Liver cancer rates in Southeast Asia are anticipated to double by 2050, potentially causing over 200,000 deaths annually, according to projections from the World Health Organization. This form of cancer is currently the fourth leading cause of cancer-related deaths in the region, which includes India, and ranks as the second deadliest cancer among men.
In India, nearly 35,000 new liver cancer cases are reported annually, making it the eighth most common cancer. The country’s current liver cancer incidence rate stands at 2.15 per 100,000, with a prevalence of 2.27 per 100,000, resulting in approximately 34,000 deaths each year.
Dr. Jaskaran Singh Sethi, Sr. Consultant & Chief of GI, HPB & Pediatric Radiation Oncology Services, RGCIRC explains the types and risks of cancer.
Key Risk Factors for Liver Cancer
Major risk factors for liver cancer include high alcohol consumption, hepatitis B infection, obesity, certain lifestyle habits, dietary choices, and exposure to environmental toxins. Alcohol-related liver cancer often follows cirrhosis, while hepatitis B is a significant cause of non-alcohol-related liver cancers.
Late detection is a significant issue, as liver cancer symptoms often go unnoticed until the disease progresses. In India, approximately 80% of liver cancer cases are diagnosed at stage 3 or 4. This is often due to delays in seeking medical assistance, with many patients initially turning to self-medication or alternative treatments.
Types of Liver Cancer
Liver cancer manifests primarily in two types: primary liver cancers, which originate in the liver itself, and metastatic liver cancers, which begin elsewhere and spread to the liver. Metastasis is the more common form found in the liver, while primary liver cancers include hepatocellular carcinoma, intrahepatic cholangiocarcinoma, and hepatoblastoma.
Diagnosis and Common Symptoms
An ultrasound is an effective initial diagnostic tool for liver cancer, as it can reveal abnormalities like cysts, abscesses, or solid masses. Advanced diagnostic imaging, such as triple-phase contrast CT scans and MRIs, are frequently used to confirm diagnoses.
Common symptoms of liver cancer include loss of appetite, unintended weight loss, jaundice, severe itching (especially with jaundice), and generalized symptoms like indigestion and acidity, which often lead to delayed diagnosis due to their vagueness.
Treatment Approaches
Treatment for liver cancer depends on the extent of the disease. For limited cases, including up to five liver metastases, local treatments like surgical resection, stereotactic body radiotherapy (SBRT), microwave ablation (MWA), and radiofrequency ablation (RFA) are options. These treatments are also viable for primary liver cancers confined to the liver. In cases of hepatocellular carcinoma (HCC), a liver transplant may be possible, though patients often undergo bridge therapies like SBRT, TACE, or TARE while awaiting transplantation.
For more widespread metastatic liver cancer, systemic therapies such as chemotherapy and immunotherapy are available. Today, treatment options are tailored to the patient’s overall condition and disease stage. For instance, elderly patients who may not be suitable candidates for surgery can benefit from non-invasive treatments like SBRT or RFA, which were not widely available in the past.
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