Liver cancer, also known as hepatic cancer, is the uncontrollable growth of liver cells due to genetic changes which cause malignant tumours to form. Liver cancer has emerged as a growing health priority across the globe, with rising incidence and mortality rates. Hepatocellular carcinoma (HCC) is the most common type of liver cancer, accounting for over 80% of liver cancer cases and is the 3rd leading cause of cancer deaths worldwide.1
Typically in the early stages of the disease, liver cancer will have undetermined signs. As the disease progresses, abdominal pain, jaundice, weight loss, and fatigue could be possible symptoms. The increasing burden of liver cancer emphasises the need to prioritise preventative strategies to avoid this type of cancer, including vaccination against Hepatitis B, treatment for Hepatitis, avoidance of excessive alcohol and obesity, and overall healthy living.2 Liver cancer is projected to increase after 2040, creating a reason to develop a strategy that encourages prevention, early detection, and treatment across continents.3
At a global level, liver cancer continues to be a significant public health challenge. The liver is a critical organ which is responsible for detoxification, bile production, and nutrient storage. Liver cancer limits these functions, and patients often do not exhibit symptoms until the disease has progressed significantly, reducing overall quality of life.
There are known risk factors associated with liver cancer such as chronic infections with hepatitis viruses, cirrhosis, alcohol abuse, and obesity which can help to improve public awareness and stimulate preventive action. The implications of these factors promote clinical research, enhance early detection of liver cancer, and ultimately improve clinical outcomes with the advent of targeted therapy and immunotherapy for advanced disease. Raising public awareness of liver cancer and mitigating risks modifiable in the clinical setting can help reduce the global burden of liver cancer.
Cancer-causing changes to liver cells impair the necessary functions of the liver, most commonly after chronic injury from a disease such as hepatitis or cirrhosis. These problems impair detoxification, metabolism, the inflammatory response, immune function, and the ability of the liver to synthesise important proteins. When these functions begin to fail, liver cancer can develop and metastasize, leading to additional complications affecting other organ systems.4
Liver cancer has two types. Primary liver cancer develops from the liver itself. The most common form of primary liver cancer is hepatocellular carcinoma (HCC), which arises from liver cells called hepatocytes. HCC has associations with conditions such as hepatitis B, hepatitis C, cirrhosis, and nonalcoholic fatty liver disease. Secondary, or metastatic liver cancer, occurs when cancer cells from a different organ, such as a person's colon, breast, lung, or stomach, metastasise, or spread, to the liver. In these situations, liver tumours contain cancer cells from the original location, and treatment is generally based on the original cancer type.
Many factors can increase the chance of developing liver cancer:-
Awareness of these risk factors empowers individuals to take preventive steps like vaccination, moderate alcohol use, weight management, and hepatitis testing and treatment.
Typically in the early stages of the disease, there are no liver cancer symptoms, which decreases the potential for early detection. As the disease progresses, people may notice weight loss, appetite loss, pain in the upper abdomen, nausea, fatigue, jaundice, and a swollen abdomen due to fluid buildup (ascites).5 Pale stools and dark urine may also develop, as well as a lump in the upper abdomen. In some patients, easy bruising, fever, or itchy skin may occur.
Timely diagnosis will result in a greater chance for successful treatment. Individuals at high risk (e.g. those with cirrhosis or hepatitis B) should have regular screening.
The list of methods includes the following:
Preventing liver cancer is very important and can often be done by using preventive strategies that can reduce the risk of liver cancer. Vaccination against hepatitis B is highly effective in decreasing the rate of chronic infection. Maintaining a healthy weight through exercise and healthy food can also prevent fatty liver disease. Limiting alcohol consumption and not using tobacco products can lessen the risk of liver cancer. Engaging in safe sex practices and avoiding sharing needles will try to limit the risk of having hepatitis after exposure.6 Early testing and treatment of hepatitis C will also greatly reduce the risk of liver cancer.
The treatment of liver cancer typically can be based on the type of cancer, the location of the cancer and how advanced it is.
Curative options typically include surgery:
Other treatment options utilize procedures:
If surgery is not an option, other treatments can be just as effective. Chemotherapy can be administered either systemically or directly into the liver via the hepatic artery.8 Targeted medications can block cancer growth at the molecular level, and immunotherapy can trigger the body's immune system to kill cancer. Selective Internal Radiation Therapy (SIRT), often called radioembolization, provides localized radiation directly to the tumours.
Palliative Care Role: Palliative care is focused on enhancing the quality of life for individuals living with liver cancer through the alleviation of pain, fatigue, nausea, and other symptoms.9 It involves a team of healthcare professionals (doctors, nursing staff, counsellors etc.) involved in alleviation of pain and symptoms, psychosocial support, and providing treatments aimed at comfort. Starting palliative care earlier creates pathways for dignity and compassion through the cancer experience.
A liver-friendly diet facilitates healing during and after your treatment. Nutrient-dense foods, such as lean proteins, whole grains, fruits, vegetables, and healthy fats, help support tissue repair and immune function. Staying hydrated also helps the liver function well.10
Regular physical activity can help the liver recover. Moderate activity exercises, such as walking, yoga, and swimming, enhance circulation to the liver, improve digestion, and increase your mental well-being.11 Staying active helps maintain a healthy weight which decreases stress on the liver and supports long-term health.
Avoiding certain foods can aid liver healing:
These can worsen liver inflammation and impede recovery.12
Liver cancer is an increasingly serious global health problem, originating from liver cells (primary) or spreading from other organs (secondary). In most cases, the cancer originates from hepatocellular carcinomas (HCC), and risk factors include infections with hepatitis viruses, cirrhosis, obesity, alcohol use, and tobacco use. Early detection is very important, but is also a challenge and includes the use of ultrasound, AFP and imaging. Prevention through vaccination, lifestyle modifications, or addressing hepatitis virus infections can decrease risk. Treatment options include surgery, ablative therapies, embolic therapies, chemotherapy, immunotherapy, and radiation. Palliative care can optimize comfort and quality of life. Recovery can include a nutritious diet, physical activity, and non-hazardous materials. With education and awareness, and even support, people can journey through the cancer process with strength and hope.
