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What is Liver Cancer?
Liver cancer or hepatocellular carcinoma is a cancer that arises from the liver cells.
It is much more common in countries like Africa, Southeast Asia, China, Japan and Korea.
More than 800,000 people are diagnosed with liver cancer each year throughout the world. It is also a leading cause of cancer deaths worldwide, accounting for more than 700,000 deaths each year.
In Singapore, Liver cancer was ranked the 3rd most common cancer in men between the year of 2015 to 2019 and it occurs more commonly in those above 50 years of age.
So we have to recognise that liver cancer or hepatocellular carcinoma is a pretty common cancer.
In this article, we will discuss some of the risk factors for getting primary liver cancer and what you can do to prevent it or to identify it earlier.
Risk factors for liver cancer
Hepatocellular carcinoma is much more common in men than in women.
Race and ethnicity
Asians and Sub-Saharan Africans are at a higher risk.
Chronic hepatitis viral infection
Hepatitis B and C can cause long term liver inflammation resulting in liver cancer.
In fact, Hepatitis B is the most common cause of primary liver cancer at the moment.
An individual with hepatitis B is 100 times more likely to get liver cancer compared to someone who doesn’t have hepatitis B.
Excessive alcohol consumption and tobacco use
Someone who drinks excessive amount of alcohol over a long period of time can increase their risk of getting liver cirrhosis and liver cancer.
Similarly, smoking can also increase the risk of liver cancer.
Being obese and diabetic
Obesity and diabetes increases the risk of getting Non-alcoholic fatty liver disease or NAFLD for short.
Uncontrolled NAFLD can lead to liver inflammation, known as non-alcoholic steatohepatitis ( or NASH for short ). NASH can result in cirrhosis and eventual liver cancer.
Patients with liver cirrhosis
In summary, cirrhosis is an irreversible hardening of the liver due to a variety of causes. Patients with liver cirrhosis are at a greater risk of developing liver cancer and they should undergo regular screening.
Exposure to aflatoxins
Aflatoxins are harmful food contaminants made up by certain moulds that grow on poorly stored grains and nuts. People can be exposed to aflatoxins by eating contaminated plant products such as peanuts or by consuming meat or dairy products from animals that ate the contaminated feed.
Preventive measures for liver cancer
Now that we know what increases your risk of liver cancer or hepatocellular carcinoma, what are some of the preventive measures you can adopt?
Avoid getting hepatitis B or C
We can do that by getting our Hepatitis B vaccination which is more than 98% effective in preventing a Viral hepatitis B infection.
There is no vaccination for Hepatitis C at the moment. However in the cases of both hepatitis B & C, avoiding promiscuous sexual activities, practising safe sex and not sharing needles will greatly reduce your chance of getting both viruses.
Regular follow-up and checks if you already have chronic Hepatitis B & C
Now in the event you already have been infected with Hepatitis B and C, the next best thing you can do for yourself is to go for regular checks.
These checks may involve regular physical examination, blood checks and scans to assess the stage of your viral infection. In doing so, your doctor may be able to stop or slow down the progression of your disease and may even pickup any early cancer that is potentially curable.
Stop drinking and stop smoking
As discussed above, excessive alcohol consumption and smoking has a direct causative effect on liver cancer. So quitting will definitely have a positive impact on liver cancer prevention
Fight obesity and diabetes
Obesity is a known risk factor for cancer. Diabetes together with obesity very much increases the risk of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis or NASH for short. NASH in the long run if left unchecked can increase your risk of liver cirrhosis and liver cancer.
Check on Signs and Symptoms
Lastly, do see a doctor immediately if you experience any of the below symptoms and signs.
- Unexplained weight loss or loss of appetite
- Feeling very full after a small Meal
- Generalised weakness and lethargy
- Nausea or vomiting
- Abdominal swelling or bloated abdomen
- Hard mass felt under the ribs on the right or middle of your upper abdomen
- Leg swelling
By : Dr Chen Yiming
Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)