Liver cancer: Warning signs and symptoms; how to prevent its occurrence
Liver cancer can be preventable if you manage to keep risk factors like hepatitis B and C viruses, alcohol use, excess body weight, and type 2 diabetes at bay. Here is all you want to know about the warning signs and symptoms of liver cancer.
Liver cancer cases are on rise worldwide and according to an estimate published in Journal of Hepatology, primary liver cancer was one of the top three causes of cancer death in 46 nations in 2020, and by the year 2040, the number of primary liver cancer diagnoses and deaths could increase by more than 55% annually. Liver cancer is broadly classified into two types - primary liver cancer and secondary liver cancer and it is the sixth most common cancer in the world. Unfortunately, there are no early signs and symptoms of liver cancer and most people will report it only when the disease has advanced. Liver cancer is to a great extent preventable by avoiding risk factors like hepatitis B and C viruses, alcohol use, excess body weight, and type 2 diabetes. (Also read: Liver cancer deaths are expected to rise by more than 55% by 2040: Research)
Liver cancer begins in the cells of your liver. It may be primary liver cancer or secondary liver cancer. In case of secondary liver cancer, the cancer begins in some other part of the body and spreads to liver.
CAUSES OF LIVER CANCER
"Primary liver cancer is most prevalent in a background of chronic liver disease or cirrhosis of liver. Chronic liver disease secondary to chronic hepatitis due to hepatitis B and hepatitis C virus infection are the most common cause. Other causes like alcoholic liver disease secondary to chronic alcohol abuse also very prevalent nowadays," says Dr Dipankar Sankar Mitra, Associate Director Minimal Access Gastrointestinal and Bariatric Surgery, Marengo QRG Hospital, Faridabad.
Dr Mitra also reveals other causes of liver cancer.
Fatty liver, obesity, diabetes
Another entity non-alcoholic fatty liver disease or fatty liver secondary to morbid obesity and long-standing diabetes mellitus is also a cause of chronic liver disease or cirrhosis and hence cause of liver cancer.
Metabolic disorder like Wilson's disease and hemochromatosis in which there is metabolic disorder in copper and iron also cause chronic liver disease and hence liver cancer.
Aflatoxin a toxin grown in moulds in old vegetations a carcinogen which is also known to cause primary liver cancer.
Kinds of liver cancer
Primary liver cancer
Dr Mitra says Hepatocellular carcinoma constitutes approximately 90 percent of all primary liver cancer and that Hepatoblastoma and hepatic cholangiocarcinoma are the other two major variants of primary liver cancer.
Secondary liver cancer
Also known as metastatic liver cancer, these tumours are the most common malignancy found in liver. When the primary cancer is present in some other organ in the body and tumour cells spreads to liver by hematogenous route then we can have these metastatic or secondary liver cancer. Most common secondary liver cancer is found from primary tour in colon, rectum, breast, kidney and gall bladder and pancreas.
Symptoms of liver cancer
Dr Mitra says liver tumours are usually asymptomatic to begin with. Patient may have history of liver disease or he or she may have history of Hepatitis B or Hepatitis C infection.
Here are symptoms you must pay attention to:
- Vague pain or dragging sensation over the right upper abdomen may be present.
- Refusal to eat food, weight loss may be present.
- Symptoms of chronic liver disease like yellow discolouration of eyes and urine or jaundice, distension of abdomen due to ascites (accumulation of fluid in abdomen) may also be present.
Liver cancer diagnosis
"Patients who have chronic liver disease must follow up and get investigated for possible liver tumour with Alpha fetoprotein and ultrasound whole abdomen every 6 months. Patients with chronic active hepatitis or cirrhosis of liver are at the highest risk for primary liver cancer. Most common causes for cirrhosis are infection with Hepatitis B and C as well as the patient with alcohol abuse. These patients should be followed up carefully," says Dr Mitra.
Liver cancer treatment
- Surgical resection is the mainstay of treatment in primary liver cancer.
- In view of chronic liver disease or cirrhosis of liver in the background of primary liver cancer many of patient cannot withstand primary resection. Hence orthotopic liver transplant is the treatment of choice in patient with cirrhosis with primary liver cancer.
- Secondary liver cancer is treated along with the primary tumour. This may be either surgery like resection of primary tumour along with the liver secondary followed by adjuvant therapy.
Prevention of liver cancer
It is possible to prevent liver cancer by avoiding certain chronic liver diseases.
"For prevention of primary liver cancer, we need to prevent occurrence of chronic liver disease or cirrhosis of liver. We need to prevent Hepatitis B and Hepatitis C virus infection. Awareness of both these infection as well as awareness about morbid obesity and diabetes mellitus will help us to reduce the incidence of chronic hepatitis as well as the liver cancer," says Dr Mitra.
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