Besides Hepatitis B and C virus, can diabetes be a risk factor for primary liver cancer?
- Certainly yes. Diabetes too is a major risk factor with diabetics being at least two and a half times more vulnerable for chronic liver disease, that can progress to liver cancer. Non-alcoholic liver disease is also an emerging concern.
What are the types of liver cancer?
- The common ones are metastatic cancers. These are cancers either in the lungs or breast or colon and these can spread to the liver. These are thus known as either metastatic breast cancer or metastatic lung cancer and so on. The common primary liver cancer is hepatocellular cancer. Others which are less common are cholangiocarcinoma or hepatoblastoma.sunflower hospital Nagpur
What are the symptoms of hepatocellular carcinoma?
- In the early stage of the disease, there may be no symptoms or clinical features. The common one includes pain in the right upper quadrant of the abdomen. Poor appetite, loss of weight, nausea and vomiting, general weakness and fatigue are common features. Abdominal swelling, white chalky stools and severe jaundice are other features. sunflower hospital Nagpur
What are the factors that can increase the risk of primary liver cancer?
- Chronic infection with B or C virus increases the risk of liver cancer. Cirrhosis of the liver due to any cause increases the chances of liver cancer. Diabetics have increased the risk of liver cancer than non-diabetics. Increased accumulation of fat in the liver increases the risk of liver cancer. Excessive alcohol consumption is also a risk factor for liver cancer. Aflatoxins are produced by moulds that grow on crops that are stored poorly. These are peanuts or corn crops. These aflatoxins can cause liver cancer. sunflower hospital Nagpur
How to reduce the risk for liver cirrhosis and thus hepatocellular carcinoma?
- Liver cirrhosis is scarring of the liver. It is irreversible damage to the liver. Reducing the consumption of alcohol is the most important aspect. Maintaining a healthy weight is the next important step. Avoiding aflatoxins is the next step. Vaccination against hepatitis B virus is a very important step. Irrespective of age one can be vaccinated against hepatitis B. Thus 80 % of liver cancers can be prevented by taking vaccinations, avoiding alcohol, reducing weight and exercising regularly.
How to reduce risk against Hepatitis C virus?
- Seek very safe and clean shops when you get a piercing or a tattoo. Please be sure about their safety practices. Know the health status of your sexual partner. Do not have unprotected sex with strangers. Do not inject illicit drugs in your body. If at all use a sterile needle and do not share your needles.
How is the diagnosis of liver cancer made?
- Besides the routine blood tests to assess the liver function, alpha foetoprotein level in the blood may help. Ultrasound of the liver, CT scan of the liver and liver biopsy are the main tests. PET scan of the body may help to rule out metastatic liver cancer. As many liver cancer patients are asymptomatic in the early phase or may have non-specific symptoms, early diagnosis of liver cancer is a big challenge.
What are the treatment options available for the treatment of hepatocellular carcinoma?
- The treatment depends on the stage of the disease. Treatments vary but may include removal of the part of liver, transplant, chemotherapy and in some cases radiation. Chemoembolisation, targeted drug therapy, freezing or heating cancer cells that is cryoablation or radiofrequency ablation is the recent modalities. Liver transplantation is also suggested in a few with small localised tumours and in early-stage liver cancer.
What is the survival rate with liver cancer?
- For 43% of people who are diagnosed at the early stage, the 5-year survival rate is 31% For metastatic liver cancer this 5-year survival rate is less than 10 per cent. Survival with liver metastasis from prostate or breast is measured in years. Survival with lung cancer that has spread to the liver is measured in months.
Which is the best drug available for liver cancer?
- The drug Sorafenib that is already in use when surgery is not the option works in part by preventing new blood vessel growth. This drug is being used early such as after surgery or as a transarterial chemoembolisation method.
Author: Dr Jay Deshmukh
M.B.B.S., M.C.P.S., F.C.P.S., M.N.A.M.S., MD
(Internal Medicine – Bombay and New Delhi)
Chief Physician and Director, Sunflower Hospital, Nagpur