Watch Out For Liver Cancer, The Silent Killer
Liver cancer is one of the leading causes of death in Thailand. It is more common in male than female. Causes of liver cancer are hepatitis B and C infection and alcohol drinking. Usually, liver cancer is not discovered until it is too late to be treated effectively. Therefore, it is important to have a regular health check-up and reduce the risk of this condition.
What is liver cancer?Liver has a complex role in the function of the body, including detoxification, metabolism, bile production, regulation of blood level of sugar, and conversion of excess glucose and fat for storage. Liver cancer is a type of cancer that begins in the cells of your liver. Primary liver cancer (hepatocellular carcinoma) tends to occur in livers damaged by chronic infection, alcohol abuse, and cirrhosis. Cancer starts when abnormal liver cells begin to grow out of control. Most people do not have signs and symptoms in the early stages of primary liver cancer.
- Cirrhosis due to chronic hepatitis B and C infection
- Alcohol abuse
- Fatty liver
- Exposure to aflatoxins – found in contaminated peanuts and dried chillies
Signs and symptoms
- Upper abdominal pain
- An enlarged liver, felt as a mass under the ribs on the right side
- Loss of appetite, unintentional weight loss
- Yellowing of the skin and eyes (jaundice)
- Nausea, vomiting
DiagnosisTests and procedures used to diagnose liver cancer includes as follows:
- Ultrasound – is often the first imaging used. Additional imaging will be required if any abnormality is found.
- Serum tumor marker – Alpha-fetoprotein blood test (AFP) is used to screen for liver cancer. If AFP levels are very high in someone with a liver tumor, it can be a sign that liver cancer is present.
- CT scan with contrast – produces detailed cross-sectional images of your body. This imaging technique is not suitable for patients with renal impairment and should not be done often.
- Magnetic resonance imaging (MRI) – provides detailed images of soft tissues in the body. MRI scans can be very helpful in looking at liver tumors. Sometimes they can tell a benign tumor from a malignant one. This imaging technique cannot be done in patients with a metal implant.
- Liver biopsy – The doctor will insert a thin needle through your skin and into your liver to obtain a tissue sample. In the lab, doctors examine the tissue under a microscope to look for cancer cells.
TreatmentTreatments for primary liver cancer depend on the stage of the disease. The treatment options include:
- Surgery – In certain situations, your doctor may recommend an operation to remove the liver cancer. However, a small portion of healthy liver tissue that surrounds the tumor also needs to be removed. Therefore, the patient must have good liver function in order to undergo the surgery. Only 10-20% of patients with liver cancer can be treated with surgery.
- Radiofrequency ablation (RFA) – Electric current is used to heat and destroy cancer cells by using an ultrasound or CT scan as a guide. This is a common treatment method for small tumors.
- Transarterial Chemoembolization (TACE) – uses a catheter to deliver both chemotherapy medication and embolization materials into the blood vessels that lead to the tumor. This allows doctors to treat tumors that cannot be treated by surgery. It is a common treatment method for 7-10 cm tumor. Some patients may be asked to return for further treatment, depending on the size, number and location of the tumors.
- Microwave ablation – is quite similar to radiofrequency ablation. In this procedure, microwaves transmitted through the probe are used to heat and destroy the abnormal tissue. The tumor has to be less than 5 centimeters. This procedure can be done using ultrasound or CT-scan as a guide.