The liver is one of the most important and largest internal organs. It performs a variety of vital body functions such as removing harmful toxins, distributing and storing essential nutrients, secreting bile as well as making proteins important for blood clotting. The body can only live 1-2 days if the liver fails, which is why it’s considered the second most important organ for survival.
WHAT IS LIVER CANCER?
Liver cancer is 5th most common cancer in the world with incidence rates of over one million new cases each year. According to the National Cancer Institute, about 15,000 men and 6,000 women in the US are diagnosed with the disease every year.
Liver cancer can develop in two forms – primary, when the cancer starts in the liver, and secondary or metastatic, which forms in other parts of the body and spreads to the liver.
Primary liver cancer is quite rare in the US representing about 2% of all cancers, although there’s been a current rise in incidence rates. It affects twice as many men as women, at an average age of 67. Secondary liver cancer is far more common, though.
As with many other types of cancer, liver cancer symptoms don’t normally appear until the cancer has reached later stages. For one thing, small liver tumors are hard to detect on a physical exam because most of the liver is covered by the right rib cage. By the time a tumor can be felt, it might already be quite large, which is why it’s generally diagnosed at a more advanced stage.
WHO IS MOST AT RISK?
Although the main causes of primary liver cancer are linked to genetics, history of diseases and bad habits, there are a number of risk factors that show who is more at risk.
- Gender: According to research, men are much more subject to liver cancer than women. In fact, this disease affects twice as many men than women.
- Race: Extensive research shows that liver cancer incidence rates are especially high in countries in sub-Saharan Africa and Southeast Asia. In fact, primary liver cancer is the most common type of cancer in some of these countries. Also, countries with less developed medical treatments experience many more cases than in the U.S.
- Age: This is a major factor as 95% of liver cancer patients are diagnosed at or after the age of 45.
- Cirrhosis: Studies reveal that more than half of the people diagnosed with liver cancer have scarring in the liver or cirrhosis, which causes liver cells to become damaged and die off.
- Hepatitis: Chronic viral hepatitis, caused by the transmission of body fluids that lead to hepatitis B and C, is another major cause.
- Diabetes: People with diabetes are more susceptible to this cancer as they have a higher risk of fatty liver disease, which in time can lead to liver cancer.
- Metabolic diseases: Inherited metabolic disorders are also a risk factor. Even rare diseases like antitrypsin deficiency and Wilson’s disease are entirely linked to liver cancer.
- Heavy drinking: Over time, frequent alcohol abuse can damage the liver and destroy its cells. Cancer is normally triggered by DNA cell mutations that take place when the liver attempts to repair this damage.
- Smoking: Smoking significantly increases the risk of liver cancer. According to one study, smoking accounts for almost 25% of liver cancers in the UK.
LIVER CANCER SYMPTOMS
Unfortunately, liver cancer symptoms don’t normally appear until the cancer has developed substantially. These may vary from person to person, and can even be caused by other types of benign liver infections or diseases. However, in the case of liver cancer, these symptoms will continue to develop and worsen as the disease progresses. So, if you experience any of these, it’s important to consult a doctor for an accurate diagnosis.
These are some of the earliest warning signs of liver cancer:
- Sudden weight loss not associated with changes in diet
- Sharp pain within the abdomen
- Sudden decrease in appetite or a feeling of fullness after a small meal
- Unexplained nausea and vomiting
- Continual weakness and/or fatigue
- Pain occurring in the right upper abdomen or near the right shoulder blade
- Swelling or bloating in the abdomen
- Enlarged liver felt as a mass under the ribs on the right side
- Enlarged spleen felt as a mass under the ribs on the left side
- Jaundice, or yellowing of the skin and eyes
- Abnormal digestion and stool with white in it
- Persistent itching of the skin
- Unexplained fever
HOW TO REDUCE YOUR RISK
Liver cancer is normally detected in its more advanced stages because signs and symptoms appear quite late. Although testing might be recommended for some people at higher risk, there are no widely recommended screening tests for liver cancer in people who are not at increased risk. Therefore, the best treatment against liver cancer is prevention.
It’s not always possible to prevent liver cancer, but some simple lifestyle and self-care measures can reduce your chances of developing the condition.
- Prevent hepatitis infection. You can achieve this by avoiding sex with people who haven’t been tested and wearing protection during intercourse. If you use injected drugs, the best way of avoiding this infection is to not share any of the drug-injecting equipment with other people. This does not just apply to needles, but to anything that could come into contact with other people’s blood.
- Avoid too much alcohol. Cutting down alcohol will reduce your risk of cirrhosis, a disease of the liver that increases your risk of liver cancer. As smoking usually goes hand in hand with drinking, cutting out this habit is also highly advisable. Smoking, too, is a risk factor for liver cancer.
- A balanced diet and regular exercise. A healthy diet that is low in fat and salt and high in fruit and vegetables and regular workout routine will boost your immune system and make your body more prepared to fight off disease. Plus, these lifestyle habits reduce your risk of obesity, which is commonly linked to liver cancer.
- Avoid industrial chemicals or environmental carcinogens. If your work requires using industrial chemicals or environmental carcinogens, make sure all protective measures are fulfilled. Also, if possible, try to find natural alternatives to these chemicals.
- Regular screening in case of family history of liver cancer. If there’s a family history of diseases that increase the risk of liver cancer, you should be screened regularly. As there are no widely recommended routine screening tests for liver cancer, people with a family history of the disease or other risk factors should talk with their doctor about steps they can take to monitor or reduce their risk. According to the National Comprehensive Cancer Center (NCCN), people with a high risk of developing liver cancer should do alpha-fetoprotein (AFP) blood tests and ultrasounds every 6 to 12 months.
- Regular testing. Liver cancer is most treatable if detected early, which is, more or less, the case with every disease. Having regular testing will enable you to identify any changes early, especially if you have any of the above-mentioned risk factors or symptoms.
CAN YOU GET CHECKED FOR LIVER CANCER BEFORE YOU HAVE SYMPTOMS?
As mentioned above, symptoms of liver cancer normally appear in its advanced stages which makes successful treatment quite difficult. In general, doctors don’t recommend screening tests for liver cancer for most people. Even the American Cancer Society does not have recommendations for liver cancer screening. However, if you have any of the known risk factors, including heavy drinking, cirrhosis, or hepatitis, your doctor will recommend testing.
In case you have cirrhosis of the liver, you’ll be closely monitored by your doctor, and this may ask for repeated blood tests for alpha-fetoprotein (AFP). As AFP is a tumor marker for liver cancer, its high value can indicate liver cancer. This will require further testing.
Ultrasound imaging of the liver is another screening used to find liver cancer before it gives symptoms in people at high risk. If you belong to this group, your doctor may ask you to do ultrasounds every 6 months.
MRI or CT scan is also done for diagnosis.
References for the article include: