Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC), also known as liver cancer, is a type of cancer that starts in the liver. The liver is the largest organ in the body and it performs many important functions, including detoxifying the body, producing bile, and regulating blood sugar levels.
HCC is the most common type of liver cancer, accounting for about 90% of all liver cancer cases. It is a serious and often fatal disease, with a poor prognosis, if left untreated. HCC is more common in men than women, and the incidence of HCC increases with age.
Risk Factors
- Chronic viral hepatitis (hepatitis B and C): long-term infection with the hepatitis B or C virus can increase the risk of developing HCC.
- Cirrhosis: which is scarring of the liver caused by chronic liver disease, increases the risk of HCC. The risk of HCC is higher in people with cirrhosis caused by viral hepatitis or alcohol use than in people with other types of cirrhosis.
- Excessive alcohol consumption: heavy alcohol use can cause liver damage and increase the risk of HCC.
- Non-alcoholic fatty liver disease (NAFLD): NAFLD is a condition in which fat builds up in the liver. This can lead to inflammation and liver damage, increasing the risk of HCC.
- Exposure to certain chemicals and toxins: exposure to certain chemicals, such as aflatoxins (found in moldy crops) and vinyl chloride (used in the manufacture of PVC plastic), can increase the risk of HCC.
- Hemochromatosis: hemochromatosis is a genetic disorder in which the body absorbs too much iron. This can lead to liver damage and increase the risk of HCC.
- Inherited metabolic disorders: certain inherited metabolic disorders, such as tyrosinemia and Wilson’s disease, can increase the risk of HCC.
- Age: the risk of HCC increases.
Symptoms
Symptoms of hepatocellular carcinoma (HCC), also known as liver cancer, can vary depending on the size and location of the tumor, as well as the overall health of the individual. Some common symptoms include:
- Fatigue: HCC can cause the liver to not function properly, leading to fatigue and weakness.
- Loss of appetite: HCC can cause nausea and a loss of appetite, leading to weight loss.
- Nausea and vomiting: HCC can cause nausea and vomiting, which can be caused by the tumor blocking the bile ducts.
- Abdominal pain: pain in the upper right part of the abdomen can be caused by the tumor growing and pushing against nearby organs.
- Jaundice: jaundice, or yellowing of the skin and eyes, can occur if the tumor blocks the bile ducts, causing bile to build up in the bloodstream.
- Swelling in the legs and abdomen: HCC can cause fluid to build up in the legs and abdomen, leading to swelling.
- Bruising or bleeding easily: HCC can cause low platelet count (thrombocytopenia) which can lead to easy bruising and bleeding.
- Enlarged liver: HCC can cause an enlarged liver, which can be felt as a lump or mass in the abdomen.
It’s important to note that some of these symptoms can be caused by other conditions, and not all people with HCC will have all symptoms.
Diagnosis
Diagnosis of HCC is usually made through the following tests:
- Blood tests.
- CT scan.
- MRI.
- A liver biopsy may be necessary to confirm the diagnosis.
Complications
Hepatocellular carcinoma (HCC) can lead to several complications if left untreated or if the cancer has advanced. These can include:
- Metastasis: HCC can spread to other organs such as lungs, bones, and lymph nodes.
- Liver failure: HCC can cause the liver to stop functioning properly, leading to liver failure. Symptoms of liver failure include fatigue, weakness, confusion, and jaundice (yellowing of the skin and eyes).
- Obstruction of the bile ducts: HCC can cause a blockage in the bile ducts, which can lead to jaundice and other symptoms.
- Portal hypertension: HCC can cause increased pressure in the portal vein, leading to portal hypertension, which can cause serious complications such as variceal bleeding and ascites (fluid accumulation in the abdomen).
- Nutritional deficiencies: HCC can cause poor appetite, weight loss, and malabsorption of nutrients, leading to nutritional deficiencies.
- Psychological and emotional issues: HCC can cause anxiety, depression, and emotional stress for the patient and their family.
It’s important to note that not all people with HCC will develop these complications, and the rate of complication depends on the stage.
