Liver cancer is a common fatal disease. According to the statistical figures published by the Hong Kong Cancer Registry in 2013, liver cancer is the third-leading cause of death from cancer in Hong Kong, after lung cancer and colorectal cancer.
Known causes of liver cancer include:
Hepatitis B or C infection
Consumption of food contaminated by aflatoxins
Ingestion of oral contraceptives that contain certain ingredients
Ulcerative colitis (UC)
Consumption of food containing toxins
Long-term exposure to certain environments or pollutants
Cholangitis or choledochal cysts
Symptoms may not be apparent during the early stages of liver cancer. As the tumour grows larger, patients may experience the following symptoms:
Loss of appetite and significant weight loss
Upper abdominal and right shoulder pain
Upper abdominal pain, discomfort, or lumps
Jaundice, yellowing of the skin and eyes
Tea-coloured urine, clay-coloured stools
Ascites (accumulation of fluid in the abdominal cavity)
However, these symptoms are not unique to liver cancer. If the above symptoms appear, there is no need to worry too much but medical attention should be sought as soon as possible so that any necessary diagnostic procedures and treatments may be started early to prevent disease progression.
Screening and Diagnosis
People with a high risk of developing liver cancer should undergo regular medical examinations. They include elderly men and patients with chronic liver disease. Tests for liver cancer include:
Liver ultrasound scan
Alpha-fetoprotein (AFP) blood test
Computed tomography (CT) scan
Magnetic resonance imaging (MRI)
Indocyanine green (ICG) clearance test
Among the tests, the preoperative indocyanine green (ICG) clearance test is especially important for liver cancer surgery. This test is mainly used to assess the detoxification and metabolic function of the liver, which allows doctors to accurately evaluate the condition of the liver and assess the risk of the surgery.
Treatment for liver cancer depends on the patient’s condition, which is determined based on the type, size, location, and degree of metastasis of the tumour, as well as the patient’s age and physical condition.
Surgery aims to cure cancer by removing the tumour and part of the liver. In the past, laparotomy (i.e. the traditional method) was the surgical method of choice, but nowadays, minimally invasive procedures for liver cancer resection have become very popular. Procedures such as laparoscopy, robotic surgery, and radiofrequency ablation can help reduce complications that arise from surgical wounds. Patients undergoing these procedures may be discharged from the hospital as early as two to three days after surgery.
Chemotherapy is treatment with drugs to destroy cancer cells in an effort to shrink the tumour or control the growth of cancer. Chemotherapy may be administered as a systemic therapy (circulates throughout the body) or a topical therapy (applied to the skin).
Radiation therapy uses high-energy beams to destroy cancer cells. New radiation therapy systems such as Tomotherapy, a high-speed helical radiation system, direct radiation energy to the tumour, minimizing exposure of energy to normal cells and reducing the development of possible side effects.
Targeted therapy employs molecular biology techniques that focus on the mechanisms by which cancer cells mutate, proliferate, and spread in an effort to inhibit their ability to grow and repair. In the treatment of liver cancer, targeted therapy is often performed in combination with other treatments.