Hepatocellular carcinoma causes most liver cancer worldwide. The most significant cause of cancer fatalities is HCC, which is especially dangerous for patients with liver problems. Many persons with cirrhosis or long-term viral infections like hepatitis B and C experience this.
In this blog, we define Hepatocellular Carcinoma (HCC), its risk factors, how to detect it, and its treatment medical abbreviation in Gastroenterology. It stresses early detection and treatment of HCC.
Explain HCC or Hepatocellular Carcinoma
HCC is the most prevalent primary liver cancer. Those suffering from liver diseases are more prone to get this most common liver cancer. Over time, liver cancer wears down the liver. Its frequency is rising with chronic hepatitis, drinking, and non-alcoholic fatty liver disease. Treating later-stage liver cancer can be more difficult. Thus, some patients don’t show symptoms.
Chronic liver swelliness causes malignant cells to proliferate, causing hepatocellular carcinoma. The liver’s impaired blood filtering and protein production lead to HCC. Associated with liver cancer and other liver issues, it can migrate to the lungs and lymph nodes.
HCC Risk Factors
People with chronic liver disease are more prone to liver cancer. Several variables enhance liver cell cancer risk. The top liver cancer risk factors are:
Hepatitis B and C
These viruses can damage the liver. Permanent infection with any virus considerably increases the risk of liver cancer. More strong viruses like Hepatitis B can cause liver cancer. Hepatitis C harms the liver and raises the risk of cirrhosis and liver cancer.
Aflatoxin
Molds create dangerous aflatoxins. They can induce liver cancer, especially in peanut and wheat-growing regions.
Drunk alcohol
Too much alcohol causes cirrhosis, which raises the chance of liver cancer. Regular, heavy drinking destroys liver cells and produces inflammation, fibrosis, and HCC. The liver suffers damage and scar tissue results from overdrinking, therefore compromising its ability.
Disorders of Fatty Liver
Particularly in richer countries, NAFLD and NASH are increasingly linked to liver cancer (HCC). Specifically, NASH is non-alcoholic steatohepatitis while NAFLD is fatty liver disease. NAFLD is the result of liver fat building up without drinking. More detrimental is NASH, a significant liver swell and inflammation. In uncontrolled cases, these disorders can lead to liver cancer and cirrhosis.
Chronic liver disease
Long-term viral hepatitis or alcohol abuse can cause cirrhosis. These issues considerably raise liver cancer risk. Repeated liver inflammation can alter cells and cause cancer.
Genetic Factors and Family History
HCC risk increases with gene alterations or a liver cancer family history. Hemochromatosis and Wilson’s disease can cause liver damage and malignancy. HCC risk rises with a first-degree cousin having the disease.
Diagnosis of Hepatocellular Carcinoma
Hepatocellular Carcinoma Diagnosis
Liver cancer survival depends on early diagnosis. The liver can take a lot of damage; thus, symptoms may not occur until the disease is advanced. This makes early issue detection difficult. There are several approaches to detect and assess HCC risk:
Blood Tests
Blood tests assess liver function and identify malignancy. Alpha-fetoprotein (AFP) testing is the standard liver cancer screening. Other liver disorders can raise AFP levels, which may indicate liver cancer (HCC). Liver function tests evaluate liver function. They measure enzymes, bile, and blood-clotting factors.
Imaging Methods
- Ultrasound: The initial test for abnormalities is generally a liver ultrasound. It is safe, affordable, and effective at identifying liver growths, cysts, and tumours.
- CT scan: A CT scan clearly shows the liver and surrounding tissues. It shows physicians how large, where, and if a cancer is growing. CT scans help determine disease severity.
- MRI or Magnetic Resonance Imaging: Produces crisp liver pictures using magnets and radio waves. MRI better detects small tumours and liver health than CT.
- Liver sample: Testing the liver may confirm the diagnosis. A doctor uses an instrument to remove a tiny liver tissue sample and inspect it under a microscope for cancer cells. Physicians use samples to diagnose liver problems.
- Molecular and Genetic Testing: Genetic and molecular testing can detect liver cancer-related genetic alterations and causes. This can reveal how the cancer behaves and help choose treatments. Genetic testing predicts cancer spread and drug response.
