Liver Cancer (Hepatocellular Carcinoma): A Medical Overview
Overview:
Hepatocellular carcinoma (HCC) constitutes almost 90% of primary liver cancers and is in fact the third leading cause of cancer mortality worldwide. GLOBOCAN modelling predicts that if current trends continue, a 55% rise in incidence and a 56% rise in deaths may observed between 2020 and 2040 , highlighting the urgency of early detection and prevention.
Pathophysiology:
Hepatocellular carcinoma develops as a result of frequent liver cell injury due to chronic inflammation followed by fibrosis . Repeated cycles of liver cell damage and regeneration promote genetic mutation for which malignant transformation may occur. Key risk factors may include:-
- Chronic viral hepatitis (HBV & HCV) .
- Cirrhosis of liver (from alcohol, NAFLD, or metabolic disorders).
- Aflatoxin exposure (a toxin produced by molds).
- Genetic disorders like hemochromatosis etc.
Signs & Symptoms:
In it's early stage hepatocellular carcinoma is usually asymptomatic. Progressive disease may present with some symptoms like:-
► Abdominal pain or discomfort in right-upper-quadrant .
► Early satiety while eating.
► Unexplained weight loss.
► Jaundice ( yellowish discolouration of skin and sclera of Eyes) .
► Ascites( accumulation of fluid in peritoneal cavity within the abdomen).
► Decompensated portal- hypertension and its sequelli such as variceal bleeding and encephalopathy etc.
Sudden deterioration in a previously stable cirrhotic patient should be reviewed with suspicion.
Diagnostic Approach:
According to the International liver society's recommendation an individual should advised for ultrasound in every 6 months interval. In addition to this other investigations are also helpful for diagnosis like,
♦ Alpha-fetoprotein (AFP)—for all patients with cirrhosis or chronic HBV infection.
♦ Nodules ≥1 cm should carefully reviewed with multiphasic contrast CT or MRI ( the classic pattern of arterial hyper-enhancement with venous wash-out is diagnostic).
♦ Liver biopsy( if imaging findings are positive).
Remember AFP, des-γ-carboxy prothrombin and emerging liquid-biopsy panels refine risks, while LI-RADS and BCLC staging is helpful for further treatment planning.
Complications:
HCC can invade portal or hepatic veins through which metastasise may occur to lung, bone or adrenal glands, and precipitate massive variceal bleeding, refractory ascites, renal failure, cachexia and even fatal hepatic decompensation.
When to visit to a doctor:
Consult your doctor promptly if you have a chronic HBV/HCV infection, heavy alcohol use, non alcoholic faty liver disease with cirrhosis, or a family history of liver cancer—especially if abdominal pain, jaundice, fluid retention within the abdomen or unexplained weight loss appears.
Recent research data:
Immunotherapy through augmented homeopathy is a new concept which exhibits great efficacy in the treatment of advanced stages of HCC. In different stages of the disease the scope of treatment available in modern medicine like chemotherapy is limited.Targeted therapies with specific homeopathic medicine is showing some positive result to improve survival rates. You must understand that in an advanced case of hepatocellular carcinoma the prognosis is not satisfactory. So early diagnosis is always a key factor for better outcome. Understanding of using modern techniques like liquid biopsy for early diagnosis and proper homeopathic treatment for modifying pathology of HCC constitute the key factor in did.
Conclusion:
Preventing cirrhosis, adhering to six-monthly surveillance and acting early remain the most powerful defences against HCC. Yet emerging immuno-oncologic homeopathic medicines and augmented strategies are steadily bending the survival curve towards positive direction. Timely referral to proper centres can increasingly transform an end stage diagnosis into a controllable disease.
Reference:
1. WHO Liver Cancer Guidelines, 2023.
2. Indian Journal of Gastroenterology, 2022.
3. National Cancer Institute (NCI).
An article by, Team DNC ACADEMY.
Edited by, Dr. Soumallya Chattopadhyay.