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Liver cancer

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Liver cancer is a serious medical condition involving the uncontrolled growth of abnormal cells within the liver.

Big Liver Tumor
Big Liver Tumor

This disease is generally categorized into two main forms: primary and secondary. Primary liver cancer begins directly in the liver tissues. Secondary liver cancer, known as liver metastasis, occurs when cancer starts in a different organ and spreads to the liver. Metastasis is actually the more common type of liver cancer. Because the liver is located near many highly active organs, it often receives cancer cells from the gastrointestinal tract. This includes cancers originating in the pancreas, stomach, colon, or appendix. It can also spread from the breast, lungs, or ovaries.

To understand how this happens, we must look at the different types of primary liver cancer. The most frequent type is hepatocellular carcinoma, or HCC. This cancer develops from hepatocytes, which are the main functional cells of the liver. HCC accounts for approximately 75% to 80% of all primary liver cancer cases.

Hepatitis-B virions
Hepatitis-B virions

Another major type is intrahepatic cholangiocarcinoma, or CCA. This cancer starts in the epithelial cells of the intrahepatic biliary tree, which are the small tubes that carry bile. CCA is the second leading cause of primary liver cancer and is often asymptomatic until it has progressed. Rare types also exist, such as angiosarcoma. These aggressive tumors grow from the endothelial layer of the blood vessels.

Cirrhosis high mag
Cirrhosis high mag

While they only make up 0.1% to 2.0% of cases, they are very difficult to treat.

In children, the landscape of liver cancer is quite different. The most common primary liver cancer in children is hepatoblastoma. This rare tumor forms from immature liver cells. It is particularly significant because it accounts for about 79% of all primary liver cancers in children under the age of 15.

Liver cancer world map-Deaths per million persons-WHO2012
Liver cancer world map-Deaths per million persons-WHO2012

Other childhood types include hepatocellular carcinoma and embryomal sarcoma of the liver. Certain conditions, such as Beckwith–Wiedemann syndrome or low birth weight, are linked to a higher risk of hepatoblastoma.

Many biological processes can trigger these cancers. Viral infections are a leading cause of HCC worldwide. Hepatitis B (HBV) and hepatitis C (HCV) are responsible for about 80% of HCC cases. These viruses cause massive inflammation and fibrosis, which can lead to cirrhosis. Cirrhosis is a condition where the liver becomes heavily scarred.

photodynamic therapy
photodynamic therapy

The viruses also cause genetic changes. They can alter gene methylation and affect how genes are expressed. They may even prevent cells from undergoing apoptosis, which is programmed cell death. This allows the damaged cells to survive and multiply.

Other environmental and lifestyle factors also play a role. Aflatoxins are toxic chemicals produced by fungi like Aspergillus flavus. These fungi can contaminate crops such as peanuts and cereals. Ingesting these toxins can cause mutations in the p53 tumor suppressor gene. Alcohol use disorder is another major cause of cirrhosis, especially in the Western world. Additionally, obesity and diabetes are emerging risk factors. These conditions can lead to non-alcoholic fatty liver disease (NAFL) or non-alcoholic steatohepatitis (NASH), both of which increase the risk of HCC.

Global statistics show the significant impact of this disease. In 2018, primary liver cancer occurred in 866,136 people. This resulted in 758,725 deaths globally during that year. Primary liver cancer is the sixth most frequent cancer in the world. It is also the fourth leading cause of cancer-related deaths. Higher rates are often seen in Asia and sub-Saharan Africa, where hepatitis B and C are more common. Diagnosis is most frequent in adults between the ages of 65 and 74.

Medical professionals use several methods to diagnose and treat the disease. Doctors often start with blood tests and medical imaging like ultrasounds. If an ultrasound shows a focal area larger than 1 centimeter, a patient may need a CT or MRI scan. A tissue biopsy is often required to confirm the exact type of cancer. Treatment options vary based on the specific cancer type. These include surgery, radiation therapy, or targeted therapy. In some cases, doctors may use ablation therapy, embolization, or a liver transplant to help the patient.

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File:Hepatitis-B virions.jpg
Hepatitis-B virions.jpg
File:Cirrhosis high mag.jpg
Cirrhosis high mag.jpg
File:Big Liver Tumor.JPG
Big Liver Tumor.JPG
File:photodynamic therapy.jpg
photodynamic therapy.jpg
File:Liver cancer world map-Deaths per million persons-WHO2012.svg
Liver cancer world map-Deaths per million...
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