Liver Cancer Symptoms, Causes, Treatment & Prevention (2022)

What is liver cancer? Find out what causes it, symptoms, treatment options, and prevention strategies.

Types of liver tumors.

There are two main types of tumors

Benign tumors

The most common types are liver hemangioma and regeneration nodules of liver cirrhosis.

Malignant tumors (liver cancer)

Types of liver cancer.

Primary liver cancer: arising from the liver cells themselves.

Secondary liver cancer: tumors that move to the liver from other places, such as the digestive system, breast, or lung.

In this article, we will discuss in detail the primary liver cancer

Primary liver cancer (hepatocellular carcinoma)

Is liver cancer common?

Primary liver cancer is the sixth most common cancer worldwide, and it is the 3^rd most common cancer of cancer-related mortality. It is first cancer in males and 2^nd cancer in females after breast cancer.

Liver cancer causes.

1- Liver cirrhosis whatever the cause is.

2- Chronic viral hepatitis due to either HBV, HCV, or HDV.

3- Fatty liver with advanced hepatic fibrosis

4- Aflatoxin

Aflatoxins are created by a specific fungus that can be found on crops like maize (corn), peanuts, cottonseed, and tree nuts. Especially when stored in hot humid circumstances.

Consuming large quantities of such toxins for a long time may cause liver cancer.

Liver cancer symptoms and signs.

Don’t wait for symptoms or signs of liver cancer to appear because it usually occurs in an advanced stage, for example

Loss of weight

Excess fatigue

Upper abdominal pain

Increase in jaundice i.e., yellowing of the eyes and skin.

Swelling or lump in the upper abdomen.

How is liver cancer diagnosed?

Can liver cancer be detected by a blood test?

Liver cancer tumor marker:

The analysis of tumor markers (Alfa-fetoprotein) in the blood is one of the methods of diagnosing liver cancer, but it is not very reliable, as it is useful in diagnosing only 30% of cases when its level is more than 200. But if the level of this tumor marker is normal, it does not exclude the presence of liver cancer.

Three-stage CT scan (Triphasic CT abdomen):

The three-stage CT scan is the mainstay in diagnosing liver cancers, especially primary liver cancer, and it can differentiate very accurately between hemangioma and liver cancers.

Liver cancer biopsy:

Until recently, we used to rely on ultrasound-guided samples of liver tumors to diagnose liver tumors, but after the advent of the three-stage CT scan, its role was limited to diagnosing cases that were difficult to diagnose with the three-stage CT scan.

Liver cancer treatment options

Liver cancer arises on top of cirrhosis of the liver in 95% of cases, and therefore two things must be considered when choosing a treatment method. The first is the liver status, and the second is the size and number of tumors in the liver.

1- Liver cancer and liver transplantation.

It is the ideal solution to get rid of tumors and cirrhosis at the same time, but there are specific conditions to get the best results of liver transplantation; the tumor diameter should not exceed 5 cm in case there is only one tumor, but if they are several tumors, their number should not exceed 3, and the diameter of the largest one of them does not exceed 3 cm. It is also required that there be no cancerous clot in the portal vein and no spread of the tumor outside the liver.

2- Liver cancer hepatectomy

It is surgical excision of the tumor, it is done in very limited cases, as this requires the presence of a single tumor of no more than 3 cm in size, and the condition of the liver should be excellent.

3- Interventional radiotherapy of liver tumors (treatment of liver cancer without surgery):

There are several methods of interventional treatment of liver cancer:

Liver cancer heat therapy (Radiofrequency and microwave):

Whether it is radiofrequency or microwave, the two depend on one idea, which is burning the tumors inside the liver through a needle that enters the liver under the guidance of ultrasound. The tumor is burned within a few minutes through the radiofrequency, or the microwave device connected to this needle, and in order to get the best results for this type of treatment is preferable that the tumor diameter does not exceed 3 cm and the number of tumors does not exceed 3 tumors, provided that the condition of the liver is good. It is also possible to burn larger tumors (≥ 8 cm) if it is used with other methods such as chemotherapy through the catheter or the injection of radioactive isotopes through the catheter.

Liver cancer chemotherapy (Chemoembolization)

Chemotherapy through catheterization, in which the artery feeding the tumor is entered with a catheter and the chemotherapy is injected into the tumor itself, and then the feeding artery of the tumor is closed by injecting a certain substance.

