Liver cancer: Risk factors and Prevention Strategies

Hepatocellular carcinoma (HCC), another name for liver cancer, is a form of the disease that starts in the liver’s cells. Detoxification, metabolism, and the creation of proteins are just a few of the many tasks the liver is in charge of carrying out. Normal liver cells can develop genetic flaws, which cause them to divide and expand out of control, resulting in liver cancer.

Liver cancer can come in two primary forms:

1. Primary liver cancer is a term used to describe cancer that starts in the liver. Hepatocellular carcinoma (HCC), which develops from hepatocytes, the primary kind of liver cells, is the most prevalent type. Inherited liver conditions including chronic hepatitis B or C infection, cirrhosis (liver scarring), or heavy alcohol use are frequently linked to primary liver cancer.

2. The term “secondary liver cancer” (also known as “metastatic liver cancer”) refers to liver cancer that has progressed to the liver from another part of the body, such as the colon, breast, or lung. The cancerous cells spread through the bloodstream or lymphatic system to form new liver tumors.

There is a chance that liver cancer will be significant and fatal. stomach pain, weariness, jaundice (a condition in which the skin and eyes become yellow), appetite loss, and stomach swelling are just a few of the symptoms that it may produce. Liver cancer may, however, occasionally go undetected until it has advanced.

The Risk Factors of liver Cancer

  • Chronic viral hepatitis: Liver cancer risk is considerably increased by persistent infection with the hepatitis B virus (HBV) or hepatitis C virus (HCV). These viruses increase the likelihood of malignant alterations by causing chronic inflammation and damage to liver cells.
  • Cirrhosis is the scarring of the liver tissue and is frequently brought on by long-term alcohol misuse, viral hepatitis, or other liver conditions. Cirrhosis increases the likelihood of malignant changes by causing chronic liver cell destruction and regeneration. This makes cirrhosis a significant risk factor for liver cancer.
  • Heavy drinking: Prolonged and heavy alcohol usage can result in liver cirrhosis, which raises the risk of liver cancer. Alcohol immediately harms liver cells and impairs their ability to function normally.
  • Non-alcoholic steatohepatitis (NASH) and non-alcoholic fatty liver disease (NAFLD) are diseases in which there is a buildup of fat in the liver. Obesity, diabetes, and metabolic syndrome are all linked to these ailments. NAFLD and NASH have the potential to develop into liver cirrhosis over time, raising the risk of liver cancer.
  • Flavonoids: Flavonoids are poisonous compounds made by specific types of molds that can contaminate foods including cereals, peanuts, and corn. Liver cancer risk can be increased by sustained exposure to aflatoxins, which is primarily accomplished through contaminated food.
  • Diabetes: Type 2 diabetics are more likely to get liver cancer than other diabetics. Although the precise cause of this connection is not entirely understood, it is thought that chronic inflammation and insulin resistance may be a contributing factor.
  • Obesity: Obesity is associated with an elevated risk of liver cancer. The liver can store extra body fat, which can cause inflammation, damage to the liver’s cells, and ultimately a higher risk of developing cancer.
  • Genetic components: Hepatocellular carcinoma risk can be raised by inherited liver conditions including Wilson disease and hereditary hemochromatosis. In addition, there may be an increased risk of the disease in people with a family history of liver cancer.

