Liver Cancer Survival Guide: What You Should Know

You call it liver cancer; we call it hepatic cancer - this happens when cells in your liver grow abnormally. Primary liver cancer refers to an ailment in which malignant (cancer) cells form in the liver’s tissues. In India, there are around 34,743 new cases of liver cancer each year, and around 33,793 people die from it.

The liver has many different kinds of cells; several tumours can originate here. Such tumours happen because of different reasons and are treated differently. Your recovery will depend on the kind of tumour that you have. There are many causes of liver cancer, and depending on the cause, your doctor will provide a course of treatment.

Hepatocellular Carcinoma (HCC)

This is the most common type of primary liver cancer in adults, beginning in the hepatocytes, the main cells in the liver. One of the risk factors for liver cancer is cirrhosis, which is scarring of the liver caused by hepatitis B or C or drinking for a long time.

Hepatocellular carcinoma becomes more common as people age and is more likely to develop in men. Symptoms include abdominal pain or tenderness, especially in the upper-right area, easy bruising or bleeding, enlarged abdomen because of fluid retention (ascites), yellow skin or eyes (jaundice) and unexplained weight loss.

Cholangiocarcinoma

This is called bile duct cancer, which begins in the cells lining the bile ducts. The bile ducts refer to small tubes transporting the bile from the liver to the small intestine. Symptoms include abdominal right side pain, jaundice, itchy skin, dark urine, fever, weight loss, clay-coloured stool, nausea and vomiting. This is of three types.

Intrahepatic cholangiocarcinoma: Grows in the bile ducts inside the liver.

Hilar cholangiocarcinoma: Grows in the bile ducts right outside of the liver.

Distal cholangiocarcinoma: Grows in the bile ducts near the small intestine.

Angiosarcoma

This is a rare kind of liver cancer that begins in the blood vessels. It is more likely to occur in people past the age of 70. Angiosarcoma is aggressive; this is rare and can happen anywhere in the body, but it mostly happens to the skin, spleen, liver, heart and breast.

Symptoms include a raised area of skin that resembles a bruise, a bruise-like lesion that becomes larger over time, a lesion that might bleed if it is scratched or bumped, swelling in the skin near the lesion, and pain where the tumour grows.

It also includes difficulty breathing, fatigue, chest pain, syncope (passing out) and heart palpitations.

The symptoms of liver cancer often don’t appear during the primary stages of the disease. Instead, they appear towards the end stage of the disease.

Weight Loss Without Trying

One theory for the drastic weight loss during liver cancer is that cancer cells need more energy than healthy cells, which can result in weight loss. Cancer treatments might also result in weight loss by making eating difficult or painful.

The role of the liver in processing fats and foods gets compromised, which leads to weight loss. There is also a significant loss of muscle mass, which is quite the norm in people with advanced liver cancer.

Loss of Appetite

You don’t feel like eating. You don’t even feel hungry. Such is the bane of liver cancer that appetite goes for a toss. This is because when you are suffering from something as painful as cancer, eating a good meal might be the last thing on your mind.

The liver is vital for digesting food, processing nutrients, and removing toxins. When cancer goes haywire, the desire to eat decreases. The liver can’t process toxins properly, causing discomfort and reduced interest in food.

Feeling Full After a Very Small Meal

Liver cancer increases satiety. When you are suffering from liver cancer, even if you eat a very small meal, the feeling of fullness increases. This is because of the impact of the tumour on the digestive system.

The liver plays a very important role in processing nutrients and bile. When a tumour disrupts this, it can lead to a sensation that you are full. This can happen because of bloating, tumour pressure on the stomach or a compromised digestive system.

Nausea and Vomiting

There is a distinct feeling of nausea and vomiting when you are affected by liver cancer. This is because the liver processes waste products and regulates bile, helping digestion. When liver function is impaired, waste products build up in the bloodstream, resulting in nausea.

An Enlarged Liver, Felt as Fullness Under the Ribs on the Right Side

When the liver becomes cancerous, it enlarges. This can be felt as a lump or a mass in the upper-right side of the abdomen. This enlarged liver might feel like a lump or a mass underneath the right ribs.

As the cancer grows, it can form a mass you can feel through the skin. The resultant lump might feel firm or hard to touch, accompanied by tenderness or pain.

An Enlarged Spleen, Felt as Fullness Under the Ribs on the Left Side

The spleen is an organ under the left rib cage whose job is to filter blood and support the immune system. The spleen swells because of infections, liver disease and certain cancers. If you have liver cancer, your spleen might swell.

Please note: an enlarged spleen is not always indicative of liver cancer. Doctors treat or remove the spleen according to the situation.

Pain in the Abdomen (Belly) or Near the Right Shoulder Blade

Liver cancer causes pain in the right upper abdomen or around the shoulder blade because the tumour grows and puts pressure on surrounding tissues, like the gallbladder and diaphragm.

Dull or sharp, this pain can also travel to the shoulder blade. This gets worse after eating or when you lie down.

