Posted on November 27, 2024 by IGA

The liver, often described as the body’s oil filter, is a football-sized organ located beneath the right side of the diaphragm. It performs crucial functions such as detoxifying the blood, producing bile for digestion, and storing nutrients. Unfortunately, this vital organ can fall victim to cancer, which can either originate within the liver (primary liver cancer) or spread to it from other organs (secondary or metastatic liver cancer).

The focus here is on primary cancer, particularly hepatocellular carcinoma (HCC), which arises directly from the liver. This form of cancer is a growing concern globally and especially in countries like Pakistan, where its causes and prevention need urgent attention.

Major Causes

1. Hepatitis B and C Infections
   Chronic infection with the Hepatitis B or C virus is one of the leading causes of liver cancer. These viruses lead to long-term liver inflammation, scarring (cirrhosis), and eventually cancer if untreated.
2. Metabolic Dysfunction Associated Steatotic Liver Disease (MASH)
   Formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD), MASH has now been recognized as a significant cause of liver damage and cancer. It is commonly associated with obesity, diabetes, and metabolic syndrome. In Pakistan, the prevalence of MASH-related liver cirrhosis is rising, making it a critical area of concern.
3. Other Factors
   • Liver storage diseases.
   • Chronic alcohol use.
   • Exposure to aflatoxins in contaminated food.

Symptoms of Liver Cancer

Early symptoms of cancer affecting liver can be subtle, often including:

• Unexplained weight loss.
• Loss of appetite.
• Fatigue.
• Abdominal pain or discomfort.
• Yellowing of the skin or eyes (jaundice).

Symptoms may overlap with other gastrointestinal issues, making it critical to consult healthcare professionals and undergo relevant diagnostic procedures like ultrasound fibroscan, stomach endoscopy, or Flexible Sigmoidoscopy.

Screening and Early Detection

Detecting liver cancer at an early stage significantly improves treatment outcomes. High-risk patients, such as those with cirrhosis due to Hepatitis B, Hepatitis C, or MASH, should undergo regular screening every six months. Key screening methods include:

1. Abdominal Ultrasound and Fibroscan
   Non-invasive imaging techniques that help identify abnormalities and assess liver fibrosis.
2. Blood Tests
   • Alpha-Fetoprotein (AFP): A traditional marker for liver cancer.
   • PIVKA-II: A more sensitive test offering detailed insights into cancer staging.
3. Endoscopic Procedures
   Colonoscopy and upper endoscopy, or a stomach endoscopy procedure, may be needed to rule out secondary causes or related gastrointestinal issues. These tests are also valuable for patients showing symptoms like abdominal pain or jaundice.

Treatment Options

When liver cancer is detected early, the following treatments can be effective:

• Surgical Resection: Removing the tumor if localized and liver function is adequate.
• Ablation: Using heat or chemicals to destroy cancerous tissue minimally invasively.
• Peg Tube Placement Procedure: Occasionally required to support nutrition during treatment phases.

However, the advanced stage, particularly stage 4, offers limited options, often relying on palliative care to manage symptoms.

Why Early Screening Matters

The key to combating liver cancer lies in proactive screening, especially for high-risk groups. Combining diagnostic tools like helicobacter pylori breath tests (to address underlying gut issues), stomach endoscopy costs and procedures, and imaging tests like ultrasound fibroscan, can help in early detection. Regular monitoring enables effective intervention when treatment outcomes are optimal.

Without timely screening, the disease progresses to advanced stages, leading to severe health complications and financial and emotional strain on families.

Conclusion

Liver cancer is preventable and treatable if diagnosed early. Awareness of its risk factors, and symptoms, and the importance of regular medical healthcare evaluations such as colonoscopy, endoscopy, and ultrasounds, is crucial. Take control of your health, prioritize screenings, and encourage others to do the same.

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