World Cancer Day is celebrated every year on February 4. The year 2022 day was celebrated over the globe with awareness and advocacy campaigns. Cancer is the second leading cause of death globally. It can occur at any age and if not detected at the right time and untreated, it can increase the risk of death.
Cancer is a disease in which normal cells change and grow uncontrollably, that can form a lump called a tumor or mass. A tumor can be benign (not cancerous) or malignant (cancerous). The name given to a cancer depends on the part of the body where the cancer first started.
Cancer that starts in the liver is called primary liver cancer. Cancer that has spread to the liver from another part of the body (a process known as metastasis) is not called liver cancer. The term “liver cancer” refers to hepatocellular carcinoma (HCC), the most common type of primary liver cancer.
Risk factors
A risk factor is anything that increases a person’s chance of developing a disease such as cancer. Different diseases or cancers have different risk factors. The risk factors do not always directly cause cancer. Some people may have several risk factors but never develop cancer, while other people who have no known risk factors do develop cancer. The more risk factors a person has, the greater the chance of developing cancer. Knowing the risk factors and discussing them with the health care provider may help one make more informed lifestyle and health care choices about how to reduce the risk of cancer.
The most common risk factor for liver cancer is chronic infection with the hepatitis B virus. Individuals chronically infected with hepatitis B have a 25 per cent to 40 per cent lifetime risk of developing liver cancer. Chronic infection with the hepatitis C virus is also a cause of liver cancer because of the great number of people infected with this virus. Chronic hepatitis B infections, however, cause at least 54 per cent of all liver cancer worldwide.
Additional risk factors for developing liver cancer include cirrhosis and excessive alcohol use, smoking, as well as obesity, diabetes and nonalcoholic fatty liver disease. Some inherited diseases that cause liver damage also increase the risk of liver cancer. Race or ethnicity and a family history of liver cancer are known risk factors. Liver cancer is more common among men than women regardless of race or ethnicity. Others are inherited metabolic diseases, exposure to aflatoxin and environmental toxins.
Symptoms
Early-stage liver cancer often does not cause symptoms, which is why regular screening is so important for early detection. Common symptoms may appear:
- Pain in the upper abdomen (belly) on the right side
- A lump or a feeling of heaviness in the upper abdomen
- Swollen abdomen (collection of fluid)
- Loss of appetite and feelings of fullness
- Weight loss
- Weakness or feeling very tired
- Nausea and vomiting
- Yellow skin and eyes (jaundice)
- Pale stools and dark urine
- Fever
These symptoms could also be caused by other health problems, so it is very important to see a qualified health care provider early on so that problems can be diagnosed and managed as soon as possible.
Diagnosis
The health care providers will conduct physical examinations, ask about family history, any symptoms and order blood tests (such as Hepatitis B and C tests,Alpha Feto Protein (AFP) levels, liver function tests) or imaging tests (such as ultrasound, CT, or MRI scans).
Prevention
Liver cancer is preventable if the primary risk factors such as chronic hepatitis B and C infections can be eliminated. The hepatitis B vaccine was named the first “anti-cancer” vaccine by the U.S. Food and Drug Administration because it prevents chronic hepatitis B infections, thereby preventing liver cancer caused by the hepatitis B virus.
The hepatitis B vaccine is recommended for all infants, children and adults at high risk for infection. Vaccinating newborns with the hepatitis B vaccine at birth has resulted in a dramatic reduction in the number of new cases of liver cancer caused by hepatitis B.
At least 80 per cent of people diagnosed with liver cancer also have cirrhosis. Although chronic hepatitis B infections can lead to liver cancer without cirrhosis, in general preventing cirrhosis can reduce the risk of liver cancer. The most important way to prevent cirrhosis is to prevent chronic infections of hepatitis B and C in the first place. In addition, cirrhosis can be prevented by decreasing alcohol use, stopping smoking, and avoiding exposure to cancer-causing industrial chemicals or aflatoxins in poorly stored food, nuts and grains.
Screening
Regular screening for liver cancer and early detection are the most effective ways to improve treatment success and survival rates. Early detection of liver cancer results in more treatment options, which greatly improves the chances of survival after initial diagnosis. This is why regular liver cancer screening is so important.
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