Learn about the prevention of liver cancer, including risk factors,...
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Liver Cancer
Liver is one of the largest and essential organ of body. Food nutrients absorbed from intestine reaches liver via portal blood circulation where they are metabolized and essential building blocks are formed. Liver is an important organ for digestion, metabolism and synthesis of many chemicals required by body. Apart from primary cancers arising in liver, it is also one of the most common sites of metastasis from other cancers of body.
- Over the last decade incidence and deaths because of liver cancer has increased by 25%.
- Liver cancer is 6th most common cancer and 3rd most common cause of cancer related deaths.
No of new cases and deaths from liver cancer are expected to rise by more than 55% by 2040.
- Long term survival of patients suffering from liver cancer is very low 3-5%.
Types
- Hepatocellular Carcinoma: most common type of liver cancer, in 80% of cases
- Cholangiocarcinoma: 15%
- Hepatoblastoma: rare, mainly in children
Risk Factors: Liver Cancer causes: Why liver cancer occurs?
Most of the times liver cancer occurs in cases with liver cirrhosis which can be because of alcohol or hepatitis. But liver cancer can also occur in normal liver without cirrhosis.
Alcohol: Around 15% of liver cancer occurs because of alcohol consumption. There is no safe limit of alcohol consumption. risk of veloping hepatocellular carcinoma in alcohol related liver cirrhosis is 2.9% per year.
Hepatitis B Virus: can spread through blood or other body fluids. Around 40% of liver cancers are because of hepatitis B. Risk of developing liver cancer in hepatitis B virus associated cirrhosis is 0.5% per year.
- Hepatitis C Virus: Hepatitis C virus can spread through blood. Around 18% of liver cancer occurs in hepatitis C virus associated liver cirrhosis. Risk of developing liver cancer in hepatitis C virus associated liver cirrhosis is 5% per year.
- Non-Alcoholic Fatty Liver Disease (NAFLD): It is excess or abnormal amount of fat in liver. Fatty liver disease is present in 30% of general population, in 74% of those with diabetes and 90% of very obese people. In some countries like Germany, it is most common cause of liver cancer. Yearly risk of liver cancer in fatty liver disease is 2.6%/ year. So fatty liver disease is also as equally damaging as alcohol. Even social intake of alcohol in conditions with fatty liver disease increase the risk of liver cancer significantly.
- Obesity increases the risk of liver cancer
- Smoking is also a known factor
Alfatoxin exposure: produced by mold/ fungi that grow on food grains, peanut, corn. When food such as corn and nuts are stored improperly in hot, humid places, then a fungus called Aspergillus grows over them. It forms a white layer over the food item. This fungus produces a kind of poisonous chemical, the aflatoxin. Eating such food can cause liver cancer.
Anabolic steroids
Environmental pollution by insecticides and pesticides
Chemical exposure like arsenic, viny chloride, hemochromatosis
Older age >50 years
Male are more predisposed than females
Screening for Liver Cancer:
There are no general screening guidelines for liver cancer. Those patients who are at risk because of cirrhosis are advised to remain in close followup and screening with ultrasound and S. Alfa-fetoptotein (AFP) every 6 months.
- Liver Cancer Screening: Regular screening for liver cancer is recommended by Oncologists/ Doctors treating liver cancer for individuals at high risk, such as those with chronic hepatitis B or C, cirrhosis, or a family history of liver cancer. Screening can help detect cancer early when it is more treatable.
- Regular Medical Check-Ups: Regular visits to your healthcare provider can help monitor liver health and manage risk factors such as hepatitis infections, obesity, and diabetes
Alarmimg Signs/ Symptoms of Liver Cancer
Most of the time liver cancer is detected in late stages because it keeps on growing without any symptoms. 70% -80% patients present in stage IV. There are certain symptoms which if present, visit an oncologist and get checked to find the exact cause.
- Enlarged liver- swelling in ride side upper abdomen
- Swelling because of fluid in abdomen (Ascites)
- Abdominal pain
- Feeling full/ loss of appetite
- Nausea/ vomiting/itching
- Unexplained weight loss/ weakness/ fatigue
- Signs and symptoms of liver failure: Jaundice is yellowish discoloration of skin and body. In liver cancer jaundice occurs because of raised level of bilirubin.