Swelling or Fluid Build-up in the Abdomen (Belly)

Someone suffering from end-stage liver cancer will always have a swollen belly. The cancer can cause swelling or fluid build-up in the abdomen, also called ascites. This is very uncomfortable, making it difficult to breathe.

A cancerous liver grows larger, resulting in swelling on the abdomen’s right side. And once the cancer spreads, there’s nothing much that can be done.

Yellowing of the Skin and Eyes (Jaundice)

When your skin or eyes become yellow because of jaundice, it results from too much bilirubin in the blood. Bilirubin is a chemical made by the liver. This might also happen because of liver dysfunction like hepatitis, liver cancer or cirrhosis.

Conditions that impact the gallbladder or bile ducts, like cholangitis or gallstones, can result in jaundice.

Your doctor might suspect that you are afflicted by liver cancer if they find the signs and symptoms while carrying out a physical exam. They may order a battery of tests, some of them being.

Blood tests

Doctors might do a blood test for cancer, like a liver function test, to take a look at liver enzymes, proteins and other substances that show whether the liver is healthy or damaged. They might test for alfa-fetoprotein (AFP), high levels of which are an indicator of liver cancer.

Ultrasound

Also known as sonography, this test gives us comprehensive photos of soft tissue structures. Doctors depend on an ultrasound to detect tumours in the liver.

Computed Tomography (CT) Scan

This is a special X-ray that takes high-resolution pics of the liver, giving you instant information about liver tumour size and where it is situated.

Magnetic Resonance Imaging (MRI)

In this test, clear images of the body are taken out using a large magnet, computer and radio waves.

Angiogram

Through this test, healthcare providers look at the blood vessels of the liver. They inject a dye into an artery to be able to track blockages.

Biopsy

In this method, healthcare providers remove tissue from the liver to look for signs of cancer. Often done in a hospital setting, a biopsy is the best way to confirm a liver cancer diagnosis.

Healthcare providers stage Hepatocellular Carcinoma (HCC) depending on standards set by the Barcelona Clinic Liver Cancer System. This system judges HCC based on characteristics, functionality, tumour size and symptoms.

Healthcare providers might implement different terms for each BCLC stage, sometimes presented as stages I-IV or 0-C, by names such as early and advanced-stage Hepatocellular Carcinoma.

Stage I / Very Early Stage

This means a single tumour in your liver that is less than two centimetres (cm). Blood tests show that bilirubin levels are normal in this stage.

Stage II / Early Stage/ Stage A

This denotes a single tumour that is five cm or less or more than one tumour that is three cm or less. At this stage, the tumour might have spread to the blood vessels.

Stage III/Intermediate Stage/Stage B

In this stage, you could have more than one tumour and /or a tumour that is more than five cm. The tumour might have spread to the lymph nodes, another organ or your large blood vessels.

Stage IV /Advanced Stage/Stage C

In this stage, the cancer has spread indiscriminately (metastasised) to other places in the body, like the lungs or bones, as well as the lymph nodes

Which treatment is ideal for you will be chosen based on the size and location of the liver cancer, how well your liver is functioning and overall health.

Surgery

Surgery to get rid of the cancer and a little bit of healthy tissue that surrounds it might be the best course of treatment for people who are suffering from early-stage liver cancers who have normal liver function.

The most common surgical options are liver resection, where a part of the liver having the tumour is removed, and liver transplantation, which involves removing the whole liver and replacing it with a donor liver.

Surgery is best for people with small, isolated tumours and minimal liver damage. However, if a patient has advanced disease or multiple tumours, surgery might not be an option.

Using Heat or Cold

Getting rid of cancer cells using heat or cold. Ablation procedures to kill the cancer cells in the liver using extreme heat or cold might be the best recourse for people who can’t have surgery.

These procedures include radiofrequency ablation, ablation using alcohol or microwaves, and cryoablation. Radiofrequency ablation (RFA) uses heat to target and destroy tumours, while cryotherapy uses extreme cold to freeze and kill cancer cells.

Minimally invasive, these procedures are best for small tumours or people who cannot undergo surgery.

Chemotherapy

By way of a catheter that passes through the blood vessels and into the liver, doctors can administer chemotherapy drugs (chemoembolisation) or minuscule glass spheres containing radiation (radioembolisation) directly to the cancer cells.

This is a targeted approach to treat tumours while minimising damage to surrounding healthy tissue. Chemotherapy is directly injected into the blood vessels, feeding the tumour, blocking its blood supply and delivering concentrated treatment.

Radiation Therapy

This therapy uses energy from X-rays or protons. A special kind of radiation therapy, known as stereotactic body radiotherapy (SBRT), involves focusing many beams of radiation at once at a point in the body.

Radiation therapy is great for controlling pain, bringing down tumour size, and preventing the spread of cancer. It’s great for patients with tiny, localised tumours or those who can’t tolerate surgery because of certain health complications.

The side effects include fatigue, digestive issues and skin irritation.