HCC Treatment Options
Liver cancer treatment depends on tumour size, location, stage, and liver condition. The optimal care requires surgeons, cancer physicians, liver experts, and radiology. The main HCC possibilities are:
Surgery for Treatment
- Liver removal (partial hepatectomy): If the liver is healthy and the cancer is in one region, surgery to remove the tumour and some healthy tissue may be possible. Those without cirrhosis with early-stage liver cancer should get therapy.
- Liver transplantation: Should cancer solely affect the liver and the individual have cirrhosis, they might want to discuss a liver transplant. Under this procedure, a healthy liver from a donor replaces the whole liver. Often donated to those whose liver is still functioning but cannot have surgery to remove a portion of it, liver grafts
Ablation Methods
- Ablation by radiofrequency: High-frequency radio waves heat tumours in radiofrequency ablation (RFA). It helps tiny growths and people who cannot undergo surgery. People without liver surgery who have minimal liver damage should consider RFA.
- Cryoablation: Freezing cancer cells kill them via cryoablation. These treatments can substitute RFA for tiny malignancies or individuals who couldn’t have surgery. Ultrasound or CT scans guide cryoablation.
- Ethanol Injection: Killing cancer cells requires injecting alcohol into the tumour. This therapy targets tiny liver tumours in hard-to-reach regions.
Transarterial Chemoembolization
TACE uses a tiny tube to deliver anticancer medications directly to the tumour through hepatic blood arteries. This method delivers medicine directly to the cancer while blocking blood flow, denying it oxygen and nourishment. For middle-stage liver cancer patients who cannot undergo surgery, TACE is often considered.
TARE radioembolization
Radioembolization injects fragile glass beads with radioactive substances into liver tumours. These beads release radiation that shrinks and removes cancer—people with non-surgical malignancies and those who cannot undergo TACE benefit most from it.
Radiotherapy
Strong beams destroy cancer cells in radiation therapy, which can help those who cannot undergo surgery or other local therapies. Stereotactic body radiotherapy (SBRT) precisely targets cancer by directing numerous radiation beams from different angles, protecting surrounding healthy organs.
Specific Treatment
Targeted therapies target biological pathways that help tumours grow and survive. Sorafenib inhibits cancer-feeding blood vessels.
Immunotherapy
Immunotherapy medications like checkpoint inhibitors help the immune system find and kill cancer cells. Combining these approaches with additional drugs appears to treat advanced liver cancer. Nonresponders to regular medications may consider immunotherapy.
Clinical Trials
Clinical trials allow people to explore novel medicines before they open to everyone. New liver cancer (HCC) drugs can enhance lives through clinical trials. Talk to your doctor about research studies.
Prevention of Liver Cancer
Manage liver-damaging factors to avoid liver cancer. Problem-prevention tips:
Vaccination for Hepatitis B
Hepatitis B vaccination prevents long-term infections and liver damage that might lead to liver cancer. Babies and at-risk individuals should get the Hepatitis B vaccination.
Regular Monitoring for Hepatitis B and C
Regular Hepatitis B and C screenings are necessary, especially for persons with these illnesses. Early antiviral medication helps prevent liver damage and HCC.
Limiting Alcohol
Drinking less helps prevent liver damage and HCC. Reduce alcohol consumption for a healthy liver.
Healthy Weight
Keeping a good weight lowers liver cancer risk. This covers the avoidance of diabetes, obesity, and fatty liver disease. Healthy living matters, and regular exercise and a varied diet are required.
High-Risk Screening
Cirrhosis, hepatitis, and fatty liver disease patients should undergo routine screenings to detect liver cancer early. Early treatment improves survivability.
Conclusion
Protective measures, early detection, and better treatment can improve hepatocellular carcinoma outcomes. Health professionals and patients may control this deadly illness by knowing the risk factors and acting immediately. HCC patients may benefit from new therapies and methods as medical research advances.
Reference:
https://www.hopkinsmedicine.org/health/conditions-and-diseases/liver-cancer-hepatocellular-carcinoma
https://www.mountsinai.org/care/cancer/services/liver/hepatocellular-carcinoma
https://my.clevelandclinic.org/health/diseases/21709-hepatocellular-carcinoma-hcc
