Liver cancer
Incidence
There are 3200 new cases in the UK each year which is approximately 5 per 100,000 of population. Males are affected more than females in a ratio of 5:3
The vast majority of liver cancers are not true liver cancer but have spread from some other organ and seeded in the liver.
Risk factors
Chronic alcohol abuse and viral infections such as hepatitis B and C. In Far Eastern countries, food can be contaminated with a fungal infection that produces a substance called aflatoxin which can also cause liver cancer.
Heredity
The inherited condition primary haemochromatosis which is due to excessive storage of iron in the liver is also a risk factor.
Diet
Excess alcohol and the ingestion of nuts or meal infected with aflatoxin.
Symptoms and signs
The commonest symptom is pain under the rib cage on the right side due to swelling of the liver. Other symptoms include swelling of the abdomen due to the presence of fluid associated with poor liver function. Non specific symptoms occur such as weight loss, poor appetite, temperature and a feeling of general malaise. Jaundice may or may not be present.
Treatment
Surgery is the treatment of choice with removal of part of the liver containing the tumour. If it is not possible to remove part of the liver then the liver can be completely removed followed by a liver transplant. However, this is rarely done due a number of reasons such as a limited number of livers available for transplantation.
Other treatments include the injection of a substance to cut off the blood supply to the tumour, placing probes into the tumour during an operation and then freezing these probes with liquid nitrogen (cryosurgery) or alternatively using radiofrequency ablation which can be done through the skin or the injection of alcohol directly in to the tumour. The choice depends on the size number and position of the tumour.
If these therapies are not possible then chemotherapy is a further option.