Symptoms of Liver Cancer
Symptoms of Liver Cancer
Symptoms of Liver Cancer
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Symptoms of Liver Cancer
Symptoms of Liver Cancer
Investigations for liver cancer
- Blood Investigations: Liver Functions tests, tumor markers like AFP, CA 19-9, PIVKA
- Triphasic CECT/ MRI: very accurate test for diagnosis, staging and treatment planning
- Bone scan/ PET CECT : for staging and assessment of disease spread.
- Ultrasound is many times initial investigation
- Biopsy is required sometimes when diagnosis is not clear
Treatment: Liver cancer treatment
Treatment of liver cancer as per best oncologists depends on
- Number/ size and location of the tumor within the liver
- Functional reserves of liver
- Underlying liver parenchyma normal or cirrhosis
- Involvement of other organs
Surgery: Liver cancer surgery is planned by liver cancer surgeon considering all these parameters. Surgery is the only curative treatment in localized liver disease. Resection and transplant are two curative options, and these are advised and planned by considering function of liver and underlying cirrhosis grade.
Hepatectomy: hepatectomy surgery for liver cancer removes a portion usually right or left half of liver. The remaining healthy liver regrows. Sometimes extended liver resections are also done to completely clear the disease where only 25% of liver is left. Proper assessment of underlying liver parenchyma reserve is very important. Sometimes PTBD to decrease jaundice is required before major surgery. Sometimes tumor side portal vein embolization is done to increase function capacity of remaining liver.
Liver transplant: replaces the entire diseased liver with a healthy liver from a suitable donor. Multiple cancers and patients with underlying cirrhosis of grade B and C are suitable candidates for this surgery.
To Book Appointment for Liver Cancer Surgery :
Integration of Multimodality Treatment
- Ablation: Heat (Radiofrequency ablation) or ethanol injections are used to destroy the cancer cells. They are useful in small tumors in patients who are not fit for surgery. Radiofrequency ablation uses fine needle like probe which inserted in liver tumor. This probe delivers high frequency electrical current that generate heat which destroys cancer cells.
- Embolization and chemoembolization: Embolization and chemoembolization block off the hepatic artery supply to tumor. Small particles are used for this to reduces blood flow to the tumor. In chemoembolization, chemotherapy drugs are embolized into the hepatic artery. This procedure is used in patients where there are multiple tumors in both lobes of liver and disease has not spread beyond liver.
- TACE: Transarterial Chemoembolization- a catheter is inserted into hepatic artery and chemotehrapy drugs are delievered directly into the tumor. This procedure maximize the concentration of chemotehrapy drug in the tumor while minimizing general side effects.
- TARE: Transarterial Radiembolization: performed similar to TACE using radioactive isotope Yttrium-90 instead of chemotherapy.
- Both improves similar survival, choice among two is decided upon various tumor and patient factors.
- Targeted therapy: medications are designed to hit/ target cancer cells with specific receptors. It decreases the tumor growth. Targeted therapy can be helpful for people where disease has spread beyond liver to other organs.
- Immunotherapy is also helpful to some extent in metastatic patients.
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Colon cancer can start anywhere in the colon, which is about 5 feet long and absorbs water from the stool. Rectal cancer begins in the rectum, which is the last 12 cm (about 5 inches) of the large intestine. This is where the body defecates until you have a bowel movement. Contact Cancer Surgery clinic Arogyam Care at Gurugram, Delhi NCR or book online appointment for colon and rectal cancer treatment in Gurgaon.
- If all relavant examination and investigations has been done than plan of treatment is finalized with colon cancer surgeon
- After deciding surgical procedure cost estimate can be taken from billing department or hospital. Clinic or hospital department coordinator will assist in case any help required. +918750587489,
- you can visit nearby hospital for colonoscopy screening as advised in our screening section or you can read various society guidelines like American cancer society, USPTF.
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Best Doctor for Rectal Cancer in Gurgaon says for rectal cancer, the overall 5-year survival rate for people is 67%. If the cancer is diagnosed locally, the survival rate is 89%. If the cancer has spread to surrounding tissues or organs and / or regional lymph nodes, the 5-year survival rate is 72%
It is 10 times more likely to cause stomach cancer than rectal cancer, where it returns after treatment has begun. Stomach cancer has about a 20 percent risk of local recurrence, versus about 2 percent with colon cancer. Contact Dr Kaushal Yadav for Cancer Surgery & for colon and rectal cancer treatment in Gurgaon, Delhi-NCR, India