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800,000+ people are diagnosed with liver cancer each year worldwide. Not only that, but liver cancer is also a leading cause of cancer death globally, accounting for 700,000+ deaths every year.
Liver cancer is more common in different regions of sub-Saharan Africa and Southeast Asia compared to the USA. It is emerging as one of the fastest-spreading cancers in many countries, including India. According to the latest data recorded in 2014, about 3-5 cases of liver cancer per 1,00,000 people are detected each year. This amounts to 30,000-50,000 new cases per year.
A diagnosis of liver cancer is not a death sentence; it happens to thousands of people every single year. It is not to be feared but to be treated. You can manage it, treat it, and beat it by consulting an expert like Dr. P.K.Das, a top liver cancer doctor in Delhi
What is liver cancer?
A little about the liver first.
The dark reddish-brown organ, liver, weighs about 3 pounds. It is an essential organ of the human body. It is located in the upper right-hand portion of the abdominal cavity beneath the diaphragm, on top of the stomach, the right kidney, and the intestines. It is shaped like a cone.
Hepatocytes primarily make up the liver. However, some other types of cells also make up the liver, including cells lining the liver’s blood vessels and cells lining the small tubes in the liver called bile ducts. These ducts carry bile (a fluid that helps with digestion) from the liver to the gallbladder or directly to the intestines.
The liver breaks down & stores nutrients as required by the body. It also makes clotting factors, delivers bile, and breaks down alcohol, drugs, and toxic waste from the blood.
Liver cancer begins in the liver cells. Liver cancer is a disease that occurs when abnormal cells grow too quickly and leave less space for normal cells to grow.
There are two ways to classify liver cancer-primary liver cancer and secondary liver cancer. Primary liver cancer is the type of liver cancer that begins in the liver cells; secondary liver cancer, on the other hand, develops when cancer cells from another organ in the body spread to the liver.
Types of liver cancer
Types of primary liver cancer
Different types of primary liver cancer originate from the various cells that make up the liver. Primary liver cancer can start as a single lump growing in the liver, or it can start in many places within the liver at the same time.
Hepatocellular carcinoma
Hepatocellular carcinoma is the most common type of primary liver cancer. It is also called hepatoma.
Cholangiocarcinoma
Cholangiocarcinoma originates in the lining of the bile channels, either in the liver or in the bile ducts.
Hepatoblastoma
Hepatoblastoma affects both infants and children. It sometimes causes the release of certain hormones resulting in early puberty.
Angiosarcoma
Angiosarcoma is a rare type of primary liver cancer. It originates in the blood vessels of the liver.
Treatments of liver cancer
Surgery 1
There are two types of surgery to treat liver cancer-surgery to remove the cancerous tumor and liver transplant surgery. For tumor removal, an operation is performed to remove liver cancer and a small portion of healthy liver tissue surrounding the tumor (in certain cases). For liver transplant, the diseased liver is removed and replaced with a healthy liver from a donor.
Localized treatments 2
Some treatments are directly administered to the cancer cells or the area surrounding the cancer cells. There is one way that involves heating cancer cells through radiofrequency ablation. It uses electric current to heat and destroy cancer cells. Then another treatment involves freezing cancer cells through cryoablation which uses extreme force to destroy cancer cells. There's pure alcohol injection directly into the tumor to aid in cancer cell death, directly injecting chemotherapy drugs into the liver, and placing radiation-filled beads in the liver.
Radiation Therapy 3
Radiation therapy uses high-powered energy/beams from different sources like X-rays to destroy cancer cells and shrink tumors. The energy is directed into cancer in the liver by specialists whole sparing the surrounding healthy tissues. Radiation is mostly used if other treatments are not available or in advanced cases to manage symptoms.
Targeted therapy 4
Targeted therapy focuses on unique, specific abnormalities in cancer cells. They block these abnormalities causing cancer cells to die. Targeted therapy and immunotherapy in cancer patients are rapidly evolving and becoming more personalized.
Immunotherapy 5
Immunotherapy utilizes the body's own immune system & immune response to fight cancer. The immune system doesn't attack cancer cells in the beginning because these cells produce proteins to blind the system. Immunotherapy interferes with the process and helps the body fight cancer.
Chemotherapy 6
Chemotherapy drugs kill rapidly growing cells, including cancer cells. It can either be administered through a vein in the arm, in the form of pill/s, or a combination of both.
