To mark Liver Cancer Awareness Month this October, we’re taking a look at risk factors, symptoms and treatment of liver cancers here in Australia.
Sadly, liver cancer is a type of cancer that can affect us all, although it is very rare in children and more common in men than in women . In 2020, it is estimated that 1,923 males and 739 females will be diagnosed with liver cancer in Australia alone. As with most cancers, the incidence rate increases with age, peaking at 80-84 years.
The chances of surviving for at least 5 years after a liver cancer diagnosis sits at around 20%.
Primary liver cancer occurs when cells in the liver multiply and grow out of control. The cancers can stay within the liver or can spread to other parts of the body.
Secondary liver cancer refers to a cancer that has started somewhere else in the body and spread (or metastasized) into the liver.
Who is at risk of developing liver cancer?
Some factors that increase your risk of developing liver cancer include:
- Exposure to Hepatitis B or C viruses, which result in chronic infection (the biggest known risk factor for primary liver cancer in Australia
- Type 2 diabetes
- Fatty liver disease
- Genetic disorders
- Excessive alcohol consumption
Symptoms of Liver Cancer
Liver cancer symptoms tend to present themselves more obviously as the disease progresses. They may include:
- Stomach/abdominal pain or swelling
- Right shoulder pain (caused by the enlarged liver putting pressure on the nerves under the diaphragm)
- Appetite loss/nausea
- Yellow skin/eyes
- Pale stools
Diagnosing Liver Cancer
Liver cancer is usually diagnosed through a series of tests. Common tests include:
- Blood tests - examining how well the liver is working, how well your blood clots, the presence of certain chemical tumour markers and whether you have hepatitis B, C or any genetic problems.
- Ultrasound - commonly used to detect primary liver cancer
- Biopsy - a small sample of liver tissue will be removed and sent to the lab for testing
- CT scans - CT stands for ‘Computed Tomography’. A CT scan uses multiple X-ray images taken from different angles to produce tomographic images, allowing doctors to see inside the body.
- MRI scans - MRI stands for Magnetic Resonance Imaging. MRI scans use strong magnetic fields, magnetic field gradients, and radio waves to generate images of the organs in the body.
- PET-CT scans are often used for secondary cancers in the liver, PET-CT scans produce three-dimensional colour images that show where any cancers are in the body.
CT, PET-CT and MRI scans are normally only used when a liver cancer diagnosis has been determined. They help to diagnose the location and stage of the cancer.
Upon completion of tests, doctors will be able to tell what stage the liver cancer has progressed to.
Once a diagnosis has been made, doctors can decide on the most suitable treatment option. Treatment options may include:
The removal of part of the liver is called a partial hepatectomy.
Following a partial hepatectomy, the remaining part of the liver can usually repair itself. For multiple tumours, surgery may be conducted over two stages to allow the liver to regrow in different areas.
A liver transplant may also be an option, although this tends to only be suitable for a small number of people with liver cancer who do not smoke, take drugs or drink alcohol. Waiting for a suitable donor liver can also take a long time.
A suitable treatment option for small primary liver cancers, which uses radio waves and microwaves or (less commonly) alcohol or cryotherapy to destroy cancer cells. This treatment is administered by either an injection or incision in the skin.
Chemotherapy is the use of a combination of anticancer drugs to destroy or control cancer cells. Chemotherapy is often used to help shrink the cancer before surgery, or post-surgery to help kill any cancer cells that have been left behind.
Other Treatment Types
The medical team may recommend other treatment types, or a combination of treatment types, depending on the stage and progression of the liver cancer. These can include biological therapies (treatments that stop the cancer’s growth or function, or help the immune system destroy them), SIRT (targeting the liver tumours directly with high doses of internal radiation in tiny beads), endoscopic stent placement (if the cancer in the liver has obstructed the bile duct and bile has then built up in the liver, a stent can be used to drain the bile) or palliative care.
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