It moves in a stealthy progression. That is why the World Health Organization (WHO) has identified liver cancer as a silent killer. It often has no symptoms until advanced stages. That sure makes it difficult to detect.
Globally, liver cancer is the sixth most common cancer and the third leading cause of cancer deaths. Over 900,000 new cases are reported annually. In Africa, the rate is even higher due to other factors that we will soon discuss. This means it kills more than cervical cancer.
In Nigeria, specifically, liver cancer accounts for around 50,000 new cases each year. It is the third most common cancer. This alarming number reflects the disease’s silent nature, with many cases going undiagnosed until it is too late. According to WHO, liver cancer causes over 830,000 deaths globally, with a staggering number occurring in regions like Sub-Saharan Africa and East Asia.
Why liver cancer is silent killer
Liver cancer refers to malignancy that originates in the liver cells, which are crucial for digestion. The most common form of liver cancer is hepatocellular carcinoma (HCC), according to the National Cancer Institute (NCI). It is the most common type of liver cancer. It starts in the main liver cells, called hepatocytes. This type of cancer usually affects people with liver diseases, like hepatitis or cirrhosis. Simply put, HCC means cancer in the liver cells. It progresses slowly, hence the term, silent killer.
This type is responsible for about 75% of liver cancer cases worldwide. The liver, which sits in the upper right side of your abdomen, performs essential functions. When liver cells become cancerous, these functions are disrupted.
Another type of liver cancer is cholangiocarcinoma, which begins in the bile ducts. This form is rarer and involves the tubes connecting the liver and intestines. Cholangiocarcinoma is a type of liver cancer that begins in the bile ducts. The bile ducts are small tubes that carry bile from the liver to the intestines to help digest food. This cancer affects the tubes rather than the liver cells themselves. So, cholangiocarcinoma means cancer in the bile ducts.
Intrahepatic cholangiocarcinoma originates inside the liver, while extrahepatic cholangiocarcinoma starts outside the liver. The Mayo Clinic explains these types but underscores that HCC is the most common.
Symptoms of Liver Cancer
Liver cancer symptoms can be vague and subtle, contributing to its reputation as a silent killer. Common symptoms include:
- Unexplained weight loss
- Loss of appetite
- Abdominal pain and swelling
- Fatigue and weakness
- Jaundice (yellowing of the skin and eyes)
- Nausea and vomiting
These symptoms often develop when the cancer has already advanced. The Mayo Clinic points out that these signs can mimic those of other liver conditions, which makes timely diagnosis difficult.
Causes, risk factors and diagnoses
According to the National Cancer Institute, chronic infection with hepatitis B or hepatitis C is the primary cause of liver cancer. These viruses cause long-term liver inflammation, which can lead to liver cirrhosis and eventually cancer. Alcohol abuse, obesity, and non-alcoholic fatty liver disease (NAFLD)are also significant risk factors.
The WHO reports that liver cancer is most prevalent in regions where chronic viral infections are common. This includes Sub-Saharan Africa, East Asia, and parts of Latin America. In these areas, hepatitis B infection rates are high, directly contributing to the cancer burden.
Diagnosis of liver cancer often occurs late because of the silent nature of its symptoms. Blood tests, including the detection of elevated alpha-fetoprotein (AFP) levels, are often used to help diagnose liver cancer. Alpha-fetoprotein (AFP) is a protein that is usually found in high levels in a developing baby during pregnancy. It can also be found in the blood of adults, but when levels are high, it may be a sign of liver cancer or other liver problems.
In simple terms, AFP is a blood marker that doctors use to help detect liver cancer or check for liver damage. If the levels of AFP are higher than normal in an adult, it can suggest the presence of liver cancer. Imaging techniques, such as CT scans or MRI scans, are essential for identifying tumors in the liver. Biopsy may be performed to confirm the diagnosis.
Treatment options for the silent killer
WHO and NCI advise that patients with cirrhosis or chronic hepatitis should undergo regular screening. This helps detect liver cancer in its early stages, improving the chances of successful treatment.
Treatment for liver cancer, the silent killer, depends on its stage and the patient’s overall health. Early-stage may be treatable with surgery, such as liver resection or liver transplant, according to the Mayo Clinic. However, for advanced stages, treatment options are more limited.
For many patients, ablation therapy (using heat or cold to destroy the tumour) may be an option. Chemotherapy and radiation therapy are used in some cases, though they are less effective for liver cancer. The NCI mentions targeted therapies and immunotherapy are emerging treatments being tested in clinical trials.
Prevention and risk management
The WHO recommends vaccination against hepatitis B as one of the most effective ways to prevent liver cancer. Vaccination programs have been shown to dramatically reduce the incidence of hepatitis B infection and, consequently, liver cancer rates.
Dr. Michael Lead, a hepatologist, explains that, “Vaccination, along with better management of chronic hepatitis infections, is the cornerstone of reducing liver cancer incidence.” Maintaining a healthy weight, limiting alcohol consumption, and managing diabetes are also important preventive measures against the silent killer, he added.
Leave feedback about this