sores on the hands and feet, and loss of appetite
A complete curable treatment of Liver Cancer is quite difficult. Also, in most of the cases of Liver Cancer, the detection is delayed till later stages, where Cancer has spread to different organs. While Liver Cancer is usually difficult to cure, treatment consists of chemotherapy and radiation. In some cases, surgical resection or Liver transplantation is performed.
People with a high risk of Liver Cancer are recommended to visit the doctor in every 6 months for regular screening tests that might help in the early detection of this silent disease.
Being aware of the symptoms, and any health issue that might indicate the presence of the disease needs to be examined thoroughly. Also, going for screening tests might unveil the presence of the disease in an early stage thus making treatment easier.