Frequently Asked Questions around Liver Cancer

The liver is the largest and one of the most vital internal organs of the human body, present in the upper-right quadrant of the abdomen, just below the diaphragm. It performs a wide range of functions. Bile produced by the liver helps the body absorb fat-soluble vitamins, fats, and cholesterol. The organ processes nutrients and medicines consumed by the person as well as hormones secreted by the body. So also it eliminates bacteria and toxic material from the blood thereby minimizing the risk of infection and monitoring the performance of the immune system. The liver also produces proteins that help the blood to clot.

It’s clear from the above that the liver is indispensable for good health. Like any other organ in the body, the liver too is susceptible to a range of ailments and conditions that affect its normal functioning. One such condition is Liver cancer.

What exactly is liver cancer?

Liver cancer is a rarer type of cancer that affects a small percentage of the population. Technically, there are three types of liver cancer, the most common being hepatocellular carcinoma that begins in hepatocytes which is the main type of liver cell. Interestingly, cancer originating in the liver is less common. Cancer that spreads from other parts of the body such as lung, breast, stomach, and intestine are more common. These are called metastatic cancers.

Why does it occur?

DNA, present in our cells, directs every single chemical process in our body through constant instructions. Sometimes the DNA mutates, or its genetic code changes. This disrupts the normal instruction cycles. As a result, cells start growing randomly and uncontrollably, creating a condition called as tumour. Such abnormal cells are called cancerous cells. This is how cancer occurs in general. When the same phenomenon happens in the liver, with the liver cells, the condition is liver cancer.

One of the causes attributed to liver cancer is severe Hepatitis infection. However, with people who have not had a bout of hepatitis, what causes liver cancer is not clear.

Who is at risk?

The following people or conditions increase the risk of developing liver cancer.

• A hepatitis B or C viral infection: As mentioned before, if the infection becomes severe, the risk of liver cancer increases.
• Alcohol abuse: Consuming more than a drink or two, every day, over many years progressively damages the liver and increases the risk of liver cancer.
• Cirrhosis: This is a condition where liver tissues develop scars that may eventually trigger liver cancer. Cirrhosis is generally caused by alcohol abuse but there can be other reasons too.

• Inherited liver conditions: If one of the parents or grandparents has suffered from hemochromatosis (iron accumulation in the liver) or Wilson’s disease (copper accumulation in the liver), the person is at higher risk of liver cancer.
• Diabetes: People with either type A or type B type of diabetes are at higher risk of developing liver cancer, compared to a healthy person, with all other conditions being the same.
• Non-alcoholic fatty liver disease: In this condition, fat starts accumulating in the liver. Such a person is at risk of liver cancer.
• Aflatoxins: When farm produce or even prepared food is not stored properly, it can develop mold or fungus. When a person consumes such food quite often, his/her risk of liver cancer increases.

What are the symptoms?

Patients experience a wide range of symptoms, the most common being:

• Nausea and vomiting
• Feeling weak or fatigue
• Weight loss without exercise or diet changes
• Reducing or no appetite
• Pain in the upper abdomen
• Swelling in the abdomen area
• Skin and eyes become yellow, which is a sign of jaundice
• Stools that are white and chalky

If you are experiencing one or more of these, and consume alcohol frequently, or have suffered a bout of hepatitis recently, get yourself screened immediately for liver cancer.

How will I know if cancer has spread?

Liver cancer is detected using one or more of the below methods. Exactly the same procedure is done on surrounding organs to see if cancer has spread.

• Common lab tests: The blood and urine of the person to gauge the health of the person which can indicate the presence of cancerous tissue or any other condition in any organ.
• Imaging tests: While ultrasound is generally preferred, the doctor may call for MRI or CT scans as well.
• Heart tests: This helps assess your cardiovascular health and disturbance if any.
• Medical history: Yours and your parents’ medical history will be thoroughly reviewed to confirm or rule out genetic disorders.

Are cysts on the liver the same as cancer?

No, they are not! Cysts on the liver are a fairly common condition and can be easily treated through medication or surgery (for multiple or stubborn cysts). The doctor will anyway screen you for liver cancer.

