Liver cancer

Liver cancer

What is it

Liver cancer is a disease in which malignant or cancerous cells form in the tissues of the liver. Liver cancer can either originate in the liver (primary liver cancer) or start elsewhere and then spread to this organ (metastatic liver cancer).

The liver is the largest organ within the body and among its most important functions are the following:

  • Filter harmful substances in the blood so that they can be transported from the body to fecal matter and urine.
  • Produce bile to help the digestion of fats from food.
  • Store the sugar that the body uses to obtain energy.

Causes

Among the main risk factors when contracting this type of cancer are hepatitis B and hepatitis C , the consumption of large amounts of alcohol, cirrhosis , hemochromatosis, obesity or diabetes . However, only the exact way in which these factors can influence normal cells to become cancerous is partially understood.

Cancers originate when the deoxyribonucleic acid or DNA of a cell is damaged. DNA is the chemical of each of the cells that make up the genes. In addition to accumulating information about physical appearance, genes contain instructions on how cells function, when they grow, divide and die. Oncogenes are the genes that control their growth and division, and tumor suppressor genes, which slow down cell division or cause cells to die at the right time. Cancer can be caused by changes in DNA that activate oncogenes or inactivate tumor suppressor genes.

It is known that certain chemicals cause liver cancer by damaging the DNA of liver cells, such as aflatoxins , organisms produced by small concentrations of fungi. It is also believed that the hepatitis virus can damage DNA by carrying instructions on how to infect cells and produce more viruses, although scientists still do not know exactly how the infection occurs.

In short, liver cancer has many different causes and there is a wide variety of genes involved in its formation and development. A better understanding of how liver cancers develop will contribute to the finding of better ways to prevent and treat this disease.

symptom

It is possible that the patient does not have symptoms until the cancer is already advanced, which makes treatment very difficult. Some of the most common signs of this disease, according to the National Cancer Institute are the following:

  • Notice a hard mass on the right side just below the thoracic cavity.
  • Sensation of discomfort in the upper and right part of the abdomen.
  • Swelling in the abdomen
  • Feel pain in the area near the right scapula or on the back.
  • Manifest jaundice or yellowing of the skin
  • Ease to present bruises or bleeding.
  • Tiredness or weakness out of the ordinary.
  • Frequent nausea and vomiting.
  • Loss of appetite or feeling of fullness after eating a small portion.
  • Weight loss for no apparent reason.
  • Pale intestinal evaluation, calcareous and dark urine.
  • Fever.

Prevention

Although the exact causes of this disease are not known with absolute precision, according to the American Cancer Society, a series of measures can be taken to combat the most common risk factors.

Avoid infection of hepatitis B and hepatitis C

Being the infection with the hepatitis B virus and hepatitis C the most frequent cause of this disease, the main way to prevent its appearance is by adopting the most important measures to avoid contracting hepatitis. These include vaccination of hepatitis B, avoiding the exchange of needles and the adoption of safe sexual practices.

Limit alcohol and tobacco consumption

Cirrhosis is another of the risk factors that increases the chances of getting cancer of the liver and, in addition to hepatitis B or C, the main factor that causes cirrhosis is alcoholism. Drinking in moderation could reduce the risk of suffering from this type of cancer since cirrhosis is one of the most repeated risk factors. For the same reason, reducing tobacco consumption could decrease the chance of developing liver cancer.

Conduct a healthy diet

The prevention of obesity through the adoption of healthy habits such as following a balanced diet and practicing exercise could prevent the development of cancer.

Limit exposure to chemicals that cause cancer

Although most developed countries have regulations and bodies to protect consumers from certain chemicals such as aflatoxins or arsenic that are known to be cancer enhancers, there are still countries where these chemicals can be present in certain foods or in the drinking water.

Treatment of diseases that increase the risk of liver cancer

Although many diseases that increase the risk of suffering from this type of cancer, such as liver cirrhosis, are hereditary and therefore prevention is very limited, detecting and treating these diseases in time could reduce the risk of developing liver cancer.

Types

Most of the time liver cancer is detected, the origin of the cancer is not the liver but another area of ​​the body such as the pancreas, colon, stomach, breast or lung. However, these tumors are treated according to the primary site, where they originated.

The two most common types of primary liver cancer are:

  • Hepatocellular carcinoma:

It is the most common type of primary liver cancer in adults and the third leading cause of death from cancer worldwide, according to the National Cancer Institute. This type of primary liver cancer, sometimes called hepatoma , follows different growth patterns. Some originate as a simple tumor that develops and only in advanced stages spreads to other parts of the liver. Others begin not as a single tumor, but with many small spots through the liver.

  • Cholangiocarcinoma or bile duct cancer:

These cancers begin in the cells that cover the small bile ducts, those that carry bile to the gallbladder, and make up 10 to 20 percent of the cancers originating in the liver, as reported by the American Cancer Society.

