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The relationship between liver disease and mental health
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Topic
Hepatocellular carcinoma is the most common type of primary liver cancer, comprising about 80% of all liver cancer diagnoses globallyi. Cancer is a serious subject, and not one that’s easy to talk about, but if you or a loved one is faced with a diagnosis, knowing the facts can help make it easier to tackle the disease with confidence. Read on to learn more about this type of liver cancer, as well as it’s causes, symptoms, and treatment methods.
What Is Hepatocellular Carcinoma?
Hepatocellular carcinoma, also referred to as hepatocellular cancer or simply HCC, is a tumour that develops in the liver2, and it’s the fifth most common type of cancer worldwideii.
Often (although not always) associated with liver diseases like hepatitis B and C, and fatty liver disease, HCC is more prevalent in men than in women, and it usually strikes after the age of 50iii.
Hepatocellular carcinoma can also be the result of long-term scarring of the liver, in the form of cirrhosis.3
It’s important to note that HCC is different from something called metastatic liver cancer – which is where the cancer originates in another part of the body, and then spreads to the liver.3 Instead, hepatocellular carcinoma is a primary tumour of the liver, meaning it begins to grow directly in the liver.
What Are the Causes of Hepatocellular Carcinoma?
Cirrhosis, a form of long-term liver damage and scarring, is often the cause of hepatocellular cancer, and it can be brought on by any of the following:
- Alcohol abuse
- Autoimmune diseases of the liver
- Hepatitis B or hepatitis C infections
- Inflammation of the liver that is long-term (chronic)
- Too much iron in the body (hemochromatosis).3
Additionally, cigarette smoking has been linked to a higher risk of liver cancer, and that risk increases if a person is a heavy or long-term smoker. There are several other medical conditions that, although rare, can also increase the risk of liver cancer, including glycogen storage disease, Wilson disease, and a hereditary form of hemochromatosis, mentioned earlier.
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What Are the Symptoms of Hepatocellular Carcinoma?
The most common symptom of HCC is usually abdominal pain2 (especially in the upper right side of the abdomen), but it often goes hand in hand with a few other symptoms, too.
Bruising or bleeding easily, jaundice (yellowing of the skin and eyes), as well as unexplained weight loss or even an enlarged abdomen can all potentially indicate HCC.3
Itchy skin, having a low appetite, and reduced brain function (known as hepatic encephalopathy) are also possible symptoms of hepatocellular carcinoma.
How Do You Test for Hepatocellular Carcinoma?
If you notice any of the symptoms described here and have concerns about your liver health, the first thing to do is to talk to your doctor.
Your healthcare provider may decide to conduct a CT or MRI scan, both of which are common methods of testing for HCC. In some cases, though, a biopsy may be the best course of action.
One other test is called an alpha fetoprotein (AFP) tumour marker test, which is a blood test that can measure the levels of alpha fetoprotein in your blood and is used to detect various types of cancers. An AFP test is used in conjunction with other tests to confirm the presence of liver cancer.
How Can You Prevent Hepatocellular Carcinoma?
Because hepatitis is one of the more common causes of hepatocellular carcinoma, and its viruses can lead to cirrhosis or liver cancers, it is worth doing everything you can to prevent contracting hepatitis in the first place. This means avoiding risky lifestyle behaviours, like sharing needles and having unprotected sex.
There is a vaccine available in many countries, including the United States and the United Kingdom, for the prevention of hepatitis B, which is available for children and adults up to the age of 59. In the UK, the vaccine is provided to babies as part of their regular early childhood vaccination schedule, and it is also available to anyone who may be at risk of liver diseases.
In general, though, you’ll want to adhere to some everyday lifestyle habits, including limiting (or eliminating) alcohol and tobacco use, maintaining a healthy weight, and avoiding exposure to cancer-causing chemicals such as aflatoxins (which are produced by fungi that overgrow perishable foods) to prevent HCC.
How Can You Treat Hepatocellular Carcinoma?
There are a variety of medical treatment options for hepatocellular carcinoma available, and your doctor will be able to recommend the best course of action for you. Let’s take a look at a few of them:
- Liver resection.2 This is a surgical procedure to remove some or all of the liver.
- Liver transplant.2 A transplant may be used in the case of liver failure, and it refers to replacement of a damaged liver with a healthy “donor” liver.
- Tumour ablation.2 This method uses heat to destroy HCC tumours in the liver. It can be done by either of two methods known as radiofrequency ablation (RFA) or microwave ablation (MWA).
- Chemotherapy.2 The specific drug is called Sorafenib, and it’s a targeted cancer drug known as a cancer growth blocker, which inhibits the growth of cancer cells. It is taken orally.
- Transarterial therapies.2 When re-sectioning or chemotherapy isn’t an option, medication can be injected intravenously with the intention of stopping or slowing HCC tumour growth.
When Should You Reach Out to a Doctor?
Take a look at the hepatocellular carcinoma symptoms we described above. If you notice any of them, and especially if they worsen over time, or even if something simply doesn’t feel normal to you, you’ll need to talk to your doctor about what you’re dealing with.
It can be helpful to keep notes of your symptoms to discuss with your doctor. (Keep a list of when the symptoms started, how long they’ve been affecting you, and anything that makes you feel better or worse).
If you have a family history of cancer or liver disease, you’ll want to disclose this to your doctor as soon as possible.
Frequently Asked Questions About Hepatocellular Carcinoma
Hepatocellular cancer is known for being aggressive, especially as it often coincides with other, underlying liver disorders that require treatment, as well.
Researchers have developed something called an aggressiveness index (AgI) and have determined that it’s a useful way to predict recovery and survival rates for patients with HCC.
Pain is common with HCC and can seriously affect quality of life. Because HCC often goes hand in hand with other liver diseases, it can be difficult to treat without pain medications aggravating pre-existing liver conditions. Your doctor can discuss safe and effective options for pain management of hepatocellular carcinoma.
Studies have shown quite a bit of variation in tumour growth patterns, so the answer to this is highly individual.iv
More studies are needed, but there are a few factors that can lead to more rapid growth of liver tumours, including the presence of the hepatitis B virus, a smaller size of the tumour (in diameter), and the individual time (or rate at which) it takes for the tumour to double in size (also known as AFP doubling time).4
Essentially, there are a few foods that have been shown to be protective against the development of liver cancer – specifically vegetables, cereals, fruits, white meat, and fish. Foods that should be avoided include red meats and excess sugar. Alcohol and tobacco are also important risk factors that should be consumed in moderation, or not at all to avoid the onset of liver cancer.
Along with following the guidance of your healthcare provider, educating yourself about the causes, symptoms, and various treatments for hepatocellular cancer can go along way when it comes to tackling the disease head-on.
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- https://ods.od.nih.gov/factsheets/Choline-HealthProfessional/
- https://www.webmd.com/vitamins/ai/ingredientmono-436/choline
- https://www.hsph.harvard.edu/nutritionsource/choline/
- https://lpi.oregonstate.edu/mic/other-nutrients/choline
- https://www.healthline.com/nutrition/what-is-choline
- https://my.clevelandclinic.org/health/drugs/22202-choline-supplement
- https://www.medicalnewstoday.com/articles/327117
- https://www.sciencedirect.com/topics/medicine-and-dentistry/choline
- https://www.fda.gov/food/food-labeling-nutrition/nutrient-content-claims-notification-choline-containing-foods