Hepatocellular Carcinoma (HCC) is a cancer that starts in the liver, hence also called as primary liver cancer. Cancer that arise in other organs and spread to liver are called as secondary liver cancer or metastatic tumor. HCC is commonly associated with any type of existing liver cirrhosis.
What are the Causes?
Although there is no identifiable cause for HCC but several risk factors have been identified.
Existing Cirrhosis- This is a serious disease where liver cells are damaged thus affecting the liver function. Hepatitis B, Hepatitis C, chronic alcoholism, certain drugs and too much iron in the liver (Hemochromatosis) are the common factors causing liver cirrhosis.
Hepatitis B infection- HCC may start even many years after getting the infection
Heavy Drinking- Drinking more than 60 to 80 Gms per day of alcohol increase the risk by 2-4 times
Obesity- Obesity can lead to non alcoholic fatty liver disease which can lead to HCC
Iron storage disease- too much iron in the liver also has damaging effect
Signs and Symptoms may be:
Weight loss (without trying)
Loss of appetite
Fever
An enlarged liver, felt as a mass under the ribs on the right side
Itching
Yellowing of the skin and eyes (jaundice)
Feeling very full after a small meal
Nausea or vomiting
Diagnosis of liver cancer
Blood Tests
(a) AFP Level (Alpha Feto Protein)- this is non-specific marker but high levels more than 500 micro grams per liter are diagnostic of liver cancer.
(b) AFP- L3 and des Gamma carboxyprothrombin are more specific markers
Imaging Tests
(a) Ultrasound- to detect liver lesion
(b) CT scan/ MRI - Triple phase Study is very useful to see the characteristics of the liver lesion(weather benign type or cancer type) and also to detect presence of single or multiple very small lesions.
Liver Biopsy
With the advent of better imaging techniques, Non-surgical percutaneous needle biopsy is commonly used to remove a sample of the cancer tissue from the liver and then send it to the lab for tissue diagnosis.
Treatment
There are may treatments available both Surgical and Non-Surgical. Considering the size of the tumor. Location and any existing liver disease your doctor decides the best mode of treatment.