Diagnosis

It is usually difficult to discover cancer in its early stages because the signs and symptoms do not manifest until the disease is in its most advanced stages. On the other hand, small liver tumors are difficult to detect by physical examination, since the right ribs cover most of this organ. The result is that most liver cancers are diagnosed in their more advanced stages. However, people who are at high risk for this disease, such as those with hepatitis B, hepatitis C or cirrhosis, can undergo frequent tests to start treatment as soon as possible.

The first step to diagnose this disease will be a questionnaire from the doctor to determine the risk factors and obtain as much information as possible about the symptoms that the patient presents. Then the specialist will perform a physical examination to detect signs of liver cancer stopping in the abdomen, skin and eyeball of the patient. If the specialist considers that there is some risk of the patient suffering from liver cancer, he will send a series of tests to diagnose more accurately the problem and determine the ideal treatment for the type of cancer that presents.

Some of the most frequent and effective tests are:

  • Ultrasound : It is the first study that usually uses the specialist for the examination of the liver. It consists of the use of sound waves to create an image on a video screen that shows tumors that may be growing in the liver.
  • Imaging studies: Obtaining images of the interior of the body by using X-rays, magnetic fields or sound waves.
  • Computed tomography (CT): An x-ray study that produces detailed cross-sectional images of the body. It can provide accurate information about the size, shape and position of any tumor found in the liver or anywhere in the abdomen.
  • Magnetic resonance imaging (MRI): Images obtained by magnetic resonance using radio waves and powerful magnets that provide detailed information about the white tissues of the body.
  • Angiography: A radiologic study to examine blood vessels in which a contrast medium is injected into an artery to delineate the blood vessels while the x-rays are taken. This test can be used to show the arteries that supply blood to a liver cancer, which can help decide doctors to determine treatment.
  • Bone grammagraphy: This test can help detect cancer that has spread to the bones (metastasis).

Treatments

A patient diagnosed with liver cancer will have several options that will depend on the type and stage of the cancer. According to the American Cancer Society, the most advisable thing is to have the joint criteria of medical specialists in different fields such as surgery , oncology or gastroenterology.

These specialists can help the patient to formulate their treatment plan. This will have to take into account, in addition to the stage of the cancer and the health of the rest of the liver, the possible side effects of the treatment, the general state of health, the changes in the cure of the disease, the extension of life or the relief of symptoms. Based on all these factors, the patient and the medical team will have to choose between the following treatment options:

Surgery:

Surgical intervention, by removing the tumor or liver transplant , is currently the only reasonable possibility of eliminating liver cancer. If the operation is successful, the patient will have the best prognosis to overcome the disease.

Tumor ablation:

This option consists of the application of different treatments that destroy liver tumors without removing them. This technique is normally used in patients who have tumors of small size and who do not contemplate the option of having surgery because they have a poor health status or have limited liver function.

Tumor embolization:

Procedure by which substances are injected to try to block or reduce the flow of blood to cancer cells in the liver.

Radiotherapy:

It is based on the use of high energy rays to destroy cancer cells. It can sometimes be used to reduce the size of tumors in order to relieve symptoms such as pain.

Targeted therapy:

Consists of the prescription of several drugs other than those used in chemotherapy, which are being recently developed by researchers as the effects of cancer on cells are discovered. These drugs enter the bloodstream and reach all areas of the body, causing a wide variety of side effects.

Chemotherapy:

It is the treatment with drugs that destroy cancer cells. These, like those for targeted therapy, are applied symptomatically through the bloodstream and reach all areas of the body in order to be useful against cancer that has spread to distant organs. However, chemotherapy is not usually very effective in fighting liver cancer , and has numerous side effects.

Other data

Forecast

According to the National Cancer Institute, at present, since most liver cancers are detected at an advanced stage, only 10 to 23 percent of patients are eligible for surgical treatment with the expectation of totally healing the tumor. The five-year overall survival rates for early-stage patients who undergo transplantation range from 44 to 78 percent, and for those who undergo tumor resection or liver resection, between 20 and 70 percent. In short, the majority of patients diagnosed in the early stage recover from liver cancer.

Patients with advanced disease who do not undergo treatment survive less than six months. Unlike what usually happens with other types of solid tumors, the prognoses of liver cancer patients are not only affected by the stage of the tumor at the time of its presentation, but by the functioning of the liver.

When to go to the specialist

Those who have several of the characteristic symptoms of liver cancer such as jaundice should go to the consultation as soon as possible. On the other hand, if a person suffers some of the main risk factors of this disease such as hepatitis B, hepatitis C or cirrhosis, you should visit the specialist frequently to facilitate the possible diagnosis and treatment of cancer.