Liver is an extremely important organ in the body. The state of liver has profound impact on the well being of a person. All over the world liver problem are on the rise. Cancer of liver is one of the most common cancers especially detected among men. Primary liver cancer originates in the cells of liver whereas secondary liver tumor has its origin somewhere else in the body which spreads to liver. The spread may occur from cancer of the gastrointestinal tract, kidney, ovary, prostate or the lungs.
Situated in the right upper side of abdomen below the right lung and diaphragm, liver is divided into two lobes the right and left.Right lobe is bigger than the left. Liver has many functions to play. It stores the nutrients derived from the food that we eat, clears toxic metabolic wastes and helps in digestion of food. Cancer that begins in the liver is not as common as cancer that begins at another site and spreads to the liver.
Primary liver cancer is of many types. It depends on which type of liver cell has become malignant. At least 75 percent of primary liver carcinomas are hepatocellular cancer (HCC). It begins due to malignant transformation of the hepatocytes.Liver cancer develops more often in people suffering from chronic liver disease such as hepatitis B and hepatitis C or cirrhosis of liver due to alcoholism. The other types of primary liver cancer are less common. They are called fibrolamellar cancer, cholangiocarcinoma (cancer of bile duct) and angiosarcoma (starting from the blood vessels of liver).
Causes And Risk Factors Of Liver Cancer
Majority of people who have primary liver cancer are known to have following risk factors.
- Liver cancer is more common in men as compared to women.
- Cirrhosis of liver: It is a condition where the cells of liver are damaged forming scar tissue. People drinking alcohol for a long duration are at risk of suffering from cirrhosis of liver.
- Chronic liver infection such as hepatitis B and C can lead to cancer of liver. Nowadays chronic HIV infection is largely responsible for high prevalence of liver cancer in sub-saharan Africa and Southeast Asia.
- People suffering from type 2 diabetes, especially those who drink alcohol or suffer from hepatitis.
- Ingestion of certain type of toxins called aflatoxin which contaminates food. Long term exposure to aflatoxin which is a product made by fungus can increase the risk of liver cancer. These toxin develops when wheat, groundnuts, corn, soybean gets infected with fungus. Eating such infected food for a long time can lead to liver cancer.
- Family history of liver cancer.
- Use of anabolic steroids for a long duration.
- Exposure to vinyl chloride a type of chemical for a long time can increase the risk of angiosarcoma, a lesser type of liver cancer.
- Smokers who are suffering from hepatitis B and C.
- Liver fluke infection which mainly occurs in developing countries can increase the risk of bile duct cancer.
Signs And Symptoms Of Liver Cancer
In majority of patients primary liver cancer does not cause any symptoms until it is in its advanced stage. During the early stage, the symptoms may be vague and non specific. This may include general feeling of sickness, tiredness, loss of appetite, unexplained loss of weight, etc.
Majority of these patients are middle aged and may have history of cirrhosis of liver. If the patient is already suffering from otherwise stable cirrhosis of liver and the condition has deteriorated rapidly, than the underlying cause can be liver cancer. With further development of liver cancer symptoms become more obvious. They may include:
- Progressive abdominal pain especially in the liver area.
- Jaundice: Yellow discoloration in the whites of eye, nails, and skin.
- Abdominal lump.
- Sudden loss of weight.
- Severe itching which is not relieved with medicines.
- Swelling of the abdomen.
Some liver cancer can produce hormone that act on other organs producing high calcium level in blood, sudden low sugar level, breast enlargement in men, increase in red blood cells and high cholesterol.
Treatment Options For Liver Cancer
The main line of treatment for liver cancer is surgery or chemotherapy. However, the treatment may depend on many factors and the condition of patients. It may depend on factors such as:
- The site of tumor in the liver. If it is a solitary mass confined to small area of liver, surgical resection of that area may be considered.
- The second factor includes patients with localized liver cancer that is not amenable to surgery due to its anatomical location in liver or due to medical problems in patient or if the function of liver is compromised as in case of cirrhosis of liver. Patients with this type may be considered for liver transplantation.
- In the third type the liver cancer has spread to distant areas, chemotherapy and radiation therapy may be helpful as a palliative measure.
Prognosis: The prognosis of most patients after development of symptoms is grim. Patients who have been diagnosed early and have a small localized tumor have good chances of survival. Unfortunately, patients are diagnosed at an advanced stage of the disease or are in advanced stage of cirrhosis of liver where very little can be done to save his life.