Diagnosed Of Liver Cancer

Diagnosed Of Liver Cancer
How is liver cancer diagnosed? 
HCC screening - high risk individuals for HCC (hepatocellular carcinoma) should have regular screenings for liver cancer. Liver cancer, if not diagnosed early is much more difficult to get rid of. The only way to know whether you have liver cancer early on is through screening, because you will have no symptoms. High risk people include those with hepatitis C and B, patients with alcohol-related cirrhosis, other alcohol abusers, and those that have cirrhosis as a result of Hemochromatosis.

Diagnostic tests may include:
Blood test - afp (alpha fetoprotein), a type of protein, is produced by liver tumors and can be detected in a blood test.
Imaging scans - either an MRI or CT scan.
Biopsy - a small sample of tumor tissue is removed and analyzed. The analysis can reveal whether the tumor is cancerous (malignant) or non-cancerous (benign).
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 that has reached a blood vessel.
Stage 3 - either there are various large tumors, or there is just one that 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.
What are the treatment options for liver cancer? Unfortunately, because symptoms do not appear until the liver cancer is well advanced, currently only a small percentage of patients with HCC can be cured; according to the National Health Service (January 2010) only about 5%.

Liver cancer treatment options may include: Treating curable cancer:
Surgery - in the early stages when the tumor is small occupies just a very small part of the liver, it can be surgically removed (surgical resection). Even if part of the liver is removed during this procedure, the patient's health should not be significantly undermined.
Liver transplant - candidates for a liver transplant cannot have a tumor larger than 2 inches (5cm), according to the National Health Service (NHS), UK. If the tumor is larger the risk of the cancer coming back is too high, says the NHS.
Treating non-curable cancer - if the liver cancer has had a chance to advance, the likelihood of a cure is extremely small. However, there are things the medical team can do to treat symptoms and slow its advancement.
Ablative therapy - substances are injected directly into the tumor, such as alcohol. Lasers and radio waves can also be used.

Radiation therapy (radiotherapy) -
 radiation is directed at the tumor(s), killing a significant number of them. Patients may experience nausea, vomiting and fatigue.
Chemotherapy - medications are injected into the liver to kill cancer cells (chemoembolization). In chemoembolization the blood supply to the tumor is blocked surgically or mechanically and anticancer drugs (chemotherapy) are administered directly into the tumor.
Volunteer for clinical studies - when trials reach the human stage they are called clinical trials. Ask your doctor whether there are any available in which you may be able to take part.
Treatment options may vary, depending on the type of liver cancer. For cholangiocarcinoma the medical team may recommend photodynamic therapy, brachytherapy, radiotherapy or liver transplantation. For hepatoblastomas, doctors may use chemotherapy, radiation therapy, liver transplantation, or surgical resection. How can liver cancer be prevented? Alcohol:Long-term, regular high alcohol intake significantly increases the risk of cirrhosis of the liver, which in turn makes the likelihood of developing liver cancer much greater. It stands to reason, therefore, that moderating one's alcohol intake (or giving up completely) can significantly reduce the risk of developing liver cancer.

Hepatitis B: The following individuals should seriously consider receiving the hepatitis vaccine; drug addicts who share needles, individuals who engage in unprotected sex with partners who may be at risk of having hepatitis B, nurses, doctors, dentists and other individuals whose occupations raise their risk of becoming infected. Frequent travelers, especially those who go to parts of the world where hepatitis B is common should also consider being vaccinated.

Hepatitis C: Although there is no sure way of protecting oneself from hepatitis C, using a condom during sex may help reduce the risk of infection. There is no hepatitis C vaccination (July 2010).

Body pierceings and tattoos - make sure the establishment is reputable and new or very well sterilized needles are being used. If you have any doubt about the place, go somewhere else.

What Is Liver Cancer? What Causes Liver Cancer?

What Is Liver Cancer? What Causes Liver Cancer?
Liver cancer, also known as hepatic cancer is a cancer which starts in the liver, and not from another organ which eventually migrates to the liver. In other words, there may be cancers which start from somewhere else and end up in the liver - those are not (primary) liver cancers.

Cancers that originate elsewhere and eventually reach the liver are known as liver metastasis or secondary liver cancers, and are most commonly from cancer of the GI tract (colon cancer), lung cancer, renal cancer (kidney cancer), ovarian cancer and prostate cancer. Cancers that originate in the liver are known as primary liver cancers.

The liver, which is located below the right lung and under the ribcage is one of the largest organs of the human body. It is divided into the right and left lobes. Nutrient-rich blood is carried by the portal vein from the intestines to the liver, while oxygen-rich blood reaches the liver from the hepatic artery.

