But you don't look sick! - part 4

The last one in this series is liver cancer.

More than 2,50,000 people die of liver cancer every year worldwide. Liver cancer is difficult to control and hard to detect in its early stages. Ironically, it can be cured only when found at an early stage.

Depending on the type of liver cells affected, the cancers are of 4 types:
• Hepatocellular carcinoma (HCC): most common form of primary liver cancer in both children and adults. It starts in the hepatocytes, the main type of liver cell.
• Cholangiocarcinoma/bile duct cancer: begins in the bile ducts within the liver.
• Hepatoblastoma: rare and curable type of liver cancer that affects children younger than 4 years of age.
• Angiosarcoma/Hemangiosarcoma: These rare cancers begin in the blood vessels of the liver and grow very quickly.

Apart from these, metastatic cancers may also occur where the cancer spreads to the liver. Most scientists hypothesize that liver is the target organ for most cancers because of its extensive blood supply. Liver cancer can spread to the lungs and in very severe cases, to the bones or brain via the bloodstream.
The reason why liver cancer cannot be diagnosed at an early stage is that screening for liver cancer hasn't been definitively proved to reduce the risk of dying from liver cancer. Therefore, many medical groups don't recommend liver cancer screening. Also, in areas where the cancer is more prevalent, the tumour usually reaches an advanced stage and then causes symptoms more rapidly. In contrast, in areas of low frequency the patients tend to have liver cancer tumours that progress more slowly and, therefore, remain without symptoms longer.

The visible symptoms that one can look out for are: nausea and vomiting, abdominal pain, loss of appetite and weight, enlarged liver, abdominal swelling and jaundice.

Risk factors for contracting liver cancer include having hepatitis, having cirrhosis, or scarring of liver, being male and having low weight at birth.

One of the most conclusive diagnostic methods is AFP test. AFP stands for alpha-fetoprotein. It is a protein found only in the blood of foetuses and disappears immediately after birth. It is, however, found in patients diagnosed positive with liver cancer. The principle behind this test is the changes or mutations that occur in oncogenes due to different mutagenic agents.

The treatment methods include surgery, alcohol injections to dry out the cells of the tumour, electric current in the radiofrequency range to destroy malignant cells, radiation therapy, chemotherapy and liver transplantation. Sorafenib by Bayer is an FDA approved drug for treatment of liver cancer.

Citation: Wikipedia,http://www.medicinenet.com/liver_cancer/article.htm , http://www.cancer.org/docroot/CRI/content/CRI_2_2_1X_What_is_liver_cance..., http://www.nlm.nih.gov/medlineplus/livercancer.html, http://www.mayoclinic.com/health/liver-cancer/DS00399