The liver is a key player in the body’s digestive system. Everything we eat or drink, including medicines, pass through the liver. The liver is about the size of a football and sits under the lower ribcage on the right side. Among its several roles, most important would be detoxifying blood by getting rid of harmful chemicals produced by the body. The liver also produces bile, which helps break down fat from food and it stores sugar in the form of glucose, which gives a quick energy boost when needed.
Liver cancer or hepatocellular carcinoma (HCC) is the growth and spread of unhealthy cells in the liver. Cancer that starts in the liver is called primary liver cancer. Cancer that spreads to the liver from another organ is called metastatic liver cancer.
According to the Hepatology Society of the Philippines (HSP), liver cancer ranks number two among all killer cancers in the Philippines. Data from the Department of Health likewise shows that it is the second most prevalent cancer among men and the ninth among females in the country.
Nowadays we see that more and more Filipinos are being diagnosed with liver diseases, yet it remains a “silent epidemic.” Liver cancer is relatively common in our country primarily because many Filipinos suffer from cirrhosis (irreversible scarring) of the liver. Cirrhosis precedes 80 percent of all liver cancers. The usual cause among Filipinos is chronic hepatitis B (a major health problem in the country), hepatitis C infection, tobacco/cigarette smoking and alcoholism.
Obesity and diabetes, which are closely associated with a type of liver abnormality called nonalcoholic fatty liver disease (NAFLD), may also increase the risk of liver cancer especially in those who drink heavily or have viral hepatitis. The HSP defines fatty liver as the accumulation of fats in the organ and is highly associated with a “good food and good drinks” kind of lifestyle. HSP pointed out that a typical non-alcoholic fatty liver disease patient is also hypertensive, overweight, diabetic, and has high cholesterol.
Another risk factor for liver cancer that adds to the high incidence of the malignancy among Filipinos is aflatoxin. It is produced by certain species of molds that grow in foodstuff such as peanuts, corn, rice, etc. The high temperature and relative humidity that prevail in the Philippines and the often improper storing, processing, and handling of foodstuff are the reasons why the aflatoxin content of food products is frequently above the acceptable level.
What are the symptoms of liver cancer? Liver cancer develops ominously, often presenting with no symptoms until the tumor is in the advanced stage. As the cancer grows larger, people may notice one or more common symptoms: pain or discomfort in the right upper abdomen; a swollen or enlarging abdomen; a hard lump on the right side just below the rib cage; pain near the right shoulder blade or in the back; jaundice, or the yellowing of the skin or eyes; easy bruising or bleeding; unusual tiredness; bloatedness or feeling of fullness; nausea and vomiting; loss of appetite; and weight loss for no known reason. It is important to remember that these symptoms could also be caused by other health conditions.
How is liver cancer treated? Liver cancer treatment depends on the liver’s condition and extent of cirrhosis; the size, location and number of tumors; whether the cancer has spread outside the liver and eventually on the person’s overall health.
The American Cancer Society suggests six possible modes of treatment for liver cancer: liver transplantation, tumor ablation, tumor embolization, radiation therapy, targeted therapy and chemotherapy.
In the Philippines, however, the DOH has noted that surgery can be curative in the case of patient with early diagnosis but those diagnosed in later stages could receive acceptable, judicious and cost-effective palliative care to still promote quality of life.
Lack of access to affordable healthcare services, and obstinacy among Filipinos make it more difficult to detect the condition early and provide intervention for liver diseases. Most liver cancer patients die within a year of diagnosis, and the five-year survival rate for the disease (if no treatment is undertaken) is less than five percent. Even with treatment, the five-year survival rate for liver cancer is still a low 35 percent.
The outlook for liver cancer is poor, but the disease is preventable because the major risk factors for the disease have already been identified. Measures that can significantly reduce one’s risk for cancer of the liver include vaccination for hepatitis B, screening and treatment for hepatitis C, avoidance of high risk behavior, avoidance of alcohol and tobacco, proper diet and exercise and proper storage of foodstuff.
Published your medical corner by Josefina Laza-Luspian, Baguio Midland Courier January 14, 2018 issue
