The liver is one of the most important organs of the human body, and is the largest solid organ in the body. It acts as a filter in cleansing our blood from harmful substances by passing out the toxins from the body as waste products. The liver also makes bile that facilitates digestion of fat and production of numerous proteins by storing glycogen (or sugar). Most medical textbooks state that the liver has over 500 functions, including vital functions like energy production, fighting infections and processing digested food.
Liver cancer is a medical condition caused by the abnormal growth of the liver cells. The cancer can be of two types, primary and secondary liver cancer. A primary liver cancer originates from the liver, whereas secondary or metastatic liver cancer refers to the condition wherein the cancer spreads from other organs to the liver (secondary site) of the patient’s body.
People with fatty liver disease, significant alcohol consumption, or who are suffering from other liver diseases, including hepatitis B or C and liver cirrhosis. Patients with a positive family history of the liver cancer/hepatitis tend to have a higher risk of developing this disease. Other than that, gender is also a factor, as studies have shown that men are more susceptible to liver cancer as compared to women.
During the early stage of liver cancer, a person may exhibit no symptoms at all. The symptoms are generally visible when a swelling develops in the liver. Some of the common symptoms of the disease include:
There are four stages of liver cancer, viz.
In the earliest stage, only one tumor is found, which has not spread to any other part or organ of the body.
During this stage, the tumor can be either singular (grown into the patient’s blood vessels of liver) or multiple tumors that are ≤5cm in size (not grown inside the patient’s blood vessels).
It is sub-divided into three stages –stage 3A (with more than one tumor, of which, at least one tumor size is >5cm), stage 3B (cancer grows into either hepatic vein or portal vein), and stage 3C (cancer has spread around the internal organs of abdomen or organs nearby liver).
At this final stage, cancer could be of any size or number, and may spread to the other locations in the body, such as the lungs, bones, well as blood vessels or lymph nodes.
Curative options for liver cancer: Surgery (liver transplant or liver resection “removal of tumour”) are considered curative options. Newer ablation techniques including radiofrequency ablation or microwave ablation can potentially be curative in smaller tumours i.e. less than 3 cm size, and located in a favorable site in the liver. Similar to other types of cancers, liver cancer can also be treated by surgery wherein the cancerous tissue or affected part of the liver is removed. In some cases, the liver may be entirely removed and replaced with the donor organ (liver transplant procedure).
Palliative Options: Transarterial chemoembolization, selective internal radiation therapy with Yttrium-90, percutaneous ethanol injection, oral chemotherapy (sorafenib) are considered palliative options. These options can control liver cancer, but are not considered curative. These options are generally discussed if surgical options are deemed not suitable for patients. Chemotherapy or radiation therapy can be used to kill cancerous cells while preventing disease recurrence.
With the rising incidences of hepatocellular cancer (liver cancer), check with your doctor today to avert the risks of developing this lethal disease!
Senior Consultant Surgeon
MBBS (Singapore), FRCS (Edinburgh), MMed (Surgery), MSc (Bioinformatics),
FAMS (General Surgery)
With 20 years of surgical experience, Dr Lee is trained and skilled in using minimally invasive techniques for liver, pancreas, gallbladder and hernia procedures.
His busy practice aside, Dr Lee is actively involved in postgraduate teaching and workshops for junior surgeons, and is still actively involved in academic research at the National University of Singapore.
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