All vertebrates (animals with a spinal column) have a liver, as do some other animals. The liver has a range of functions, including detoxification (getting rid of toxins), synthesizing proteins, breaking down fats,, and producing biochemicals that are essential for digestion. We cannot survive without a liver.

Liver cancer consists of malignant hepatic tumors (growths) in or on the liver.

The most common type of liver cancer is hepatocellular carcinoma (or hepatoma or HCC), and it tends to affect males more than females. According to the National Health Service (NHS), UK, approximately 1,500 people in the United Kingdom die from HCC each year.

The World Health Organization (WHO) says that liver cancer as a cause of death is reported at less than 30 cases per 100,000 people worldwide, with rates in parts of Africa and Eastern Asia being particularly high.

Experts say that common causes of HCC are regular high alcohol consumption, having unprotected sex and injecting drugs with shared needles.

Risks and causes of liver cancer

Risks and causes of liver cancer
How common liver cancer is?
Primary liver cancer is relatively rare in the UK, but it is increasing in number. Worldwide, it is the 6th most common cancer. The highest rates are in Eastern Asia.

Around 4,300 primary liver cancers are diagnosed in the UK each year. It is more common in men than in women. Our risk of liver cancer gets higher as we get older. Almost 9 out of 10 cases are diagnosed in people over the age of 55 years.

Primary liver cancer is cancer that started from the cells of the liver. It is much more common in the UK to have cancer that has spread into the liver from somewhere else in the body (secondary liver cancer). If you have secondary liver cancer, this is not the right section for you. You need to look for information in the section of this website that relates to your type of primary cancer.

What risk factors are
Anything that increases your risk of getting a disease is a risk factor. Different cancers have different risk factors. Doctors and scientists do not know exactly what causes liver cancer. But we know of some factors that can increase the risk.

Even if you have one or more risk factors, it doesn't mean that you will definitely get the disease. Researchers are investigating various factors that in the future may turn out to increase the risk.

Cirrhosis
Cirrhosis means scarring of the liver due to previous damage. This scarring can cause problems with the way the liver works. Having cirrhosis increases your risk of getting liver cancer (hepatocellular carcinoma or HCC). The risk varies, depending on the cause of the cirrhosis. Cirrhosis can be caused by

Infection with a virus such as hepatitis B or C
Long term alcohol drinking
Inherited diseases such as iron overload disorder (haemochromatosis) and alpha 1 antitrypsin deficiency

 Alcohol
Drinking more than 80g alcohol (about 10 units) a day over a number of years increases the risk of liver cancer. This amount of alcohol is well above the current government guidelines for alcohol intake. Long term heavy drinking causes cirrhosis, and may also directly damage the DNA in liver cells.
Non alcoholic fatty liver disease
Non alcoholic fatty liver disease (NAFLD) is a group of conditions including mild hepatic steatosis and non alcoholic steatohepatitis. In these conditions fat builds up in the liver. The fat causes inflammation and damage, which may lead to cirrhosis. Non alcoholic fatty liver disease is common in people who have a group of symptoms called metabolic syndrome, including

Having extra weight around the waist
Using insulin less effectively than normal
Type 2 diabetes
High blood pressure
One study has estimated that people with non alcoholic fatty liver disease have a risk of liver cancer that is 4 times higher than people without this condition.

Infection with hepatitis viruses
Long term infection with hepatitis B or C virus increases the risk of developing primary liver cancer because it causes damage to the liver (cirrhosis). If you have hepatitis B or C infection, it is important not to drink alcohol. If you do drink, it can further increase your risk of developing cirrhosis or liver cancer.

Hepatitis A and hepatitis E do not seem to increase the risk of liver cancer.

Smoking
Smoking increases the risk of liver cancer. Researchers estimate that almost a quarter of liver cancers in the UK are caused by smoking. In smokers who also have hepatitis C or hepatitis B virus infection the risk is increased further. Smokers who drink large amounts of alcohol may have a risk that is up to 10 times higher than people who don't smoke or drink.

Low immunity
HIV and AIDS lower immunity. An overview of individual studies showed that people with HIV or AIDS have a risk of liver cancer that is five times higher than people who don't have HIV or AIDS.

After organ transplants, people have to take medicines to stop their body rejecting the transplant. These medicines lower immunity and people who take them have double the usual risk of liver cancer.

The increased risk of liver cancer may be because people with low immunity are more likely to become infected with hepatitis B or C.

Family history
An American study found that people who have a first degree relative (parent, brother or sister) diagnosed with liver cancer have double the risk of developing it. One study has also shown an increased risk of liver cancer in people with a father and brother diagnosed with prostate cancer.

