Liver cancer: contributory factors, diagnosis and treatment

Liver cancer have high mortality secondary to hepatitis B,hepatitis C and secondary to alcohol.Hepatocellular carcinoma (HCC),most common form of liver cancer with highest rates in China and in Sub-Saharan Africa. Approximately 75% of all primary liver cancer is HCC (also named hepatoma). Cholangiocarcinoma can form within liver as the bile duct.Liver fluke infection increases the risk of cholangiocarcinoma in Thailand.Tumor of blood vessels-angiosarcoma.Cancers produced from muscles in the liver are leiomyosarcoma.Many cancers in the liver are due to metastasis. Contributory factors of liver cancer includes: viral infection either with hepatitis C (HCV) or hepatitis B (HBV). Viruses cause HCC because massive inflammation, fibrosis and eventual cirrhosis within the liver. Aflatoxin exposure can lead to the development of HCC. High grade dysplastic nodules are precancerous lesions of the liver. Beckwith-Weidemann syndrome is associated with hepatoblastoma in children. Liver cancer is associated with abdominal mass, abdominal pain, emesis, anemia, back pain, jaundice, itching, weight loss and fever. Diagnosis mainly by ultrasound, CT, MRI, and magnetic resonance cholangiopancreatography (MRCP). Tests for tumor markers are helpful. Treatment by surgery, antiviral drugs and liver transplant. Prevention by reducing exposure to risk factor for liver cancer, vaccination against hepatitis B virus, reducing alcohol abuse,prevention of carcinogenesis and treatment to prevent recurrence of liver cancer, by the chemotherapy drugs and antiviral drugs.With the advances in diagnosis and treatment the prognosis in liver cancer remains poor

Primary Hepatocellular carcinoma: management and prognosis

Hepatocellular carcinoma (HCC) causes high mortality worldwide with 50 per cent of them in China. HCC cases are as a result of a viral hepatitis (hepatitis B or hepatitis C), metabolic toxins such as alcohol or aflatoxin, conditions like hemochromatosis and alpha 1-antitrypsin deficiency or non-alcoholic steatohepatitis (NASH). The high prevalence rate of hepatitis C virus (HCV occurs in African and Asian countries. The markers of hepatitis C infection (positive-anti HCV) are found in 80% - 90% patients in Japan, 70% in Egypt, 40- 50% in Pakistan and 35-40% in Saudi Arabia. China is classified as high endemic area with 8% - 20 % prevalence of hepatitis B virus (HBV). Other Asian countries are characterized as moderate to high prevalence rate of HBV in their population. The prevalence of HBV infection in children has declined in countries since the beginning of the vaccination. Chronic infections of hepatitis B and/or C can aid the development of HCC by repeatedly causing body’s immune system to attack the liver cells, some of which are infected by the virus. Aflatoxin is a carcinogen and aids carcinogenesis of HCC in the liver. Ultrasound and imaging modalities are used to aid in the diagnosis. Therapies include surgical resection, interventional radiology, and liver transplant. Prognosis for metastatic or unresectable HCC has improved due to sorafenib (Nexavar ®). Prevention of hepatitis B or C infection, childhood vaccination, reduce alcohol intake and avoiding the risk factors is the key to prevent HCC