The facts about liver cancer

We do not have cancer statistics for the Cayman Islands so the incidence of liver cancer on the islands is not known. However, over half a million people are diagnosed with liver cancer each year globally.

It is more common in sub-Saharan Africa and Southeast Asia than in the United States. It is important that people know about liver cancer as it is one of the cancers that can be caused by exposure to a virus and other behavioural factors and can therefore often be prevented.

Liver cancer develops in the cells of the liver. There are different types of cells in the liver and therefore different types of liver cancer. The treatment and outlook for each of these is different. The most common type of liver cancer is hepatocellular cancer.

The liver is the largest internal organ in your body and is located under your right ribs below your right lung. You cannot live without your liver as it performs several important jobs necessary for the normal daily functioning of our body. It has a role in digestion, breaking down and storing nutrients absorbed from the intestine that your body needs to function on a daily basis and it secretes bile into the intestines to help absorb nutrients. Additionally it plays a part in removing toxic waste from the body and it makes most of the clotting factors that keeps the body from bleeding excessively.

Cirrhosis of the liver is a condition in which the liver cells become damaged and are replaced by scar tissue and almost all people who develop liver cancer have some evidence of cirrhosis. While cirrhosis is usually associated with abuse of alcohol it is caused by anything that causes damage to the cells of the liver.

One of the most common causes of cirrhosis and subsequent development of liver cancer is exposure to the hepatitis virus and in particular the hepatitis B and hepatitis C viruses. Hepatitis B and Hepatitis C are transmitted between people through unprotected sex or the sharing of contaminated needles such as those used by drug users. The viruses can also be passed on during childbirth and through blood transfusions. Hepatitis B in particular initially manifests with symptoms that are often flu-like accompanied by jaundice (yellowing of the eyes and skin).

Inherited metabolic conditions, diabetes, obesity can increase the risk of developing liver cancer. Other risk factors include long-term use of anabolic steroids, as well as exposure to toxins such as aflatoxins and arsenic.

The best way to prevent the development of liver cancer is to reduce your exposure to known risk factors such as the hepatitis virus including avoiding intravenous drug use and the sharing of needles and not having unprotected sexual encounters. Vaccination against hepatitis B is now routine for children and adults may want to consider vaccination. Persons who are at high risk for hepatitis infection should be tested and treated if necessary.

Liver cancer often has no signs or symptoms in the early stages but as the disease progresses some of the more common symptoms are unintentional weight loss, loss of appetite, feeling full after a small meal, nausea or vomiting and fever. Abdominal symptoms will include a constant pain and fluid build-up or swelling. You may also experience itching and notice the yellowing of your skin and enlarged veins on your belly that are visible to the eye. Your doctor may detect an enlarged liver or spleen. Any worsening of pre-existing liver conditions should prompt you to consult with your doctor.

Screening is often an essential part of cancer prevention and screening every six months is encouraged for people at risk of developing liver cancer. Screening tests used are a blood test to check for elevated levels of a protein alpha-fetoprotein (AFP) and an ultrasound. However, these screening tests are not sufficiently accurate to be used for general population screening and therefore screening for liver cancer is not recommended for people of average risk.

For more information on liver cancer speak with your doctor or contact the Cayman Islands Cancer Society.

Pullout: Cirrhosis of the liver is a condition in which the liver cells become damaged and are replaced by scar tissue and almost all people who develop liver cancer have some evidence of cirrhosis. While cirrhosis is usually associated with abuse of alcohol it is caused by anything that causes damage to the cells of the liver.

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