Targeted Drug Therapy

Targeted drugs attack particular weaknesses in the cancer cells and could help slow the progression of cancer in people suffering from advanced liver cancers. Unlike chemotherapy, which impacts both healthy and cancerous cells, targeted therapies aim to block or inhibit cancer-specific proteins or genes.

Targeted therapies control advanced liver cancer by blocking cell growth. It is great for patients who have advanced or metastatic liver cancer.

Recovered From Liver Cancer? This Is How You Make Sure It Doesn’t Come Back

Liver cancer treatment and symptoms impact the body. You might be unlucky enough to have a liver transplant or surgery to remove some part of the liver. Other people might not be so lucky - they might require treatment for as long as they live.

In any case, you should have regular appointments with your doctor so they can track your progress and keep an eye out for remission. For instance, if you have recovered and don’t show symptoms of liver cancer after being treated, you must do follow-up imaging and blood tests every three to six months for the first couple of years after treatment.

If you have been treated for liver cancer, these are some steps to take that might bring down the chances of recurrence of liver cancer.

Stay Safe From Hepatitis B and C Viruses

If you want to keep your liver healthy, avoid hepatitis B and C viruses. Get vaccinated against Hepatitis B, at least, because a vaccine can keep you safe from infection. Use condoms while having sex to bring down the risk of viral transmission.

Avoid sharing needles or personal items that could be blood-stained. Get regularly screened for HCV, especially if you have risk factors. Stick to medical treatments and proper check-ups, and your liver will be healthier.

Don't smoke

If you are a smoker, try stopping. If you require assistance in stopping, speak to your healthcare provider so they can educate you about smoking cessation programs. Smoking damages the liver and accelerates liver disease progression, making it tougher for the liver to recover after cancer treatment.

Chemicals present in cigarettes increase inflammation, bring down immune function and promote the growth of cancer cells, especially in the liver. If you smoke, you are at risk of developing other cancers and cardiovascular diseases as well, to worsen your health.

Eat Healthy

Liver cancer and liver cancer treatment might impact your appetite at a crucial time when your body requires nutrition to heal and remain strong. If you have issues eating, speak to a nutritionist, who can guide you to get the nutrition you need.

Maintain a balanced diet of fruits, whole grains, vegetables and lean proteins for liver health. Consume foods rich in antioxidants like berries, leafy greens, and cruciferous vegetables to bring down inflammation and safeguard the liver from damage.

Exercise

Ask your doctor what exercise is the best for you, given your situation. Cancer is stressful. Exercising can bring down that stress.

Regular exercise can play an important role in preventing liver cancer by boosting overall liver health and bringing down risk factors like obesity, fatty liver disease and insulin resistance.

Exercising helps you maintain your weight, which is important because excess body fat can result in non-alcoholic fatty liver disease, a risk factor for liver cancer.

Get Enough Rest

Fatigue is a very common side effect of liver cancer and treatment. Sleeping well supports overall health and helps the body recover from cancer treatments while bringing down stress, which can compromise your immune system.

During sleep, your liver regenerates and detoxifies itself, repairing damaged cells. Sleep deprivation can result in increased inflammation, metabolic disturbances and a higher risk of conditions like fatty liver disease, which can cause a remission of cancer.

Take Your Medications

One way of ensuring that liver cancer doesn’t come back is by taking your medication regularly. While you were recovering from liver cancer, your doctor would have prescribed certain strong medications for you to take.

Once you recover, don’t stop taking these meds. They might be more important than you think. Carry on taking medicines so that you ensure that liver cancer, once gone, doesn’t return.

In conclusion, liver cancer doesn’t show any symptoms during its initial stages. However, as the cancer progresses, symptoms become apparent. Loss of appetite, weight loss without trying, feeling full after a small meal, nausea and vomiting are some of the symptoms of liver cancer.

When it comes to the treatment of liver cancer, surgery, radiation therapy, hot or cold treatment for cancer cells, and targeted drug therapy are some of how liver cancer, in its various stages, gets treated.

If you have liver cancer, speak to your healthcare provider about what course of treatment is the best for you. Get treatment, and stay cancer-free.

FAQs

How do I know whether I have liver cancer?

Nausea, vomiting, satiety after a small meal, weight loss without trying, and loss of appetite are some of the symptoms of liver cancer. If you exhibit any of these symptoms, please have your healthcare provider check them.

My appetite is rather small. Do I have liver cancer?

A small appetite is not necessarily a symptom of liver cancer. If you have a small appetite, speak to your healthcare provider about what you can do to improve it.

I have blood in my urine. Is this liver cancer?

Blood in the urine might be a cause for concern. It might not mean liver cancer, but it is a sign of something serious.

I recovered from liver cancer. Will it return?

Remission is a real threat when it comes to liver cancer. Make sure that you take certain protective steps to ensure that the cancer does not return.

I don’t smoke or drink. Am I at risk for liver cancer?

Non-smokers and teetotallers are still at risk for liver cancer; it’s just that smoking or drinking accelerates the entire process and puts you at risk for liver cancer.