This method is used in cases that are not suitable for surgical resection or heat ablation due to the large size of the tumor and or its location in places in the liver that are difficult to reach surgically or through heat treatment.

One of the most important advantages of chemotherapy through catheterization is that the side effects are few compared to conventional intravenous chemotherapy due to the concentration of chemotherapy injections inside the tumor without harming other organs of the body or healthy liver cells.

Liver cancer radiation (liver cancer Y90):

It is the latest way to treat liver cancer, especially in the presence of a cancerous clot in the portal vein of the liver (the main feeding vessel of the liver). It relies on the same idea of chemotherapy through catheterization, but we inject radioactive substance Y90 instead of chemotherapy. Its advantage over chemotherapy, the radioactive substance can pass to the malignant clot in the portal vein and dissolve it completely. This type of treatment has very encouraging results, but it is disadvantaged by its high cost.

Is there a treatment for liver cancer stage 4?

Stage 4 is a late stage of liver cancer, however, If the condition of the liver is still good, medical treatment with sorafenib or newer drugs such as immunotherapy can be offered to improve the prognosis.

Sorafenib for liver cancer.

Sorafenib helps to hinder the proliferation of cancer cells and blocks the formation of new vessels by the tumor. It is used in advanced cases in which surgical or interventional treatment is not available.

Immunotherapy for liver cancer.

Our immune system is used in immunotherapy to combat cancer. It functions by assisting the immune system in identifying and eliminating cancer cells.

The best results in the treatment of advanced stages of liver cancer are obtained with Atezolizumab and Bevacizumab combination.

Prognosis of liver cancer.

The prognosis of liver cancer depends on the stage of liver cancer. Cases with early liver cancer have a better prognosis than those of late-stage liver cases, but in general, the 5-year survival is about 60-70%.

Liver cancer prevention:

- Primary prevention:

By early treatment of the causes of liver cirrhosis before reaching the stage of cirrhosis, we will prevent liver cancer, for example

Treatment of hepatitis C, B

Treatment of fatty liver

Avoid excess alcohol intake

- Liver cancer early detection (2ry prevention):

Detection of liver cancer at an early stage makes it a curable disease.

We must screen patients with liver cirrhosis, HBV, and fatty liver patients who have advanced fibrosis by abdominal ultrasound and blood tumor markers every 3 months.

Treatment of secondary liver cancer:

First, the primary tumors outside the liver must be treated, whether by surgical excision or chemotherapy and then secondary liver tumors are dealt with, whether by chemotherapy intravenously or locally through catheterization or heat treatment according to the nature of each tumor. Treatment must be in coordination with the medical team, whether the surgeon Oncologist or interventional radiologist.

Questions and answers.

Does hemangioma need treatment?

Hemangioma is a benign tumor and often does not need treatment, as there is no damage from them if they are not huge or superficial, as in this case, they may be the cause of internal bleeding in the abdomen, at this time, we must remove it surgically.

Hemangioma vs. liver cancer.

Hemangioma may be mistaken for liver cancer on ultrasound, Triphasic CT helps to differentiate each other.

is liver cancer hereditary?

Even though liver cancer lacks a strong hereditary component, patients with risk factors of liver cancer like cirrhosis, HBV, or HCV who have a family history of liver cancer are more prone to develop cancer than those without a family history of liver cancer.

Is liver cancer painful?

Liver cancer may cause pain in the upper abdomen if the tumor reaches the liver capsule or occludes the portal vein.

Can liver cancer cause back pain?

Yes, it can, if the tumor causes metastases to the vertebra.

Can liver cancer cause diarrhea?

Yes, liver cancer may cause diarrhea, because in some cases the tumor secretes hormones that predispose to diarrhea or diarrhea may occur as a side effect of some liver cancer medications e.g., Sorafenib

Liver cancer and hiccups?

Liver cancer may cause hiccups if it infiltrates the diaphragm and irritates its nerve supply.

Where does liver cancer spread?

It can spread to occlude the main blood supply of the liver or spreads distally to the lung, brain, or bones.

Is liver cancer curable?

Yes, if it is discovered and treated at an early stage.

Can liver cancer be cured with chemotherapy?

Yes, provided that the number of tumors and few and they are small with no spread to portal vein or to distant orangs e.g., lung, bone, or brain.

Conclusion:

The treatment of liver tumors is possible, but just as the tumor was discovered at an early stage, the greater the chance of recovery and the lower the financial cost, of course. I hope I could answer your questions and I leave you now with a subtitled video about the same topic.