Hepatocellular (Liver) Cancer, Adult (Primary)

Introduction

Cancer starts when the cells in the body start to grow out of control. The cells in nearly any part of the body can become cancer and spread to other areas of the body. Only the cancers which start in the liver are called liver cancer or primary liver cancer. According to the World Health Organization (WHO), the prevalence of liver cancer is around 30 cases per 10,000 people worldwide with rates being higher in parts of Africa and Eastern Asia. Contact us to get your Liver Cancer Treatment in India at Best Hospital.

The Liver

The liver is the largest internal organ which lies under your right ribs just beneath your right lung. It is divided into lobes.

You cannot live without your liver. It has several vital functions:

  • It breaks down and stores many of the nutrients absorbed from the intestine which is needed by the body to function. Some nutrients must be metabolized in the liver before they can be used for energy or to build and repair the body tissues.
  • It makes majority of the clotting factors which keep you from bleeding too much when you are cut or injured.
  • It secretes bile into the intestines to help absorb nutrients, especially the fats.
  • It breaks down the drugs, alcohol and the toxic wastes in the blood that pass from the body through stool and urine.

The liver is mainly made up cells called as hepatocytes. It is also made up of other types of cells which include cells which line its blood vessels and cells which line the small tubes in the liver called as bile ducts. These bile ducts extend out of the liver and carry bile from the liver to the gallbladder or directly to the intestines.

These different types of cells in the liver can form several types of malignant and benign tumors which have different causes, treated differently and have different outlook.

Types of Liver Cancer

There are several types of liver cancer based on the type of cells which become cancerous

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer which occurs in people with chronic liver diseases such as cirrhosis caused by hepatitis B or C infection.



Fibrolamellar HCC is a rare type of HCC which is typically more responsive treatment than other types of liver cancer.

Angiosarcoma also called as hemangiocarcinoma accounts for one percent of all the liver cancers. It begins in the blood vessels of the liver and grows quickly. Typically they are diagnosed at an advanced stage.

Cholangiocarcinoma or bile duct cancer which occurs in the small, tube-like bile ducts within the liver carrying bile to the gallbladder. This accounts for 10-20 percent of all the liver cancers. The intrahepatic bile duct cancer start in the ducts within the liver while extrahepatic bile duct cancer develops in the ducts outside the liver.

Secondary liver cancer also known as liver metastasis develops when the primary cancer from another part of the body spreads to the liver. Most liver metastasis originates from colorectal cancer.

Risk Factors

It is not clear what causes most cases of liver cancer. The risk factors for liver cancer are:

  • Chronic infection with HBV or HCV
  • Certain inherited liver diseases
  • Cirrhosis
  • Non-alcoholic fatty liver disease
  • Diabetes
  • Excessive alcohol consumption
  • Exposure to aflatoxins
  • Age- people over 60 are more likely to get liver cancer than younger people.
  • Gender, men are twice as likely to get liver cancer than women
  • Race or ethnicity- Pacific Islanders and Asian Americans have highest rates of liver cancer followed by African Americans, American Indians/Alaska Natives and Hispanic/Latinos and whites.
  • Obesity
  • Anabolic steroids
  • Vinyl chloride and thorium dioxide
  • Tobacco use
  • Arsenic
  • Infection with parasites
  • Certain rare diseases such as:
    • Alpha 1-antitrypsin deficiency
    • Glycogen storage diseases
    • Tyrosinemia
    • Wilson disease
    • Porphyria cutanea tarda

Symptoms

Sometimes, liver cancer is called as a silent disease because in an early stage it often does not cause symptoms. But as it grows, the symptoms include:

  • Pain in the upper abdomen on the right side, the pain may extend to the shoulder and back
  • Weight loss without trying
  • Swollen abdomen (bloating)
  • Weakness or feeling very tired
  • Loss of appetite and feelings of fullness
  • Fever
  • An enlarged liver, felt as a mass under the ribs on the right side
  • Yellow skin and eyes and dark urine from jaundice
  • Nausea and vomiting
  • Itching
  • An enlarged spleen, felt as a mass under the ribs on the left side

These symptoms are not sure signs of liver cancer as other liver diseases and health problems can also cause these symptoms. Anyone with these symptoms should see a doctor as soon as possible to get proper diagnosis and treatment. Get in touch with us to know the Cost of Liver Cancer Treatment in India.