Symptoms of Liver Cancer

  • Constant ache or discomfort in the upper abdomen or on the right side of the abdomen is a common symptom. It could be continuous or irregular, dull or sharp.
  • Sudden and unexplained weight loss: People with liver cancer frequently have this symptom. Even if the person hasn’t changed their diet or exercise habit, this weight reduction could still happen.
  • Weakness and exhaustion: One of the most typical symptoms of liver cancer is a persistent feeling of exhaustion and a lack of vitality. It might be brought on by how the cancer affects the body and how poorly the liver is able to operate.
  • Appetite loss: Liver cancer can result in a lack of appetite, which decreases the urge to eat. Malnutrition and unintended weight loss are potential outcomes of this.
  • Jaundice: The eyes and skin turn yellow when someone has jaundice. It happens when the liver struggles to properly break down bilirubin, a yellow pigment created when red blood cells degrade. Jaundice can be brought on by liver cancer, which can block the bile ducts, creating a buildup of bilirubin.
  • Abdominal swelling or bloating can be brought on by liver cancer, which can cause fluid to build up in the belly. Ascites is a disorder that can lead to abdominal discomfort and a noticeable enlargement.
  • Liver cancer patients may have nausea and vomiting as well as digestive problems. It’s possible for these symptoms to come and go.
  • Bowel habits: Bowel habits can change as a result of liver cancer and include diarrhoea or light-colored, chalky stools.

How is Liver Cancer Diagnosed?

How is Liver Cancer Diagnosed?

1.Medical history and physical exam: Your symptoms, medical background, and risk factors will all be discussed with the doctor. A physical examination will also be done, looking for symptoms such an enlarged liver, jaundice, or abdominal edoema.

2.Blood tests: Blood tests are performed to assess the function of the liver and to look for specific indicators that could point to liver cancer. Alpha-fetoprotein (AFP) levels, a tumour marker, liver function tests, and other particular blood tests to evaluate the health of the liver are among these assays.

3.X-ray examinations

  • The liver can be visualised via ultrasound by using sound waves. It can aid in the discovery of anomalies such tumours or enlarged livers.
  • An X-ray is used in a computed tomography (CT) scan to provide fine-grained cross-sectional images of the liver. The size, location, and features of any tumours are described in further detail.
  • A detailed image of the liver is produced by an MRI scan, which uses magnetic fields and radio waves. The tumor’s size and distribution can be ascertained with its aid.
  • A dye is injected into the blood vessels supplying the liver during an angiography operation, and X-ray images are then captured. The blood supply to the tumour can be assessed with its aid.
  • PET scan: Positron emission tomography (PET) scan makes use of a radioactive tracer to identify regions of the liver with enhanced metabolic activity. It aids in determining whether the cancer has spread to different bodily areas.

4.Staging: After liver cancer has been identified, the disease’s size and distribution are assessed. Making treatment decisions is aided by this. 

This aids in directing therapy choices. Additional imaging tests, like as bone scans or chest X-rays, may be required for staging in order to look for metastasis (spread) to other body regions.

How is Liver Cancer Treated?

1.Surgery: Surgery for liver cancer includes the following:

  • Resection: Surgical excision of the tumour along with some surrounding healthy liver tissue. If the liver’s remaining function is sufficient and the tumour is in an early stage, this is appropriate.
  • Liver transplantation: If the patient satisfies certain requirements and the tumour is contained to the liver, liver transplantation may be an option. It entails removing the sick liver and replacing it with a donor liver that is healthy.
  • Ablation: In this process, the tumour is eliminated by using heat (radiofrequency ablation) or cold (cryoablation). When surgery is not an option or there are little tumours, it is appropriate.

2.High-energy X-rays or other types of radiation are used in radiation therapy to either kill or slow the growth of cancer cells. It can be applied as an adjuvant therapy after surgery or as a main treatment for locally advanced liver cancer.

3.Transarterial Chemoembolization (TACE): TACE is a technique that combines embolisation and chemotherapeutic medicines. It entails injecting chemotherapy medications directly into the blood vessels feeding the tumour, then closing those vessels to stop the blood flow to the tumour. For liver cancer in an intermediate stage, TACE is frequently administered.

4.Immunotherapy: Immunotherapy is the use of drugs to activate the immune system to detect and combat cancer cells in the body. Advanced liver cancer can be treated with it, especially when the tumour has a lot of the protein PD-L1 (programmed death ligand 1).

5.Chemotherapy: This treatment uses medications to eradicate cancer cells throughout the body. If the liver cancer has progressed to other organs or is advanced, it may be utilised. Both oral and intravenous chemotherapy methods are available.

