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Exploring Liver Cancer: Recognizing Signs and Symptoms

Liver cancer can go without symptoms for a long time. The first, mostly unspecific signs of liver cancer usually only appear in the advanced stage of the disease. But then it can already be too late. This is why it’s so important to recognize the signs of illness and take action as soon as possible. This guide to recognizing liver cancer is to help you do just that.

The Basics of Liver Cancer

Liver cancer, also known as hepatocellular carcinoma, is a malignant transformation of cells in the liver. Changes in the genetic material lead to the cells multiplying uncontrollably and forming one or more tumors.

Malignant cells in the liver can come directly from the liver (primary liver cancer). The starting point is then either the liver cells themselves (hepatocellular carcinoma), the bile ducts (cholangiocellular carcinoma), or the blood vessels (angiosarcoma). Although the majority of cases involve hepatocellular carcinoma, only a doctor can determine which type of liver cancer is present using a tissue sample.

The most common type of liver cancer, however, is secondary tumors (metastases) from other organs (secondary liver cancer). Cancer cells migrate from the gastrointestinal tract, lungs, or breasts into the liver and form tumors there. In this case, treatment is different from that of primary liver cancer.

Liver cancer usually develops insidiously. During the first stages, it goes without any external symptoms. It usually occurs as a result of cirrhosis of the liver. Alcohol abuse or hepatitis B or hepatitis C viruses are common causes. 

Liver cancer treatment usually includes surgical removal of the tumor or the entire liver and liver transplantation. Chemoembolization or radiofrequency ablation can also be successful.

Common Signs and Symptoms

Liver cancer can remain asymptomatic for a long time. When the first signs of illness appear, the disease is often far advanced. It can initially manifest itself as tiredness, a feeling of weakness, loss of appetite, and digestive issues (the feeling of fullness, flatulence, constipation, or diarrhea). Weight loss, pressure pain, and swelling in the upper right abdomen come later.

Advanced Symptoms and Complications

If the disease detection isn’t accidental, e.g. during an ultrasound examination, liver cancer often shows relatively late. The first signs are rarely very clear. In most cases, the symptoms also hide behind those of liver cirrhosis. Both diseases occur simultaneously in about 90% of patients.

In the advanced stages, liver cancer patients show symptoms comparable to patients with liver cirrhosis. Their liver and spleen are significantly enlarged. There are typical skin changes (vascular dilatation, yellowish complexion, xanthomas). They increase as the clinical picture worsens. Due to metabolic disorder, the body stores more water (edema). The increased bilirubin level in the blood causes skin discoloration and yellowish eye whites.

Those affected lose weight quickly and complain of permanent pain in the liver area. Fever, accumulation of fluid in the abdomen, jaundice, or bleeding from the esophagus indicate that the disease is malignant.

The degenerated liver cells can no longer fulfill their detoxification and metabolic functions. The toxins produced during protein metabolism, such as ammonia, amines, and phenols, can no longer be broken down. As a result, they reach the brain and damage the brain cells. The consequences are depression, listlessness, and personality changes. Sometimes, complications can be as severe as impaired consciousness and hepatic coma, which often ends fatally. The gradual body intoxication also leads to kidney failure.

Late-stage liver cancer can spread throughout the body and form secondary ulcers in nearby lymph nodes, peritoneum, pleura, lungs, adrenal glands, and bones. However, this complication is relatively rare.

Importance of Early Detection

The earlier liver cancer is detected the greater the chance of recovery. However, the mortality rate for this type of cancer is over 40% and keeps growing. In the case it can still be operated on, every second patient survives longer than 5 years. Life expectancy for liver cancer that has already metastasized is less than six months.

This is why it’s extremely important to take preventive measures and see a doctor in your area. Regular physical exams and screenings might save your life. 

Avoid anything that can damage the liver. Environmental toxins, medicines, excessive alcohol, fat and sugar consumption, diabetes as well as persistent infections put additional strain on the liver. This can lead to liver cirrhosis, the main risk factor for liver cancer.

Patients with cirrhosis or hepatitis should have regular screening for liver cancer. A simple blood test for tumor markers and an ultrasound examination are sufficient.

Treatment Options

The choice of therapy depends on several factors:

  • Disease stage;
  • Patient’s age and general condition;
  • The nature of degenerated tissue.

Pain therapy plays a major role in an advanced stage. There are numerous drugs and methods that can be used to relieve cancer pain. The doctor must determine the drug of choice and the dosage for each patient individually.

The surgeon can surgically remove small isolated nodules by removing the affected section of the liver in an abdominal operation. Liver cell adenomas are only operated on if they are more than 5 centimeters in size because the risk of them becoming malignant is low. If the infestation is too severe, a liver transplant may be unavoidable, but only if the cancer hasn’t yet spread to other organs.

An oncologist can also try to shrink the tumor using alternative measures.

  1. Transarterial chemoembolisation.

The blood supply to the cancer nodes is mechanically closed with gel foam or small metal spirals. In addition, the surgeon can inject a chemotherapeutic agent into the node that destroys the cancer cells locally. Although transarterial chemoembolisation inhibits tumor growth, it’s still unclear to what extent this can prolong the patient’s life.

  1. Radiofrequency ablation (RFA).

Radiofrequency ablation uses heat to destroy tumors in the liver. The heat is generated by a probe that’s inserted into the tumor under ultrasound control. This heats up the tumor tissue so much that it dies.

The advantages of radiofrequency ablation over others are the low rate of side effects and complications. This procedure can be carried out safely even in the case of impaired liver function. As a rule, a hospital stay of a few days is sufficient.

Depending on the type of tumor, it might make sense to combine radiofrequency ablation with other therapy methods such as chemoembolization. If there are multiple tumors, the tumor is too large or affects other regions of the body, RFA is usually not advisable.

  1. Liver transplantation.

Liver transplantation is a better option than surgical removal of the liver or its parts. However, it’s only possible if there are a maximum of 3 nodes with a diameter of less than 3 centimeters or a tumor with a diameter of less than 5 centimeters.

If you are looking for liver cancer treatment in Germany, don’t waste any time. Airomedical will help you find the treatment you need at the best oncology centers in the country. 

References:

  1. Volvak N. Liver Cancer Guide. Updated March 15, 2023. https://airomedical.com/blogs/disease-guides/liver-cancer-guide
  2. Meng-Chao Wu. Clinical Research Advances in Primary Liver Cancer. Published December 15, 1998. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4723432/
  3. Volvak N. Transarterial Chemoembolization for Liver Cancer Treatment. Updated January 14, 2023. https://airomedical.com/blogs/treatment-guides/transarterial-chemoembolization-for-liver-cancer-treatment
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