About Hepatocellular Carcinoma
Hepatocellular carcinoma is a type of liver cancer that occurs when liver cells start to grow and divide uncontrollably. The cause of HCC is genetic. Changes in DNA can be inherited from parents or acquired due to irregularities during cell division.
Non-modifiable risk factors (factors a person cannot change or control) for HCC include:
- History of primary sclerosing cholangitis and inflammatory bowel disease
- Geographic risk factors such as liver fluke infections in Southeastern Asia
Modifiable risk factors (factors a person potentially could change or control) for HCC include:
- Chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection
- Alcohol consumption: Excessive alcohol drinking can lead to liver fibrosis and increase the risk of HCC.
- Smoking: Smoking is associated with an increased risk of liver fibrosis and liver cancer.
- Obesity: Obesity, especially abdominal obesity, is a risk factor for HCC development.
- Type 2 diabetes: Individuals with diabetes have an increased risk of developing HCC.
- Diet: Consumption of certain foods is associated with either an increased or decreased risk of HCC. For example, a diet high in red meat, saturated fat, cholesterol, and sugar is related to increased risk, while a diet rich in n-3 polyunsaturated fatty acids, fish and poultry, vegetables, and fiber is inversely associated with HCC risk.
It's important to note that lifestyle modifications can help reduce the modifiable risk factors for HCC. However, it's always recommended to consult with a healthcare professional for personalized advice.
The early symptoms of HCC may not be specific and can vary from person to person. However, some common early symptoms of HCC include:
- Abdominal pain
- Anorexia (reduced appetite)
- Dyspepsia (indigestion)
As HCC progresses or reaches a more advanced stage, additional symptoms may occur. These can include:
- Jaundice (yellowing of the skin and eyes)
- Dark urine
- Pale stools
- Itchy skin
- Unintended weight loss
- Nausea and vomiting
- Abdominal swelling or fluid buildup in the abdomen
- Easy bruising or bleeding
- Fever
- Enlarged liver or spleen
It's important to note that many of these symptoms can also be caused by other liver conditions, so they may not necessarily indicate HCC. If you experience symptoms consistent with HCC, it is recommended to see a doctor for further evaluation and appropriate diagnosis.
To diagnose HCC, several examinations, tests, and procedures are commonly performed, including:
- Medical history review: Your doctor will review your medical history to understand any risk factors or symptoms related to HCC.
- Physical examination: A physical exam will be conducted to look for physical signs of HCC, such as pain, swelling, or masses in the body.
- Blood tests: Various blood tests may be ordered, including liver function tests, blood clotting tests, complete blood count, and tests for hepatitis B or C infections. An alpha-fetoprotein (AFP) test may also be performed.
- Imaging tests: Imaging techniques like ultrasound, CT scan, or MRI scan can be used to check for the presence of tumors in the liver. These imaging tests can often help diagnose HCC without the need for a liver biopsy.
To determine the stage or severity of HCC, additional examinations and tests may be performed, including:
- Staging: After an HCC diagnosis, staging is done to assess the extent of the cancer. This includes evaluating the size or number of tumors and checking if the cancer has spread to nearby lymph nodes or distant tissues like bones or lungs.
- Biopsy: In some cases where imaging features are atypical for HCC, a liver biopsy may be ordered. During a biopsy, a small sample of tissue is removed from the tumor and examined under a microscope for signs of cancer.
- Immunohistochemistry: This test uses antibodies linked to an enzyme or fluorescent dye to identify specific antigens in tissue samples. It can help diagnose and differentiate between different types of cancer.
Remember that these are general procedures and recommendations can vary based on individual cases. Consult your healthcare provider for personalized advice.
The goals of treatment for HCC are to prolong survival and improve quality of life. To achieve these goals, various treatment options may be recommended, including:
Surgical interventions:
- Anatomical resection (AR) and non-anatomical resection (NAR): These surgical methods involve removing the tumor and surrounding tissue to achieve long-term cancer-free survival.
- Liver transplantation: The best therapeutic option for HCC, it involves replacing the diseased liver with a healthy liver from a donor.
Local procedures:
- Ablation: This procedure uses heat or cold to destroy the tumor cells.
- Resection: Surgical removal of the tumor.
- Combination of ablation and resection: A combination approach may be used based on individual patient suitability.
Other treatments:
- Chemotherapy: Drugs that affect the growth and division of rapidly-dividing cells like cancer cells.
- Chemoembolization: Delivering chemotherapy directly into the liver artery and blocking blood flow to the tumor.
- Radiation therapy: Using high-energy radiation to kill cancer cells.
- Targeted therapy: Drugs that target specific aspects of HCC.
- Immunotherapy: Drugs that help the immune system respond to HCC.
To determine the most suitable treatment approach, factors such as tumor stage, anatomical locations, liver function, and patient's overall health are considered. It is important to consult with a healthcare professional to discuss individualized treatment options and potential side effects.
Medication dosing may be affected by many factors. Check with your healthcare provider about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.