It is one of the deadliest cancers in the world. Find out your treatment options and how to decide what’s best.
The liver is one of the largest organs in the body and responsible for a wide range of important processes. Apart from manufacturing various essential proteins and bile, the liver also breaks down toxins and other hormones; plays a role in metabolism; and stores and releases glucose. When cancer occurs in the liver, it can disrupt many of these important processes and cause severe illness.
This happens when the cells in the liver begin to grow out of control and form tumours that take over healthy tissues. Primary liver cancer is cancer that starts in the liver cells. Secondary liver cancer is cancer that starts elsewhere in the body and spreads to the liver. This type of liver cancer is most common.
As the liver is made up of several types of cells, different types of tumours can form. These tumours have different causes, are treated differently and the chance of recovery depends on the type of tumour.
Hepatocellular carcinoma is a primary liver cancer that is typically caused when the liver is damaged by birth defects or chronic infection from hepatitis B or C. It can also be caused by a hereditary disease associated with too much iron in the liver (called haemochromatosis), and cirrhosis, the scarring and hardening of the liver due to alcohol abuse. More than half of all people diagnosed with primary liver cancer have cirrhosis.
Liver cancer in Singapore
In Singapore, liver cancer is the fourth most common cancer among men. It affects about 24 in every 100,000 people a year. The disease tends to affect adults aged 40 and above. The three main causes of liver cancer in Singapore are hepatitis B, hepatitis C and alcoholic liver disease. In particular, the risk of getting liver cancer is 100 times more likely in those with hepatitis B or C compared to someone who is not infected. This underscores the importance of keeping your hepatitis vaccinations up to date. Liver cancer due to alcoholic liver disease is less common in Singapore, although it is still a major contributor to the disease.
Liver cancer is difficult to treat because it is often only detected in its late stages. By the time symptoms such as unexplained upper abdominal pain, unexpected weight loss, poor appetite, weakness, jaundice and light chalky stools turn up, the disease may have progressed. If you spot any of these signs, see a doctor for a medical check-up.
Once liver cancer is diagnosed, treatment options will depend on several factors. These include:
- How much of the liver the cancer has affected
- Whether the cancer has spread beyond the liver
- The patient’s overall health
- How best to preserve the cancer free parts of the liver
If a tumour is found at an early stage and the cancerous tumour is less than 5cm in size, surgery is typically the treatment of choice. Removing the tumour is the only way to remove the cancer completely so it does not spread.
If surgery is not an option for the type and stage of cancer, other options may help to control the tumour and prolong survival.
Radiofrequency ablation (RFA), for instance, may be an option if the cancerous area of the liver cannot be removed. Using ultrasound, needles are guided and inserted directly into the cancerous area and heat is applied into the abnormal tissues to destroy the cells.
Another treatment approach is transarterial chemoembolization. Chemotherapy medication is delivered directly into the liver tumour for a more targeted treatment. One of the best options for patients with liver cancer and liver failure is a liver transplant. This allows the diseased liver to be removed and replaced with a part of or a whole healthy liver.