Liver is one of the largest and essential organ of body. Food nutrients absorbed from intestine reaches liver via portal blood circulation where they are metabolized and essential building blocks are formed. Liver is an important organ for digestion, metabolism and synthesis of many chemicals required by body. Apart from primary cancers arising in liver, it is also one of the most common sites of metastasis from other cancers of body.
Cirrhosis: damage of liver parenchyma from chronic insult by alcohol, hepatitis or other causes
Hepatitis: Chronic infection with hepatitis B or C
Alfatoxin exposure: produced by mold/ fungi that grow on food grains, peanut, corn.Obesity
Fatty Liver Disease
Chemical exposure like arsenic, viny chloride, hemochromatosis
Older age >50 years
Male are more predisposed than females
There are no general screening guidelines for liver cancer. Those patients who are at risk because of cirrhosis are advised to remain in close followup and screening with ultrasound and S. Alfa-fetoptotein (AFP) every 6 months.
Most of the time liver cancer is detected in late staged because it keeps on growing without any symptoms. There are certain symptoms which if present, consultation should be done with doctor and get checked to find the exact cause.
Enlarged liver- swelling in ride side upper abdomen
Swelling because of fluid in abdomen (Ascites)
Feeling full/ loss of appetite
Unexplained weight loss/ weakness/ fatigue
Signs and symptoms of liver failure
Liver Functions tests, tumor markers like AFP, CA 19-9, PIVKA
Triphasic CECT/ MRI: very accurate test for diagnosis, staging and treatment planning
Ultrasound is many times initial investigation
Biopsy is required sometimes when diagnosis is not clear
I: single tumor in the liver only.
II: single tumor with vascular involvement or multiple tumor or multiple tumors of < 5cm.
III: multiple tumors with one at least >5 cm or involvement of major branch of portal vein or hepatic vein.
IV: involve lymph nodes or distant organs.
Treatment depends on-
Number/ size and location of the tumor within the liver
Functional reserves of liver
Underlying liver parenchyma normal or cirrhosis
Involvement of other organs
Surgery :Treatment is planned considering all these parameters. Surgery is the only curative treatment in localized liver disease. Resection and transplant are two curative options and these are advised and planned by considering function liver capacity and underlying cirrhosis grade.
Hepatectomy : removes a portion usually right or left half of liver. The remaining healthy liver regrows. Sometimes extended liver resections are also done to completely clear the disease where only 25% of liver is left. Proper assessment of underlying liver parenchyma reserve is very important. Sometimes PTBD to decrease jaundice is required before major surgery. Sometimes tumor side portal vein embolization is done to increase function capacity of remaining liver.
Liver transplant : replaces the entire diseased liver with a healthy liver from a suitable donor. Multiple cancers and patients with underlying cirrhosis of grade B and C are suitable candidates for this surgery.
Ablation : Heat (Radiofrequency ablation) or ethanol injections are used to destroy the cancer cells. They useful in small tumors in patients who are not fit for surgery.
Targeted therapy : medications are designed to hit/ target cancer cells with specific receptors. It decreases the tumor growth. Targeted therapy can be helpful for people where disease has spread beyond liver to other organs.
Embolization and chemoembolization : Embolization and chemoembolization block off the hepatic artery supply to tumor. Small particles are used for this to reduces blood flow to the tumor. In chemoembolization, chemotherapy drugs are embolized into the hepatic artery. This procedure is used in patients where there are multiple tumors in both lobes of liver and disease has not spread beyond liver.
Immunotherapy is also helpful to some extent in metastatic patients
⦁ Avoid cirrhosis by not taking alcohol.
⦁ Maintain healthy body weight.
⦁ Hepatitis B vaccination.
⦁ Avoid hepatitis C by safe practices
⦁ Fresh fruits and vegetable
⦁ Genetic counselling and testing for at risk individuals
Without treatment, the median survival for stage A liver cancer is 3 years. With treatment, between 50 and 70 out of 100 people (between 50 - 70%) will live for 5 years or longer. Contact Cancer Surgery Gurugram surgery gurugram for liver cancer treatment in Gurgaon.
If liver cancer is localized (limited to the liver), the 5-year survival rate is 28%. If liver cancer is regional (has developed into nearby organs), the 5-year survival rate is 7%. Once the liver cancer goes away (spreads to distant organs or tissues), the survival time is as short as 2 years. Contact Cancer Surgery Gurugram surgery gurugram for liver cancer treatment in Gurgaon.
Best Doctor for Liver Cancer in Gurgaon says liver cancer is one of the most common malignant cancers in the world. It is mainly caused by a combination of chronic hepatitis B virus infection and dietary exposure to aflatoxin B1, a contaminant from the mold Aspergillus flavus that grows on corn and peanuts.
According to best doctor for Liver Cancer in Gurgaon liver cancer can spread quickly depending on the type of cancer. Hemangiosarcoma and angiosarcoma types of liver cancer are spreading rapidly, while hepatocellular carcinoma spreads late in the disease.