What are the treatment options?

Liver cancer that is in the early stage is treated through one or more of these options: Chemotherapy, radiation, ablation (a minimally invasive probe either burns or freezes the cancerous tissue), or catheter-directed therapy (a catheter with cutting tools at the tip is inserted into the liver, the cancerous tissues cut and extracted out of the body).

However, for people with severe or late-stage liver cancer, liver transplantation is the only option left.

How easy or difficult is a liver transplant surgery?

Liver transplant surgery by itself is not a complicated procedure. However, it can take a long time to get to the operating table. The number of people awaiting a transplant is always more than the number of livers available from people who died recently. That is why a number called MELD score is assigned to the person on the waiting list. The score factors age of the person, other health conditions, how sick the liver is, and certain techno-medical parameters. This is the case when the liver is coming from a dead person.

Living people with a healthy liver can donate a part of it, as anyway, the liver will grow back to its full size over a couple of months. The live donor can be a stranger in which case one still needs to go through the waiting list. In case the donor is a family member or a friend, the transplant is done immediately if there is a perfect match between the two livers.

What are the restrictions while I await a transplant?

The doctor may impose restrictions on travel and any physical strain till such time the transplant is done. This is in addition to restrictions in diet and alcohol consumption.

How successful are liver transplants?

Liver transplants as mentioned before are not complicated and are fairly successful. The success rate depends on the general health of the donor and recipient, their ages, and any medication consumed by them in recent weeks.

Since there is a risk of the recipient’s body rejecting the new liver or part of it, immuno-suppressant drugs are given to the recipient. These must be consumed as prescribed. In addition to that, there are various diet and lifestyle changes recommended. If none of these are followed strictly, the transplant can be a failure.

What are the risks with liver transplants?

Liver transplants come with a certain risk. Immuno-suppressant drugs are given to the recipient to prevent the body from rejecting the new liver, which is achieved by suppressing the body’s immune system. As a natural outcome, the person is more susceptible to illness and infection and can suffer from a wide range of conditions such as bleeding, infections, high BP, weak bones, weak kidney, diabetes, and cholesterol.

How is life after the liver transplant?

Following the liver transplant, there are 10 days of hospitalization where the person is monitored round-the-clock. Over the next 2 months, the person will have to undergo frequent medical tests to check for rejection of the new liver by the body. These tests will be conducted for the rest of the life but in larger intervals of time. There will be various changes required in the diet and lifestyle. You will also be asked to avoid excessive physical strain. But other than these, the person can enjoy a normal life.

Will my children inherit liver cancer?

The percentage of people whose parents had liver cancer and they, in turn, develop the condition, is extremely low. But to be on the safer side, if your parents had this condition, it’s good to get yourself screened for the condition once a year.

Can liver cancer be prevented?

Yes, after several years of research, doctors are of the opinion that the risk of liver cancer can be drastically reduced by following these tips:

• If you are a chronic drinker, it’s best to quit alcohol completely! If you are finding this difficult, you can join a de-addiction center or group that will make it easy for you.
• If you drink regularly, it’s good to reduce the number of drinks or drink size, and also the frequency of drinking.
• Maintain a healthy weight: Obesity puts a person at risk of various ailments including cancer in any part of the body.
• Take the vaccine for Hepatitis B regularly. This will cut down the risk hugely.
• Reduce the risk of Hepatitis C. Hepatitis C has no cure but one can prevent its occurrence by following a few measures:
  • Avoid casual or unprotected sex: It’s best to avoid sex with people whose general health is not known to you. Also, avoid sex without the use of condoms. In addition to Hepatitis C, you are at the risk of developing venereal diseases.
  • Say no to drugs: Drugs that are injected through an infected syringe puts you at severe risk of Hepatitis C.
  • Watch out for the needle: In case you need to take IV fluids or IV medication, ensure the needle has been sterilized before use.
  • Beware of the tattoo: Avoid tattoo shops that are not maintained hygienically. The needle used for tattooing can be infected putting you at the risk of various diseases including Hepatitis C.

 

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

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