Liver cancer

Liver cancer is increasing day by day. Its probably due to increase in incidence of cirrhosis of liver that predisposes to liver cancer. Causes of cirrhosis of liver –

1. Alcohol
2. Viral hepatitis’
3. NASH – Non Alcoholic Steatohepatitis
4. Toxins
5. Autoimmune conditions- PBC, Autoimmune Hepatitis etc.

Above are main conditions that cause cirrhosis and predisposes to liver cancer. As the rate of obesity and Diabetes Mellitus is increasing all over world so is the rate of fatty liver and steatohepatitis (injury to liver) that predisposes to cirrhosis and thus liver cancer. So it becomes imperative for allpatients having above mentioned factors to be utmost careful in monitoring the progression of theirdisease to detect cancer at early stage.

FAQs

1. How can liver cancer be prevented?

Liver cancers can be prevented by keeping high risk patients under regular follow
with tumor markers and ultrasound examination. Patient at high risk of getting liver cancers
are mentioned above. So patients with above risk factors who have not progressed to
cirrhosis should be treated according to cause e.g; stopping alcohol, decreasing weight, good
control of diabetes, treating viral hepatitis etc.

2. What is peculiar about liver cancer and its treatment?

Liver cancers usually arise in patients with cirrhosis. This presents peculiar problem
as these patients have damaged liver in addition to tumor. Damaged liver further shrinks
treatment options for such patients. Moreover majority of these patients are unfit for any
form of treatment due to damaged liver. So treatment is tailored according to status of liver
disease and tumour size and location.

3. Is there any medical treatment of liver cancer?

Mainstay of treatment is surgery. Medical treatment is offered to only those cases that
cannot be offered any surgery

4. How can liver cancers be treated?

Best way to treat liver cancer is by surgery. Surgery can be

• Resecting tumor or tumor bearing liver
• Liver transplantation

First option is feasible only in normal livers or in cirrhotic with small tumours. In patients
with cirrhosis best treatment option is liver transplant provided tumor load is within one specific
range. Liver transplantation takes care of diseased liver and tumor simultaneously and thus provides best chances of prolonged life.

In cases of tumor deemed unresectable or patient is unfit for transplant, interventional
radiology provides solution for tumor treatment by

A. Radiofrequency ablation that has same results as surgery in cirrhotics,
B. Tumor chemoembolization
C. Internal tumor radiation by TARE

5. Which specialist is best to treat liver cancer?

Before starting any treatment liver or liver transplant surgeon must be contacted. Liver
surgeon is best person to evaluate patients fitness and tumour resectability and can provide
tailored approach that is best suited for patient’s condition as mentioned above.