Summary about Disease
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. It originates in the hepatocytes, the main cells of the liver. HCC often develops in people with chronic liver diseases, such as cirrhosis caused by hepatitis B or C infection, alcohol abuse, or non-alcoholic fatty liver disease (NAFLD). Early detection and treatment are crucial for improving outcomes.
Symptoms
Many people with HCC have no symptoms in the early stages. When symptoms do appear, they may include:
Abdominal pain or discomfort, especially in the upper right abdomen
A lump or mass that can be felt below the ribs on the right side
Swollen abdomen (ascites)
Yellowing of the skin and eyes (jaundice)
Nausea and vomiting
Loss of appetite
Weight loss
Weakness or fatigue
Dark urine
Pale stools
Causes
The most common causes of HCC include:
Chronic Hepatitis B or C Infection: Long-term infection with these viruses can lead to cirrhosis and HCC.
Alcohol Abuse: Excessive alcohol consumption damages the liver over time, leading to cirrhosis and increasing the risk of HCC.
Non-alcoholic Fatty Liver Disease (NAFLD) and Non-alcoholic Steatohepatitis (NASH): NAFLD is a buildup of fat in the liver in people who drink little to no alcohol. NASH is a more severe form of NAFLD that can cause inflammation and liver damage.
Cirrhosis: Scarring of the liver from any cause, including hepatitis, alcohol abuse, NAFLD/NASH, and certain genetic disorders.
Aflatoxins: Exposure to aflatoxins, toxins produced by certain molds that can contaminate food crops like peanuts, corn, and grains.
Genetic Conditions: Certain inherited liver diseases, such as hemochromatosis (iron overload) and Wilson's disease (copper accumulation), can increase the risk.
Medicine Used
The medications used to treat HCC vary depending on the stage of the cancer and the overall health of the patient. Some common options include:
Targeted Therapies: These drugs target specific proteins or pathways involved in cancer cell growth and survival. Examples include sorafenib, lenvatinib, regorafenib, cabozantinib, and ramucirumab.
Immunotherapies: These drugs help the body's immune system recognize and attack cancer cells. Examples include atezolizumab in combination with bevacizumab, and pembrolizumab.
Chemotherapy: While not as commonly used as other therapies, chemotherapy drugs may be used in some cases.
Other Treatments:
Ablation Therapies: Radiofrequency ablation (RFA), microwave ablation (MWA), and cryoablation use heat or cold to destroy cancer cells.
Embolization Therapies: Transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) block the blood supply to the tumor.
Liver Transplant: In some cases, a liver transplant may be an option.
Is Communicable
No, hepatocellular carcinoma is not a communicable disease. It cannot be spread from person to person. However, the underlying causes, such as hepatitis B or C, are communicable and can increase a person's risk of developing HCC.
Precautions
While HCC itself isn't preventable in all cases, certain precautions can lower your risk:
Get Vaccinated Against Hepatitis B: Vaccination is a highly effective way to prevent hepatitis B infection and subsequent liver damage.
Avoid or Limit Alcohol Consumption: Excessive alcohol intake is a major risk factor for cirrhosis and HCC.
Maintain a Healthy Weight: Obesity and NAFLD/NASH increase the risk of HCC.
Manage Diabetes: Diabetes is associated with increased risk of NAFLD/NASH.
Avoid Exposure to Aflatoxins: Store food crops properly to prevent mold growth.
Get Screened for Hepatitis C: If you are at risk for hepatitis C, get tested and treated if necessary.
Undergo Regular Liver Cancer Screening: People with cirrhosis or chronic hepatitis B should undergo regular screening with ultrasound and alpha-fetoprotein (AFP) blood tests to detect HCC early.
How long does an outbreak last?
HCC is not an outbreak-related disease. It is a chronic condition that develops over time, typically in individuals with pre-existing liver disease. The progression of the disease can vary significantly from person to person.
How is it diagnosed?
HCC is typically diagnosed through a combination of the following:
Physical Exam and Medical History: The doctor will ask about your symptoms, risk factors, and medical history.
Blood Tests: Liver function tests can reveal abnormalities in liver enzymes. Alpha-fetoprotein (AFP) is a tumor marker that is often elevated in HCC.
Imaging Tests:
Ultrasound: Often used as a screening tool to detect liver masses.
CT Scan (Computed Tomography): Provides detailed images of the liver and surrounding structures.
MRI (Magnetic Resonance Imaging): Also provides detailed images and can help differentiate HCC from other liver lesions.
Liver Biopsy: A small sample of liver tissue is removed and examined under a microscope to confirm the diagnosis of HCC. This is not always needed if imaging is characteristic of HCC.
Timeline of Symptoms
The timeline of HCC symptoms can vary significantly.
Early Stages: Often asymptomatic (no noticeable symptoms).
Intermediate Stages: Symptoms may be vague and nonspecific, such as fatigue, abdominal discomfort, or weight loss.
Advanced Stages: Symptoms become more pronounced and may include jaundice, ascites, severe abdominal pain, and bleeding. The time it takes for symptoms to appear and progress depends on the underlying liver disease, the rate of tumor growth, and the overall health of the individual.
Important Considerations
Early Detection is Key: Regular screening for HCC is crucial for individuals with cirrhosis or chronic hepatitis B. Early detection allows for more effective treatment options.
Treatment is Individualized: The best treatment plan for HCC depends on the stage of the cancer, the patient's overall health, and other factors.
Multidisciplinary Approach: HCC treatment often involves a team of specialists, including hepatologists, oncologists, surgeons, and radiologists.
Ongoing Monitoring: After treatment, regular follow-up appointments and imaging tests are necessary to monitor for recurrence.
Palliative Care: For advanced HCC, palliative care can help manage symptoms and improve quality of life.
Clinical Trials: Consider participating in clinical trials to access new and innovative treatments.