Liver cancer (Hepatocellular carcinoma)

Liver Cancer Text using Scrabble Tiles
Written by ademadouma

* Hepatocellular carcinoma or primary liver cancer is one of the most common cancers worldwide, it is the most common type among males and the second among females, and it is also the deadliest cancer in Thailand.

* Hepatocellular carcinoma is usually caused by hepatitis B infection.

•Chronic infection with the hepatitis B virus significantly increases the risk of cancer, and those suffering from cirrhosis have an increased risk of cancer by 3-8% per year.

•Other causes of hepatocellular carcinoma are chronic hepatitis C and non-alcoholic fatty liver disease (NAFLD), alcohol-related cirrhosis-another extremely common disorder among Thais.

How effective are liver cancer treatments

Liver Cancer Text using Scrabble Tiles

Statistical data from the National Cancer Institute of Thailand for the period 2013-2015 revealed that hepatocellular carcinoma (HCC or liver cancer) accounts for 34% of cancer cases among men and 13% of cancer cases among women, which makes it the most common type among males and the second most common type among women. liver cancer most often affects people aged 40 to 70 years, most of the initial symptoms are nonspecific and the disease can progress rapidly. This means that when the disease is diagnosed, it has reached advanced stages, which makes treatment ineffective. However, liver cancer can be treated effectively if detected early, and regular check-ups and a healthy lifestyle can help prevent liver cancer.

Risk factors and causes associated with liver cancer

A Woman Taking Her Medicines

1. Chronic epidemic hepatitis B

Approximately 60% of liver cancer cases in Thailand are caused by chronic hepatitis B infection and currently, there are about 6 million Thais suffering from hepatitis B, patients with high levels of hepatitis B virus are at high risk of developing hepatitis and cirrhosis, and approximately 3-8% are more likely to develop liver cancer every year, if you are diagnosed with hepatitis B you should undergo annual health checks as there are effective antiviral drugs that can reduce the risk of cirrhosis and liver cancer, in addition, hepatitis B can be effectively prevented by administering hepatitis B vaccines to exposed populations The risk of contracting this disease.

2. Chronic epidemic hepatitis

Although it is the most common cause of liver cancer in Western countries, it accounts for 10-20% of all liver cancers in Thailand. Injecting drug users, people who received blood transfusions before 1989, and those who were tattooed and/or pierced with a common needle are among the most susceptible to this disease, all of this can increase the risk of hepatitis C virus entering the body. Chronic hepatitis C infection leads to inflammation and damage to the liver, which can lead to cirrhosis. this infection adversely affects liver function and increases the risk of hepatocellular carcinoma. if you are diagnosed with hepatitis C infection, you should undergo a comprehensive examination, as there are antiviral drugs taken orally. these drugs are highly effective and can treat and reduce the risk of liver cancer.

3. Cirrhosis of the liver caused by other conditions

Other causes of cirrhosis are alcoholic cirrhosis caused by heavy drinking and non-alcoholic fatty liver disease (NAFLD). People in this risk group have higher than normal levels of liver enzymes (AST & ALT) due to chronic hepatitis and cirrhosis, when liver function deteriorates patients may experience jaundice, flatulence due to ascites, brain complications from liver failure, and increased risk of liver cancer. Anyone in this risk group is advised to undergo an ultrasound scan for hepatocellular carcinoma every six months.

Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic fatty liver disease (NASH) are currently being diagnosed in unprecedentedly increasing numbers due to the alarming trend of following inactive lifestyles, reduced physical activity, dependence on high-calorie diets, and obesity, which can all play a major role in cirrhosis and liver cancer.

Those suspected of cirrhosis or in the early stages of cirrhosis often do not show any clinical symptoms or the symptoms may be nonspecific, the FibroScan instrument is a non-surgical instrument for measuring and evaluating liver sclerosis and helps medical staff to closely monitor patients with hepatitis B and C infection without the need for liver biopsy. So this device helps to plan effective and timely treatment and is also able to screen for fatty liver disease.

Hepatocellular carcinoma treatments

doctor and nurses inside operating room

1. Surgery:

it is the first option for the treatment of hepatocellular carcinoma due to the possibility of recovery from the disease, but only patients whose liver is functioning normally and the size of the cancer is not more than 5 cm and the blood vessels near it are not injured undergo this surgery.

2. Liver

transplantation: this type of treatment is offered to patients who also suffer from cirrhosis of the liver because it treats cancer and cirrhosis at the same time, but this type is suitable only for patients whose cancer size is small and has not yet spread to neighboring organs; the larger the size of the cancerous tumor, the higher the risk of recurrence after transplantation. although liver transplantation is an effective form of treatment, this option is still limited in Thailand due to the small number of liver donors and the high cost of surgery.
Samitiyet Sukhumvit hospital is a liver transplant center and our team consisting of liver transplant surgeons, liver specialists, and medical staff is fully ready to provide this treatment. The hospital meets the criteria required to perform this procedure, making it a viable option for patients who meet the criteria.

3. Radiofrequency ablation( RFA):

using high-frequency radio waves that convert into thermal energy to destroy cancer cells, this method is effective in the treatment of small cancerous tumors, especially tumors no larger than 3 cm in size and located far enough from vital blood vessels.

4. Transarterial chemoembolization (TACE) or transarterial radiation embolization (TARE):

these treatments involve injecting chemotherapy or radionuclide agents directly into the cancer to destroy cancer cells. This treatment is suitable for patients who cannot be treated using the previously mentioned therapies due to the size of the tumor, those with cancer located in close proximity to another vital organ, or for whom surgery is an unsafe option. However, patients still need their liver function to be good enough for this procedure, as reduced blood flow to some areas may temporarily disrupt liver function.
TACE and TARE treatments can significantly help patients survive longer.

5. Systemic chemotherapy:

this treatment is offered in cases that have not responded well to any of the above treatments, systemic chemotherapy consists of targeted chemotherapy or immunotherapy, and the medical staff will carefully consider these options before making decisions for each individual case.
Currently, a range of treatments for liver cancer is available and the most appropriate option depends on the stage of cancer, its size, and the patient’s liver function. the patient and doctors carefully consider each treatment method before choosing the most effective one. Treatment of hepatocellular carcinoma at the moment has become more effective than in the past, and patients who have detected cancer in its initial stages are now more able to fully recover than ever before. So it is necessary to regularly monitor liver cancer using abdominal ultrasound in patients of high-risk categories.
For patients who do not suffer from chronic liver disease, they should lead a healthy lifestyle and undergo regular annual check-ups to prevent liver cancer, this includes reducing exposure to risk factors associated with liver cancer, detecting hepatitis B and C infections, avoiding alcohol, maintaining body weight in a healthy range and receiving basic vaccinations.

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