For most people conventional wisdom dictates that overconsumption of alcohol can lead to cirrhosis which in turn will lead to liver cancer, while others may mistake the two conditions as one and the same. Today, Thai people consume less alcohol; as such cases of cirrhosis have decreased. However, liver cancer is not only caused by alcohol, your diet can play a major part in the onset of this condition. For example foods containing components of alcohol, when consumed in high amounts can lead to cirrhosis or liver cancer. The main causes of liver cancer however are Hepatitis B and C (with B more common). In many cases this will be congenital and contracted from the mother in the womb, or it may come from husband-wife, or partner. Hemochromatosis can cause permanent damage and liver failure. Liver cancer may also be linked to obesity and fatty liver disease. Hepatitis B and C are communicable in the same way as AIDS, however it is considered to be more contagious. Once the virus enters the bloodstream it will make its way to the liver, whether or not this will result in hepatitis will depend on the individual’s immunity (which may vary, for details visit www.loveliver.net). For others, the condition may become chronic and last 10-20 years leading to cirrhosis and the potential for cancer developing cells. Individuals with Fatty Liver, especially those with diabetes are at risk of cirrhosis. It is recommended that they receive medical consultation and ultrasound diagnosis as well as check-up for liver cancer. Hepatitis is a major cause of cirrhosis and liver cancer; as such the medical community and wider public are paying more interest in this particular disease. For example, more blood tests are being conducted to diagnose hepatitis, as well as vaccines for hepatitis B. Furthermore, more treatments through medication are becoming readily available. During a test for hepatitis or liver cirrhosis your doctor will often order a liver cancer diagnosis to be conducted simultaneously. This can be significant as early diagnosis of liver cancer will greatly increases the chances of successful and effectiveness of treatment. A tumor that is left undiagnosed and allowed to grow may cause symptoms such as pain, tightness in upper right abdomen, reduced appetite, and drastic weight loss. Other symptoms may include issues with digestion, constipation, and lymphoma. Note that these symptoms may indicate liver cirrhosis, and not necessarily cancer. The best method of cancer treatment is early detection and prevention; as such suspicions of Hepatitis should be met with a prompt check-up.
Diagnosis is conducted according to risk factors such as chronic hepatitis B and C, family history of liver cancer, detection of lumps, and abnormal blood results.
ScreeningScreening is usually conducted through an ultrasound of the abdomen which focuses primarily on the liver. Ultrasound utilizes sound waves to create images and poses no health risks. A blood test can also be used to detect abnormalities, such as AFA (alphafetoprotein) count, this is effective in 40% of liver cancer diagnosis. It is recommended to receive cancer screening twice a year.
After the ultrasound and blood test (to check AFP levels), further diagnosis will be conducted via CT scan or MRI. These will be able to provide a clearer picture of the size, shape, location, spread, blood circulation, and surrounding organs with regards to the tumor. Importantly, it indicates whether the cancer has spread to the lymph nodes, adrenal gland, lung, and bone. If there are indicators your doctor may order further tests such as an x-ray of the lungs and a bone scan. Furthermore, a biopsy may be conducted to provide confirmation (up to 100%) of cancer.
Surgical Treatment There are several methods of cancer treatment the choice of which will depend on each patient’s condition. Liver cancer is often caused by liver cirrhosis as such a factor in treatment is measuring the severity of cirrhosis as it can cause your body to become weak through malnutrition and may cause poor immune system, issues with blood coagulation, enlarged abdomen, internal bleeding and more. These will also cause limitations on surgical treatment, in fact only 10-20 percent of patients will be suitable for surgery due to factors such as cirrhosis. Surgical treatment is a good option for individuals who do not have cirrhosis, size of tumor is not extremely large, there is no blockage, and the cancer has not spread outside the liver. With surgery, consideration must be given to sedatives required, recuperation post-surgery, other pre-existing conditions, costs, and the experience and expertise of surgical oncologists. RF Ablation Today, liver cancer and lung cancer are major illnesses for Thai people; this does not include other types of cancers that may have spread to the liver and lungs. Only a small number of patients will be suitable for surgical treatments. Patients who are unsuitable may be due to lack of time needed for successful outcomes of surgery, or being physically unfit for surgery. Luckily in the past 20 years there have been significant developments in the medical community with regards to cancer care. This includes developments in ablation, chemotherapy, and medication. In the past 5 years there have been attempts to develop non-surgical treatments that offer the same benefits as surgery. This includes brachytherapy with the assistance of x-rays and ultrasound. Once the medical device is inserted in the desired position, your doctor may decide to provide other treatment methods such as RF Ablation. Radiofrequency ablation for cancer is a minimally invasive procedure that uses electrical energy and heat to destroy cancer cells. During radiofrequency ablation for cancer, imaging tests are used to guide a thin needle through the skin or through an incision and into the cancer tissue. High-frequency energy passes through the needle and causes the surrounding tissue to heat up, killing the nearby cells. RF is used for tumors in the liver that are no larger than 4 centimeters, and number less than 4 at a time, it can also be applied to tumors in the lung that are no larger than 3 centimeters. Furthermore, in cases where surgery is preferably avoided RF ablation can be used to treat tumors in the kidney, endocrine gland, and bone. Advantages of RF include:
- Avoid surgical treatment and as such avoid anesthesia
- Minimally invasive – small scars
- Patients only need to spend 1-2 days in the hospital before being able to return to daily activities
- Less chance of complications compared to surgery
- Reduces chances of bleeding or unnecessary tissue destruction especially in the case of liver tumor
- The chances of hemorrhaging is at 3% (and most will stop by themselves)
- Mostly requires one session, however some cases may require more
- RF ablation is particularly effective in treatment of liver and lung cancer
Dr. Komgrit Tanisaro Intervention Radiologist www.drkomgrit.comBy