Liver Cancer FAQs
Metastatic liver cancer and secondary liver cancer are used interchangeably for cancer that starts in another part of the body and spreads to the liver. These tumors largely come from cancer cells in the lung, breast, colon, pancreas, stomach, or blood. However, it can come from anywhere.
The treatment for a metastatic liver tumor follows the same protocol as the treatment for original cancer. So, if cancer spreads from the lung, for example, the liver tumor is treated as lung cancer.
The 5-year survival rate of liver cancer depends upon where cancer has spread. If it is localized, i.e., confined to the liver, then the 5-year survival rate is 28%. If it is regional, i.e., grown into nearby organs, the 5-year survival rate is 7%. And finally, if it has become distant, i.e., spread to distant organs or tissues, the 5-year survival rate can be very low. In fact, the survival time in distant liver cancer can be as low as 2 years.
- Cirrhosis
Cirrhosis occurs when the liver disease progresses into late-stage liver disease and causes healthy tissue to be replaced with scar tissue. Cirrhosis can be caused by alcohol abuse, Nonalcoholic fatty liver, viral hepatitis (types B and C), excess iron in the liver due to a disease called hemochromatosis, etc. Cirrhosis is one of the most common risk factors for liver cancer.
- Obesity, NAFLD, diabetes (type 2)
Obesity can cause fat deposits on the liver leading to NAFLD. Recent research has found strong evidence suggesting NAFLD and diabetes, which is a related disease, are major risk factors for HCC.
- Viral Hepatitis
Hepatitis infects the liver. Both hepatitis C & B, types of viral hepatitis, are risk factors for liver cancer. However, hepatitis C is a more common risk factor because, unlike hepatitis B, there’s no vaccine to prevent hepatitis C.
- Age
Liver cancer can happen at any age. However, it is more common in older people. People above the age of 60 are more at risk of getting liver cancer than others. The highest rates are in those in the age range 85-89 years old.
- Gender
According to recent research, men are more likely to develop liver cancer than women. It is speculated that this is due to certain behaviors like alcoholism which are more prevalent in men. However, the fibrolamellar subtype of HCC is more common in women.
- Tobacco Use
Smoking is a risk factor for liver cancer. However, previous smokers who have now stopped are at a lower risk than those who still smoke. Nevertheless, both groups have a higher risk than those who never smoked.
- Abdominal pain
- Pain near the right shoulder blade or in the upper abdomen
- Loss of appetite
- Unexplained weight loss
- Nausea
- Abdominal swelling or bloating in the abdomen
- Yellowing of the skin and eyes (jaundice)
- Ongoing fatigue or weakness
- Unexplained fever
- Abdominal pain
- Ascites or abdominal swelling
- Loss of appetite
- Early satiety or feeling full after eating only a little
- Fluid in the abdomen
- Generalized itching
- Jaundice
- Enlarged liver
- Nausea and/or vomiting
- Pain in the right shoulder blade
- Enlarged spleen
- Unintended weight loss
There are multiple tests & procedures to diagnose liver cancer. They are:
- Blood Tests
Certain blood tests may reveal liver function abnormalities.
- Imaging Tests
Your cancer doctor or GP may recommend imaging tests like USG, CT, and MRI.
- Removing a sample of liver tissue for testing
A piece of liver tissue is sometimes removed for laboratory testing for a definitive diagnosis of liver cancer. This is called a liver biopsy.
According to cancer specialists in Delhi NCR and worldwide, liver transplantation has proven to be the most effective treatment for HCC liver cancer patients.
Liver cancer-It’s not a curse
Liver cancer is a rare form of cancer. Liver disease doesn’t always lead to liver cancer. If you or your loved ones have been diagnosed with liver cancer or suspect liver cancer, the best way forward is to consult an expert like Dr. P.K. Das, the best cancer specialist doctor in Delhi.
Certain liver cancers are fast-growing while others are slow-growing. For example, hemangiosarcoma and angiosarcoma types of liver cancer are fast-spreading, but hepatocellular carcinoma is slow-spreading.
The 5-year survival rate for secondary liver cancer is estimated at 11%.
The 5-year survival rate for metastatic liver cancer is estimated at 11%.
Chronic HBV and HCV infections are the most common cause of liver cancer worldwide.
Men over the age of 60 are more likely to be diagnosed with liver cancer.