Cancer of the liver
Dr Nirasha Chiranjan gives us a rundown on cancer of the liver.
Liver cancer is a leading cause of cancer death in both men and women. Globally, the most common type of primary liver cancer is hepatocellular carcinoma (HCC). In many cases, it arises from underlying liver disease due to viral hepatitis or non-viral chronic liver disease.
The viral causes are hepatitis B and hepatitis C. The most common non-viral causes are alcohol and non-alcoholic fatty liver disease. The incidence of liver cancers is expected to rise in the future due to poor lifestyle and diet.1,2
What is the liver?
It is a large organ that is situated in the right upper quadrant of the abdomen. It’s an important organ and is vital for detoxification of chemicals and metabolism of drugs. The liver aids in food digestion and storage. It also makes important proteins for blood clotting.
What are the signs of liver cancer?
- Jaundice (yellow discoloration of skin and the whites of eyes)
- Weight loss
- Pale stools (white, chalky stools)
- Dark urine
- Swelling of the abdomen and feet
- Abdominal pain
- Easy bruising of the skin
- Enlarging mass in the abdomen
- Early fullness when eating
- Lack of appetite
- Skin changes and rashes7
What are the risk factors?
- Chronic infection with hepatitis B or hepatitis C.
- Cirrhosis, this irreversible condition causes scar tissue in the liver.
- Inherited liver diseases, like Wilson’s disease (excess copper build-up in the body) and hemochromatosis (iron overload).
- Non-alcoholic fatty liver disease. This is when too much fat is stored in the liver cells replacing normal liver cells.
- Exposure to aflatoxins (found in grains and nuts).
- Excessive alcohol consumption2-4
How is cancer of the liver diagnosed?
There are various tests, such as blood tests, specifically liver function tests and tumour marker tests. Abdominal sonar, CT scan or MRI can be used. Then lastly a liver biopsy.9-10
What are other cancers found in the liver?
There are many different types of cancers that can develop in the liver.
As mentioned before, the most common is HCC which originates from the liver cells, called hepatocytes.
Other primary liver cancers are hepatoblastoma which tends to occur in children and intrahepatic cholangiocarcinoma (cancer that develops in the cells within the bile ducts; both inside and outside the liver).
Cancer spreading to the liver from other sites, like the colon or breast, is more common than cancers developing primarily from the liver. These cancers are called liver metastases.
- Lifestyle change: maintain your ideal body mass index and limit alcohol consumption.
- Get vaccinated against hepatitis B.
- Prevent hepatitis C by screening yourself and your sexual partners. Don’t use intravenous drugs or share needles.
- Do screening with your doctor if you have risk factors.5-6
MEET THE EXPERT – Dr Nirasha Chiranjan
Dr Nirasha Chiranjan is a radiation oncologist. Her special interests are the breast, gynaecological, head and neck, and central nervous system cancers. She is based at the Life Flora Hospital, Sandton Oncology (Morningside) and Ahmed Kathrada Cancer Institute. (cancersa.co.za/nirasha)
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- Diagnosis, Staging, and Management of Hepatocellular Carcinoma: 2018 Practice Guidance by the American Association for the Study of Liver Diseases.AU Marrero JA, Kulik LM, Sirlin CB, Zhu AX, Finn RS, Abecassis MM, Roberts LR, Heimbach JK SO Hepatology. 2018;68(2):723.
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