Hepatitis C and Liver Cancer
November 2, 2017
What is Liver Cancer?
When a cell dies, an abnormal cell can take over the mechanism of the cell and grow out of control. The abnormal cells can form into cancer cells and grow into masses that can develop within an organ, can spread to nearby organs, tissues, lymph nodes and may transport themselves via the bloodstream throughout the body. Hepatocellular cancer or hepatocellular carcinoma is the most common form of liver cancer.
The common causes of liver cancer in the United States include hepatitis C, fatty liver disease, hepatitis B, alcoholic liver disease, obesity, and diabetes. If you have more than one of these factors, it increases the risk of liver cancer especially once you develop cirrhosis. However, if you have chronic hepatitis B, you can develop liver cancer in the absence of cirrhosis. If infected with hepatitis C, liver cancer develops after severe fibrosis or cirrhosis has developed.
In early stages of liver cancer there are few symptoms. When symptoms appear they may include an ache (where the liver is located), fatigue, fever, and loss of appetite and feeling full (even after eating a small amount of food), vomiting, abnormal bruising or bleeding. Also, there may be some unexplained symptoms.
People with hepatitis C with severe fibrosis or cirrhosis should be monitored on a regular basis for liver cancer. There are three main tests -- alpha-fetoprotein test (AFP), liver biopsy, and imaging tests.
The alpha-fetoprotein test (AFP) is a chemical test that may be elevated in some people with cancer. The utility of the AFP is questionable since it is a not a very accurate test for gauging liver cancer. For instance, high levels of AFP are also present in pregnant women, other forms of cancer and may not show up as elevated for liver cancer.
Liver biopsy and imaging tests are better tools for diagnosing liver cancer.
The liver biopsy does have drawbacks because it can cause bleeding and the possibility of the biopsy needle hitting a tumor. A liver biopsy could pose a risk of "seeding the tumor" or spreading cancer to other parts of the liver -- although this belief is controversial.
Imaging tests are the preferred way to monitor for liver cancer. The American Association for the Study of Liver Disease (AASLD) recommends two forms of imaging -- computed tomography (CT scan) and magnetic resonance imaging (MRI).
CT scan is a computer-generated image of multiple x-rays of the liver that can capture different angles. CT scans use radiation to generate images. MRIs are similar but use a different technology. Both diagnostic tests are safe. Both tests require an injectable contrasting agent (ink) that will highlight blood veins and cancer tumors (if any).
The most widely used liver cancer staging system is the American Joint Committee on Cancer (AJCC) TNM method. The system includes three categories:
The stages are numbered 0 to 4: 0 is the least severe, and four is the most severe when it has spread to other organs.
There are many strategies to prevent liver cancer. For people with hepatitis C, the best option is to treat and cure hepatitis C early before severe fibrosis or cirrhosis; this will eliminate further HCV disease progression and liver cancer. People with severe fibrosis or cirrhosis, who are treated and cured, will have a reduced chance of further HCV disease progression and liver cancer.
Important strategies to further reduce the risk of liver cancer include:
There are various options to treat liver cancer -- this is just a brief overview:
FDA Approved Medications
There are three medications approved by the Food and Drug Administration (FDA) to treat HCC -- liver cancer:
Alan Franciscus is the executive director of the Hepatitis C Support Project and the editor-in-chief of the HCV Advocate website.
[Note from TheBody.com: This article was originally published by HCV Advocate in Nov. 2017. We have cross-posted it with their permission.]
This article was provided by HCV Advocate. Visit HCV Advocate's website to find out more about their activities and publications.
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