Treatment
Treatment for hepatocellular carcinoma (HCC) depends on the stage and size of the cancer, as well as the overall health of the individual. Treatment options include:
- Surgery: surgery is the preferred treatment option for HCC that is confined to the liver in patients without underlying advanced liver disease. Surgery can involve removing the tumor or a portion of the liver.
- Liver transplantation: in some cases, a liver transplant may be an option for people with HCC.
- Ablation: ablation is a procedure that uses heat or cold to destroy the tumor. This can be done using radiofrequency ablation, microwave ablation, or cryoablation.
- Embolization: embolization is a procedure that cuts off the blood supply to the tumor.
- Radiation therapy: radiation therapy uses high-energy radiation to kill cancer cells. This can be delivered externally or internally.
- Chemotherapy: chemotherapy uses drugs to kill cancer cells. It can be given intravenously or orally.
- Targeted therapy: targeted therapy is a type of treatment that targets specific genes or proteins in cancer cells.
- Immunotherapy: immunotherapy is a type of treatment that helps the body’s immune system fight cancer cells.
The choice of treatment will depend on the stage of the cancer, the patient’s overall health, and other factors. In some cases, a combination of treatments may be used. It’s important to work closely with a healthcare provider to develop an individualized treatment plan that is appropriate for your specific situation.
FAQs
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. It occurs when malignant cells develop in the liver cells, known as hepatocytes.
The main risk factors for HCC include chronic hepatitis B or C infection, heavy alcohol use, non-alcoholic fatty liver disease (NAFLD), cirrhosis, and exposure to aflatoxins.
In the early stages, HCC may not cause any symptoms. As it progresses, symptoms may include abdominal pain or swelling, jaundice, weight loss, loss of appetite, fatigue, and fever.
HCC can be diagnosed through imaging tests such as a CT scan, or MRI, and through blood tests that check for tumor markers. A liver biopsy may also be performed to confirm the diagnosis.
The treatment for HCC depends on the stage and extent of the cancer. Options may include surgery, liver transplant, ablation therapy, embolization therapy, radiation therapy, or chemotherapy. A combination of treatments may also be used.
The risk of developing HCC can be reduced by taking steps to prevent or manage risk factors, such as getting vaccinated for hepatitis B, avoiding excessive alcohol consumption, maintaining a healthy weight, and managing underlying liver conditions such as cirrhosis or NAFLD.
The prognosis for HCC depends on the stage of the cancer and the effectiveness of treatment. Early detection and treatment can improve the chances of survival.
HCC can be cured if it is detected early and treated aggressively. However, in some cases, HCC cannot be cured and treatment is focused on prolonging life and improving quality of life.
Patients who have been treated for HCC will require ongoing follow-up care, including regular imaging tests and blood tests to monitor for recurrence or progression of the cancer.
No, HCC is not contagious and cannot be transmitted from person to person. It is caused by genetic mutations and environmental factors such as viral infections, alcohol consumption, and exposure to toxins.
While most cases of HCC are caused by environmental factors such as viral infections, alcohol consumption, and exposure to toxins, a small percentage of cases may be inherited. Certain genetic mutations can increase the risk of developing HCC.
HCC is the most common type of primary liver cancer and is the fourth leading cause of cancer-related deaths worldwide.
While cirrhosis is a major risk factor for HCC, not all cases of HCC are associated with cirrhosis. HCC can also develop in people with chronic hepatitis B or C infections, as well as in people with non-alcoholic fatty liver disease (NAFLD).
While some alternative therapies may be used to help manage symptoms or side effects of treatment, there is no strong scientific evidence to support the use of alternative therapies as a primary treatment for liver cancer. It is important to speak with a healthcare professional before trying any alternative therapies.
The length of time it takes for liver cancer to develop can vary depending on the underlying cause of the cancer. In some cases, HCC can develop over a period of several years or even decades.
In some cases, liver cancer can cause pain in the abdomen, back, or shoulder. However, not all cases of liver cancer cause pain, and pain may not develop until the cancer has progressed.
Yes, liver cancer can spread to other parts of the body through the bloodstream or lymphatic system. This is known as metastatic liver cancer and is different from primary liver cancer.
Blood tests can be used to check for tumor markers that may indicate the presence of liver cancer. However, imaging tests such as a CT scan, or MRI are needed to confirm the diagnosis.