Diagnosis

If a patient has symptoms suggesting liver cancer, then the doctor performs one or more of the following procedures:

  • Medical history and physical exam
  • Imaging tests
    • Ultrasound
    • Magnetic Resonance Imaging (MRI)
    • Computed Tomography (CT) scan
    • Bone Scan
    • Angiography

Other tests and procedures include:

  • Laparoscopy
  • Biopsy
    • Needle biopsy
    • Laparoscopic biopsy
    • Surgical biopsy
  • Lab Tests
    • Alpha-fetoprotein blood (AFP) test
    • Other blood tests
      • Liver function tests (LFTs)
      • Blood clotting tests
      • Tests for viral hepatitis
      • Kidney function tests
      • Complete blood count (CBC)
      • Blood chemistry tests and other tests

Staging

Liver cancer is categorized into four stages:

Stage 1: The tumor is just in/on the liver and nowhere else

Stage 2: Either there are several small tumors but all within the liver or one tumor which has reached a blood vessel

Stage 3: Either there are various large tumors or there is just one which has reached the main blood vessel (s). Cancer may have also reached the gallbladder.

Stage 4: Metastasis. The liver cancer has spread to other parts of the body.

Treatment

The medical treatment chosen depends on how much the cancer has spread and general health of the liver. The spread and extent of spread cancer beyond the liver tissue plays a significant part in the types of treatment options which are most effective. But you and your cancer care team will also take into account the possible side effects of treatment and the chances to cure the disease, extend life or relieve the symptoms. Contact us to get the Low cost Liver Cancer Surgery in India. Send us your query to know about the Best Liver Cancer Hospital in Delhi and the Best Liver Cancer Surgeon in Delhi.

Getting a Second Opinion

If time allows, you may want to get a second opinion from another doctor or medical team. It will give you more information and help you feel more certain about the treatment plan you choose. If may ask your doctor for help, if you aren’t sure where to go for a second opinion. Book your appointment with the Liver Cancer Specialist in Mumbai at the Cheapest Hospital for Liver Cancer Treatment in Mumbai on our website.

Surgery

Liver cancer can be treated sometimes with surgery to remove the part of liver with cancer. The surgical options are reserved for smaller sizes of cancer tumors. The complications from surgery includes severe bleeding, pneumonia, infection or side effects of anesthesia.

Liver Transplant

The doctor replaces the cancerous liver with a healthy liver from another person. Usually, it is used in very small unresectable liver tumors in patients with advanced cirrhosis. The liver transplant surgery may have some complications as noted in surgery. Also the complications related to a liver transplant may include the possible rejection of the liver transplant, high blood pressure, infection due to suppression of the immune system, diabetes, high cholesterol, an increase in body hair and weakening of the kidneys and bones.

Ablation Therapy

This is a procedure which can kill the cancer cells in the liver without any surgery. The doctor can kill cancer cells using the laser, heat or by injecting a special alcohol or acid directly into the cancer. This technique may be used in palliative care wherein the cancer is unresectable.

Embolization

Blocking the blood supply to the cancer can be done using a procedure called as embolization. This technique uses a catheter for injecting the particles or beads which can block the blood vessels which feed the cancer. Thus starving the cancer of the blood supply prevents the growth of the cancer. This technique sis used on patients with large liver cancer for palliation. Complications include nausea, fever, vomiting and abdominal pain.

Targeted Agent

Sorafenib is an oral medication which prolongs survival up to three months in patients with advanced liver cancer. The side effects include rash, fatigue, sores on the hands and feet, loss of appetite and high blood pressure.

Radiation Therapy

It uses high-energy rays that are directed to the cancer to kill the cancer cells. The normal liver cells are quite sensitive to radiation. The complications include skin irritation near the treatment site, nausea, vomiting and fatigue.

Chemotherapy

It uses a medicine which kills the cancer cells. The medicine can be given by mouth or by injecting it into the vein or artery feeding the liver. You can have a variety of side effects from chemotherapy, depending on the medications used and the patient’s individual response. The complications include easy bruising, nausea, fatigue, hair loss, vomiting, diarrhea, mouth sores and swollen legs. Usually these side effects are temporary.

Follow-Up Care

Even after you have completed the liver cancer treatment, your doctors will want to watch you closely. It is significant to go for all follow-up appointments. During these visits, your doctors will ask if you have any problems, do the physical exams, blood tests and imaging tests.

If you have been treated with a surgical resection or a liver transplant and have no signs of cancer remaining, then most doctors will recommend a follow-up with imaging tests and blood tests every three to six months for the first two years, then every six to 12 months. Follow-up is needed to check for cancer spread or recurrence as well as the possible side effects of certain treatments. Almost with any cancer treatment, there are some side effects. Some of them only last a few weeks or months while others can last a long time. Do not hesitate to tell your cancer care team about any of the symptoms or side effects bothering you so that they can help you to manage them effectively. It is also vital to keep health insurance since the health care costs a lot and although no one wants to think of their cancer coming back, but this could happen. Send us your query to know the Cost Of treatment for Liver Cancer in India. Get the Best price Liver Cancer Treatment in India by contacting us on our website.

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