Liver cancer is a perilous disease

THE beginning of the past week was sorrowful as I lost my good friend, a pharmacist based in Harare. He succumbed to cancer of the liver at the age of 39. May his soul rest in peace!

Cancer of the liver is a condition that begins in the cells of your liver. Primary liver cancer is the sixth most commonly diagnosed cancer and the fourth leading cause of cancer mortality in the world with an estimated 782 000 deaths in 2018 according to the World Health Organisation. It is more common in men than women. Several types of cancer can form in the liver, but the most common type is hepatocellular carcinoma, which begins in the main type of the liver cell. There are other uncommon types like hepatoblastoma and intrahepatic cholangiocarcinoma.

Most patients do not have signs and symptoms in the early stages of primary liver cancer. However, when signs and symptoms do appear, they may include: Unexplained weight loss. Upper abdominal pains. Abdominal swelling. Yellowish discolouration of your skin (jaundice).

 Nausea and vomiting.  Loss of appetite.

 Yellow urine.

Risk factors

The following are some factors that increase the risk of primary liver cancer:

Chronic infection with Hepatitis B and Hepatitis C: This increases your risk of liver cancer

This progressive and irreversible condition causes scar tissue to form in your liver and increases your chances of developing liver cancer.

Some liver diseases can increase the risk of liver cancer and these include Wilson’s disease and Hemochromatosis.

Those with diabetes have been shown to have higher chances of developing liver cancer.

Aflatoxins are poisons produced by moulds that grow on crops that are stored poorly. Crops such as grains and nuts can become contaminated with aflatoxins which can end up in foods made of these products.

Consuming more than a moderate amount of alcohol daily over many years can lead to irreversible liver damage and increase your risk of liver cancer.

Prevention

There are so many ways which you can follow in order to reduce your risk of getting liver cancer in life. The following are some of the ways:

You reduce your risk of contracting Hepatitis B by receiving Hepatitis B vaccine. This vaccine can be given to almost everyone, including infants, older adults and those with compromised immune systems.

Currently there is no vaccine for Hepatitis C, but you can reduce your risk of infection by:

Do not engage in unprotected sex unless you are certain that your partner is free from Hepatitis B, C or any other sexually transmitted infection. Many people seem unmoved by these other serious infections and believe that once their partners test negative for HIV, then all is well. Hepatitis B and C are very dangerous viruses that need great attention.

Reduce your risk of the viruses by abstaining from illegal drugs. Contaminated drug paraphernalia is a common cause of Hepatitis C infection.

Treatments are available for both Hepatitis B and C infections. Research shows that treatment reduces the risk of developing liver cancer.

If you choose to drink, limit the amount you choose to drink. In women, this may mean not more than one drink a day. For men, this may mean not more than two drinks per day.

Diagnosis

Tests and procedures are required in order to come up with a complete diagnosis of liver cancer:

Blood tests include liver function tests (LFTs), Hepatitis screen, kidney function tests, Alpha fetoprotein

Ultrasound scans, computed tomography and magnetic resonance imaging may be required

A small piece of the liver can be removed and then sent for laboratory testing in order to make a definitive diagnosis of liver cancer.

Imaging Treatment

In poor settings, many patients present with late stage disease. However, there are treatment modalities available and these include the following:

If the tumour is small and liver function is good, an operation can be done to remove the liver cancer.

The diseased liver can be removed and replaced with a healthy one from a donor. Liver transplant surgery is only an option for a small percentage of people with early stage liver cancer. However, there are high chances of tissue rejection in the body.

Palliative

Care is continuously given to patients who may present with persistent fluid in the abdomen with distension. Episodic tapping of fluid will need to be done to give relief. Pain management should be done.

Let us all guard against liver cancer. It is not only HIV that is dangerous, Hepatitis B and C are equally toxic!

Dr Johannes Marisa is a medical doctor who can be accessed on: gmail.com