Liver Cancer

The liver is one of the most vital organs which filters the blood coming from the digestive tract, before circulating it to the rest of the body. It detoxifies chemicals and metabolizes drugs. The liver also synthesizes proteins required for blood clotting and other functions.

The liver can be affected either by primary liver cancer which arises in the liver, or secondary or metastatic cancer, which originates elsewhere in the body. Primary liver cancer tends to occur when the liver is damaged in the form of cirrhosis (a scarring condition of the liver), certain birth defects, alcohol abuse, chronic infection with diseases such as hepatitis B and C, hemochromatosis, obesity and fatty liver disease amongst others.

LIVER CANCER SYMPTOMS

• A hard lump on the right side just below the rib cage
• Swollen abdomen and discomfort in the upper abdomen (right side)
• Pain near the right shoulder blade or in the back
• Jaundice
• Easy bruising or bleeding
• Unusual tiredness
• Nausea and vomiting
• Loss of appetite
• Weight loss for no reason

Having any of these symptoms does not mean it is cancer, but if one or more of them is noticed for more than 2 weeks, then a doctor must be seen and an immediate health screening is a must.

Liver Cancer DIAGNOSIS

The diagnosis of liver cancer includes physical examination and history, serum tumor marker test, liver function test, CT scan and MRI. Biopsy is done along with laparoscopy to confirm the diagnosis.

LIVER CANCER TREATMENT

Liver cancer as staged by Barcelona Clinic Liver Cancer (BCLC) staging system is

Stage 0: Very early
Stage A: Early
Stage B: Intermediate
Stage C: Advanced
Stage D: End-Stage

Treatment of stages 0, A and B includes partial hepatectomy, total hepatectomy and liver transplant. The tumor can be ablated using radio frequency ablation, microwave therapy, percutaneous ethanol injection and cryoablation. Treatment of stages C and D includes embolization therapy and is performed by using either transarterial chemoembolization (TACE), Radio Frequency Ablation (RFA), Transarterial Radioembolization or external beam radiotherapy with high dose focused conformal technology (e.g. cyberknife)methods.

Liver Cancer is completely curable if detected early. Liver cirrhosis and viral hepatitis ca be detected early by regular health screenings. An integrated approach of a multidisciplinary team is the best way to conquer liver cancer.

Radiation Therapy for liver tumours is quite complex as the liver is one of the most radiosensitive organs in the body. Proton Therapy can play a vital role in the treatment of liver cancers as it can reduce the toxicity to surrounding healthy organs while delivering the required radiation dosage to destroy the tumour.