Diabetes
People with diabetes have a higher risk of liver cancer than people who do not have diabetes. The higher risk may be due to the higher levels of insulin in people with diabetes or due to liver damage caused by the diabetes. The risk may be increased more in people who have other risk factors such as liver cirrhosis, drinking alcohol in large amounts, and hepatitis infection.

Some treatments for diabetes such as metformin may reduce the risk of liver cancer.

Gallbladder removal
People who have their gallbladder removed (cholecystectomy) to get rid of gallstones may have an increased risk of liver cancer. The increased risk may be due to raised pressure in the bile duct causing long term inflammation in the liver tissue.

Radiation from X-rays or CT scans
Radiation from X-rays or scans can increase the risk of liver cancer but the risk is still very small. It is important to remember that X-rays and scans are very important in diagnosing illness so that people can have the right treatment.

Body weight
Two reviews have shown that the risk of liver cancer is higher in overweight and obese people. Diabetes and non alcoholic fatty liver disease are more common in people who are overweight, so this may partly explain the link.

The European Prospective Investigation into Cancer and Nutrition (EPIC) study is looking into links between diet and cancer. It found that the risk of liver cancer is higher in people who have a lot of weight around their waist (the apple shaped body).
Betel quid
Some studies have shown that people who chew betel quid have an increased risk of liver cancer. Betel quid is a combination of betel leaf, areca nut and slaked lime. It may also contain tobacco. There is a small amount of evidence that betel quid, even without the tobacco causes liver cancer. But more research is needed.

Aflatoxin
Aflatoxin is a substance found in mouldy peanuts, wheat, soya beans, groundnuts, corn and rice. People from Africa and Asia who have eaten these over a long period of time have an increased risk of developing hepatocellular liver cancer. The risk is increased further in people who also have hepatitis B infection.
Chemicals
There is evidence that exposure to the chemical vinyl chloride increases liver cancer risk. There is also limited evidence that exposure to arsenic, polychlorinated biphenyls and trichloroethylene may do so. People may come into contact with these chemicals through their work.

Factors that may lower risk of liver cancer
Some research has shown that people who drink 1 or 2 cups of coffee a day may reduce their risk of liver cancer by 23% to 43%. But the evidence for this is limited.

Symptoms Of Liver Cancer

Symptoms Of Liver Cancer
Weight loss
Doctors usually define significant weight loss as more than 10% of your body weight - a stone for every 10 stone you weigh. Obviously losing weight doesn't mean you are ill if you are dieting or there is some other reason. But if there is no obvious explanation for your weight loss, you should see your doctor.

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A swollen tummy (abdomen)
Swelling of the abdomen can happen in liver cancer for 2 reasons. The liver itself can get bigger from the growing cancer. This can cause swelling over the right side of your abdomen. Or you can have generalized swelling of the abdomen caused by a build up of fluid. This is called ascites.

Diagram showing fluid in the abdomen (ascites)

The fluid builds up because the liver is congested. This squeezes the blood vessels inside the liver and the blood that normally flows through it gets backed up in the veins. The pressure in these veins increases and forces fluid to leak from the veins into the abdomen. The veins may grow in size so much that they can be seen underneath the surface of the skin. If the liver is not able to make blood proteins as it should, fluid also tends to leak out of the veins and into the abdominal cavity. 

You can have ascites without having liver cancer, for example with liver cirrhosis.

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Jaundice
Jaundice means yellowing of the skin and whites of the eyes. It may also make the skin itch. It means that your liver is not working properly or there may be a blockage in the bile duct.

Jaundice is due to a build up of bile salts in the blood. If there is a blockage, the bile cannot drain away into the bowel as it normally would. So bile salts build up in your blood and body tissues. The bile salts make your skin look yellow and feel itchy (doctors call itching pruritis). The bile's yellow pigment is excreted through the kidneys, so your urine appears darker than normal. And because the bile is not passing into your bowel, your stools will be much paler than normal.

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Other symptoms
You may have some discomfort or pain in the tummy (abdomen) caused by the liver getting larger. You may also have pain in the right shoulder. This is caused by the enlarged liver stimulating the nerves under the diaphragm, which are connected to nerves in the right shoulder (referred pain).

Other symptoms you may have include

Loss of appetite over a period of a few weeks
Being sick
Feeling full or bloated after eating, even after a small meal
Itching
A sudden worsening of health in somebody with known chronic hepatitis or cirrhosis
A high temperature and sweating
Many of these symptoms are vague, and can be caused by conditions other than cancer. But if you do have any symptoms you should see your doctor.

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More information
The earlier a cancer is picked up, the easier it is to treat it and the more likely the treatment is to be successful. So it is important that you go to your GP as soon as possible if you notice worrying symptoms.