6.Supportive care: Supportive care aims to manage symptoms, enhance quality of life, and relieve discomfort brought on by side effects of therapy. Pain relief, dietary assistance, and emotional support could all be part of it.

Natural remedies for Liver Cancer

  • Healthy diet: A nourishing diet is essential for promoting liver health. Be sure to place an emphasis on ingesting a variety of fruits, vegetables, whole grains, lean meats, and healthy fats. Limit your consumption of processed foods, sweet drinks, and foods high in saturated fats. Garlic, turmeric, green tea, cruciferous vegetables (broccoli, cauliflower, and cabbage), and citrus fruits are some specific foods that are thought to be good for liver function.
  • Milk thistle: To promote the health of the liver, many people turn to the plant milk thistle. It contains silymarin, a substance thought to have anti-inflammatory and antioxidant properties. Although there is little scientific evidence to support its effectiveness in treating liver cancer in particular, it might aid in liver function support and damage prevention for liver cells. Consult a medical expert for advice on dosage and other matters.
  • Food supplements: Some dietary supplements, including omega-3 fatty acids, vitamin E, vitamin C, and selenium, are thought to have antioxidant characteristics and improve liver health. Prior to beginning any supplements, it is crucial to speak with a healthcare provider because they may mix with certain drugs or cause unwanted side effects.
  • Exercise on a regular basis: Physical activity on a regular basis can boost liver function and aid to improve general health. Exercise can help you keep a healthy weight, lower your risk of developing non-alcoholic fatty liver disease (NAFLD), and improve your circulation.
  • Limit your alcohol intake because it can harm your liver and raise your risk of developing liver cancer. To protect the health of the liver, alcohol consumption should be restricted or avoided.
Natural remedies for Liver cancer

Prevention for Liver Cancer

  • Immunisation: Hepatitis B virus (HBV) vaccination dramatically lowers the incidence of liver cancer. When it comes to avoiding HBV infection, which is a significant risk factor for liver cancer, the HBV vaccine is quite successful. Infants, healthcare professionals, people at high risk of exposure to HBV, and people who have never received a vaccination are all advised to get one.
  • Taking measures to avoid contracting the hepatitis C virus (HCV) can lower the chance of developing liver cancer. This entails refraining from sharing needles or other drug-use accessories, engaging in safe sex, and making sure tattoos and medical operations are performed in hygienic environments.
  • Sexually transmitted infections (STIs), such as HBV and HCV, which are linked to liver cancer, can be prevented by utilising barrier techniques like condoms during safe intercourse.
  • Limiting alcohol intake: Liver cancer is known to be increased by excessive alcohol use. It is crucial to restrict alcohol consumption or refrain from drinking at all to lower the risk. Up to two drinks per day are typically considered to be moderate alcohol use for men, whereas up to one drink per day is considered moderate for women.
  • Maintaining a healthy weight is important since liver cancer is a risk factor for obesity and non-alcoholic fatty liver disease (NAFLD). The chance of getting liver cancer can be decreased by eating a balanced diet and exercising frequently to maintain a healthy weight.Aim for a body mass index (BMI) and weight that are healthy for you.
  • Healthy eating: Eating a balanced diet high in fruits, vegetables, whole grains, and lean proteins can help to protect the liver and lower the risk of liver cancer. Consuming fewer processed meals, saturated fats, and added sugars is also advantageous.
  • Avoiding exposure to toxins can help lower the risk. Environmental pollutants and substances that are known to wreak havoc on the liver and cause cancer should be avoided. This entails staying away from or reducing exposure to aflatoxins, which are present in mouldy nuts, cereals, and legumes.

*Disclaimer: This article is for informational purposes only and should not substitute professional medical advice. Please consult a healthcare professional for a thorough evaluation of your symptoms and appropriate treatment.

Author Information

Author Contribution: Reviewed by Dr. Ram Reddy, MD – General Physician, and Rajeshwar Rao, Pharm D.

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