Liver is present on the right side of the upper part of the abdomen, just under the diaphragm. Its main function is to convert the digested food into integral parts of the body. The cells of which it is made up, are very special cells to perform their function, and have the capacity to regenerate themselves also.
The commonest disease of the liver in India is infectious hepatitis or common jaundice.
Cancer of the liver may be primary, that is, arising from the liver itself or secondary, i.e. arising from another organ (matastasis) and spreading to the liver. The incidence of the primary cancer of the liver shows great geographical variations, being common in Africa and South East Asia and India, and less common in Western countries. It occurs predominantly in males, and in 80 per cent of the cases, the patient already has cirrhosis of the liver.
Causes
A liver which has developed cirrhosis because of an earlier attack of infectious hepatitis due to Hepatitis B virus or excessive intake of alcohol, is more liable to develop primary cancer.
Presence in the food of some chemical substances such as Anatoxin, which occurs particularly in ground-nuts infected with the fungus called Aspergillus fumigatus is also known to cause cancer. In the majority of the cases, however, the cause cannot be pin-pointed.
Symptoms
· Loss of appetite
· Weakness
· Discomfort or pain, sometimes very severe in the upper abdomen.
· Swollen abdomen due to rapid enlargement of the liver and/or the presence of fluid in the abdomen, a condition called ascites.
Diagnosis
· Routine: Blood: Hb and RBC may be low.
· TLC and DLC may be normal.
· ESR is raised.
· Special: Liver function tests show impairment.
· Liver ultrasound and CT scan give the outline of the liver and its consistency, and so give an idea about the nature of the disease.
· Liver biopsy taken through a fine needle and its examination, gives the exact nature of cells and the diagnosis.
In view of its simplicity, it is recommended in all cases suspected of the disease.
Treatment
· Surgical: If the liver cancer is discovered very early and is very small in size and localized, it is possible to remove it surgically. In most other cases, surgery is of no help.
· Radiation: It only helps sometimes in relieving some symptoms, such as pain, for sometime only.
· Chemotherapy: It does not help.
Prognosis
The patient of liver cancer, may die within a year.
Secondary Cancer in Liver
Spread of cancer in the liver secondary to the initial occurrence of cancer in some other parts of the body, is a very common occurrence. Secondaries in the liver usually originate from cancers in the bronchus, breast, abdomen or pelvis. They may be single or multiple. Peritoneal dissemination frequently results in ascites.
In patients presenting with advanced cancers, secondaries in liver are present in 30 to 50 per cent of the cases. Average survival of the patient ranges between 2 to 6 months. Surgery and radiation are unhelpful. Isolated good responses may be obtained by chemotherapeutic drugs.
Early Detection
Signs & Symptoms
· History of having had jaundice earlier in life or of heavy drinking.
· Discomfort or pain sometimes severe, in the upper abdomen.
· Swollen abdomen.
Investigations
· Needle biopsy of the liver and its examination