What is liver cancer?

Liver cancer is the third most common cause of death in the world

It is like any other cancer is an overgrowth of cells which especially occurs in the liver.
India accounts for almost 22,000 cases every year of liver cancer.
The incidence of the most common form of liver cancer that is hepatocellular carcinoma is 1.6% per year. It is more common among males than females. The ratio normally seen is four times more in males as compared to females.
The liver is a football-shaped organ and the primary function of the liver is to filter out blood continuously which circulates throughout our body. It removes harmful toxins and chemicals from our bodies, thereby making them ready for excretion.
Since all of our body’s blood passes through the liver it tends to make it more vulnerable to cancer-causing cells.

How is liver cancer? Are there any risk factors?

It is more commonly seen in livers which had birth defects, or any changes(mutation) in their DNA. DNA plays a very important role in the metabolic reactions of the body. Uncontrolled growth of the cells eventually results in the formation of the liver tumour which is a mass of cancerous cells.

The Risk Factors:

These factors tend to increase the risk of having liver cancer:

1) Intake of Anabolic steroids:

It’s a male hormone. Commonly used by athletes and weight gainers.

2) Aflatoxins

The fungus produces it. They are poisonous toxins which usually grow on grains. Chronic exposure can become the reason for liver cancer.

3) Birth Defects:

Certain inherited liver diseases can also become a reason for an increase in the incidence of liver cancer. These include Hemochromatosis and Wilson’s disease.

4) Cirrhosis:

This is an irreversible condition seen when the liver cells are damaged and are replaced by scar tissues. This is one of the most important causes of liver cancer.

5) Non- Alcoholic fatty liver disease:

Non-alcoholic fatty liver disease happens when there is excessive accumulation of fat in the liver. More the fat in the liver more chances of liver cancer

6) Diabetes:

The presence of any blood sugar-related disorder acts as a major cause of liver cancer. This is also attributed to the fact that diabetics are mostly connected to fatty liver disease.

7) Excessive alcohol consumption:

A higher intake of alcohol over many years results in irreversible damage to liver cells. This ultimately results in increased chances of liver cancer.

8) Obesity:

Obesity increases the load on the liver cells, which in turn acts as a triggering point for the liver cells

9) Low Immunity:

HIV/AIDS has a five times higher risk of developing liver cancer.

10) Smoking:

Patients having hepatitis B and hepatitis C tend to have a higher risk of having liver cancer if they smoke.

11) Chronic infection with HBV OR HCV:

Triggering factors tend to increase the production of cancer cells. Chronic infections tend to secrete substances which act as those triggering agents.

What are the types of liver cancer?

Based on the origin

1) Primary type:
This is the type in which cancer originates in the liver itself and liver cells begin to grow abnormally.
2) Secondary type:
It is usually a result of cancer from nearby or different internal organs and that spreads into the liver

Based on the abnormal cell involved:

1. Hepatocellular carcinoma
   This is the most common type of carcinoma and it begins in the main type of liver cell also called the hepatocyte. Accounts for about 70% of liver cancers.
   Other less common types of liver cancer include :
2. Fibrolamellar HCC – rare type
3. Cholangiocarcinoma – occurs In the bile ducts
4. Angiosarcoma –blood vessels of the liver.

What symptoms are seen in liver cancer?

Did you know most people having cancer are not even aware of the fact that they have growing cancer within them?
Majorly symptoms of liver cancer are not seen in the primary stages of liver cancer. These are usually seen after certain damage has been caused by liver cancer.

Symptoms of Liver Cancer include

1. Loss of weight without any knowing reason. One of the early symptoms.
2. Pain swelling and tenderness in the upper right section of the abdomen. But not a characteristic symptom.
3. Loss of appetite
4. Swollen legs.
5. Yellowish discolouration of the body and nails – Jaundice.
6. Rashes and itching all over the body. Late symptom.
7. White chalky stools.
8. Generalized weakness and fatigue of the body.
9. Early satiety.
10. Nauseated and vomiting.

