Hepatocellular Carcinoma: Causes, and Diagnosis

Overview

Hepatocellular carcinoma (HCC), a primary malignancy of the liver, is the second leading cause of cancer-related mortality in the world. Hepatocellular carcinoma occurs most often in people with chronic liver diseases, such as cirrhosis caused by hepatitis B or hepatitis C infection.

HCC is the 5th most common cancer in men worldwide, and 7th among women. An estimated 560,000 new cases are diagnosed annually. The incidence of hepatocellular carcinoma worldwide varies according to the prevalence of hepatitis B and C infections.

Causes

Although it’s not clear what causes
most cases of liver cancer, some common trends amongst those diagnosed have
been identified.

  • Chronic infection
    with viruses

People contracted with certain hepatitis viruses,
such as Hepatitis B or C for a long time, are very likely to have their livers
damaged and get infected with hepatocellular carcinoma.

  • Cirrhosis of the liver

Approximately 80% of those diagnosed with hepatocellular carcinoma have experienced some sort of chronic liver inflammation.

  • Exposure to aflatoxin

Aflatoxin, a harmful substance in some nuts and
grains, can contribute to hepatocellular carcinoma. It is consumed in small
amounts annually, though already controlled by the United States FDA.

  • Heavy alcohol use

Those drinking two alcoholic drinks or more a day are at a higher risk of getting hepatocellular cancer. 

  • Obesity and diabetes

Obesity can cause normal cells to turn abnormal and potentially become cancerous. And insulin used to treat diabetes can cause damage to the liver over long periods of time too.

  • Genetic predisposition

People with a family history of liver cancer are potentially infected with hepatocellular carcinoma.

Symptoms

Symptoms are not clear in the early
stage. However, as the tumor grows, it may cause symptoms including:

  • Unexplained weight loss
  • Decreased appetite
  • Nausea or vomiting
  • General weakness and lethargy
  • Swollen legs and abdomen
  • Yellow skin and eyes
  • White, chalky stools and dark urine
  • Pain in the abdomen or near the right shoulder blade
  • Fluid build-up in the belly
  • Fever

Diagnosis

Tests and procedures
used to diagnose liver cancer include:

  • A physical exam

Your doctor will give you a physical exam to check your physical conditions and may ask about your symptoms.

  • Blood tests

If a simple blood test reveals a protein called AFP, you may have liver function abnormalities.

  • Imaging tests

Your doctor may ask you to get an ultrasound, CT scan, or MRI to look for tumors in your liver.

Your doctor may want to remove a sample of your
liver tissue and check it under a microscope for cancer cells.

Treatment

Depending on the
severity of the disease, your age, health conditions and personal preferences,
treatments for hepatocellular carcinoma can vary greatly:

Surgery

  • Surgery to remove the tumor

In certain situations, your doctor may take out the part of your liver that has the cancer and a small portion of healthy liver tissue that surrounds it if your tumor is small and your liver functions well.

  • Liver transplant surgery

During a liver transplant surgery, your diseased liver is removed and replaced with a healthy liver from a donor.

Localized treatments

  • Heating cancer cells

Radiofrequency ablation uses an electric current to heat and destroy cancer cells.

  • Freezing cancer cells

Cryoablation uses
extreme cold to destroy cancer cells within a thin metal probe.

  • Alcohol injection

During an alcohol injection, pure alcohol is injected directly into tumors, either through the skin or during an operation.

  • Chemotherapy

Doctors often place
chemotherapy drugs, usually strong anti-cancer drugs, directly into your liver.
It’s a treatment called “chemoembolization.”

  • Placing beads filled with radiation

Tiny
spheres that contain radiation may be placed directly in the liver.

Radiation therapy

This treatment uses X-rays and protons to destroy cancer cells and shrink tumors.

  • External beam radiation therapy

During this procedure, you will lie on a table and a machine will direct the energy beams on your body.

  • Internal stereotactic radiosurgery

You will receive an injection of tiny radioactive particles in the artery that sends blood to your liver.

Targeted drug therapy

Targeted drugs work
by targeting specific changes in cells that cause cancer.

Supportive (palliative) care

Palliative care focuses on
providing relief from pain and other symptoms of a serious illness.

Alternative medicine

Alternative treatments may help control pain in people with advanced liver cancer, including acupressure, acupuncture, deep breathing, music therapy and massage.

Keywords: hepatocellular carcinoma, live cancer.

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