What are the stages of liver cancer?

STAGES OF CANCER depend upon the extent to which cancer has spread.
Stage 1: The tumor is confined only to the liver and nowhere else
Stage 2: Either there are several small tumors with little increase in size, but all within the liver, or one tumor that has reached a blood vessel
Stage 3: Either there are various large tumors, or there is just one that has reached the main blood vessels. Cancer may have also reached the gallbladder
Stage 4: Metastasis. Liver cancer has the capability of spreading to other parts of the body.

Can we manage liver cancer?

The management of liver cancer includes how to diagnose liver cancer and also how to manage the same.

How would I know I have liver cancer?

All diseases have the potential to be cured fully if they are diagnosed at an early stage. Regular screening of people who can more susceptible to them is a must. There are several tests which help you diagnose and even know the stage of cancer you have.

Liver cancer tests include:

1) Physical examination

An abdominal examination is done to check for lumps, swelling or ascites
Signs of jaundice like yellow sclera and nails.
Several tests performed by the physician like

2) Blood test

It is carried out to look for certain tumour markers.
LFT a test to check liver function, it shows a rise in AFP (Alpha-fetoprotein). This is a protein produced by liver tumours.
Elevated levels of iron act as a tumor marker for liver cancer.

3) Imaging Tests

1. USG
2. CT – To measure tumour size
3. PET Scan – Liver scans
4. Biopsy: at times it is necessary to take a part of the tissue of the liver piece to make a definitive diagnosis.
5. Laparoscopy: a technique using tools and cameras, is useful in detecting small tumours through the incision. This helps in determining the extent of the liver cancer and also confirming the previous tests.

How is liver cancer treated?

Treatment of liver cancer mainly depends upon the extent of cancer, site, age and overall health of the patients.

a) Targeted drug therapy

It basically works by interfering with specific sites of the tumour cell. Majorly used for slowing hepatocellular carcinoma from progressing. They increase the overall survival rate of cancer.
Drugs used are:
• Sorafenib
• Regorafenib
• Lenvatinib
• Nivolumab

b) Radiotherapy

It involves radiation treatment on liver tumour cells causing them to reduce in their size. High energy beams sometimes even help reduce the symptoms.
For multiple small lesions, USG-guided injection of alcohol promotes dehydration of tumours cells and necrosis.

c) Chemotherapy

Drugs are used in order to reduce the size of the tumour cells. These drugs can be administered either through IV or pill form.

d) Immunotherapy

It’s a process by which the immune system of the body is used for fighting cancer. Cancer cells tend to produce proteins which bind with the immune cells and prevent their actions .this therapy interferes with this mechanism.

e) Surgical management

Hepatectomy

A portion of the liver is removed. This is dependent on the fact that the tumour is confined only to a small part of the liver and the liver is otherwise functioning well.

Liver transplant

This is the choice of treatment when a single tumour is more than 5cm in size or there are multiple tumours of 3cm.
This treatment is done only when a suitable donor is available. It is the end choice of treatment as it involves higher complications like the rejection of the donor liver, autoimmune reactions, and even death.

Can I prevent liver cancer?

Like any other disease preventive, measures can always keep you on the safer side than others.
Preventive measures for liver cancer include:
• Avoid taking anabolic steroids unnecessarily
• Always take iron supplements under a doctor’s supervision.
• If you have had exposure to hepatitis when getting yourself vaccinated as soon as possible
• Try drinking alcohol within limits
• Maintain a healthy and fit lifestyle
• If you suffer from any other liver disease get yourself screened regularly

What is the role of Truemeds?

Truemeds is an online pharmacy platform, which allows us to order medicines at the ease from our homes. It provides us with real-quality medicines with proper standardization. Some liver cancer medicines available on Truemeds are:
• Avastin 4ml
• Nexavar 200mg tablets
• Keytruda 100mg injection
• Lenvima 10mg capsule
• & many more
It’s always advised to take medication after physician’s consultations.

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