Liver Cancer (Hepatocellular Carcinoma)

Definition

Liver cancer ek malignant tumor hai jo liver ke cells (hepatocytes) se originate hota hai.

Isse Hepatocellular Carcinoma (HCC) kehte hain jab ye primary liver cells se develop hota hai, aur secondary (metastatic) liver cancer dusre organs (like colon, lung, breast) se spread hokar liver me aata hai.

Epidemiology

● One of the most common cancers worldwide.

● More common in men than women.

● High incidence in Asia and Africa due to chronic hepatitis infection.

Causes / Risk Factors

● Chronic Hepatitis B & C infection (major cause).

● Cirrhosis (due to alcohol or fatty liver disease).

● Aflatoxin exposure (contaminated grains or nuts).

● Heavy alcohol consumption.

● Non-alcoholic fatty liver disease (NAFLD).

● Hemochromatosis (iron overload).

● Obesity & Diabetes.

● Family history of liver cancer.

Pathophysiology

● Chronic liver inflammation → fibrosis → cirrhosis.

● Hepatocyte DNA damage due to viral infection or toxins.

● Abnormal cells start proliferating uncontrollably → tumor formation.

● Tumor compresses portal vein & bile ducts → portal hypertension, jaundice.

● Cancer cells may metastasize to lungs, bones, or lymph nodes.

Symptoms

● Loss of appetite, unexplained weight loss.

● Fatigue, weakness.

● Upper abdominal pain or fullness.

● Nausea, vomiting.

● Jaundice (yellowing of skin & eyes).

● Ascites (fluid in abdomen).

● Enlarged, hard liver (hepatomegaly).

● Itching (due to bile salts).

● Late stages: bleeding tendency, confusion (hepatic encephalopathy).

Complications

● Liver failure.

● Portal hypertension → variceal bleeding.

● Metastasis to lungs or bones.

● Hepatic encephalopathy (brain dysfunction).

● Death if untreated.

Diagnosis

● Liver Function Tests (LFTs): Elevated ALT, AST, bilirubin.

● Alpha-fetoprotein (AFP): Tumor marker (↑ in HCC).

● Ultrasound / CT / MRI scan: Detect liver mass.

● Liver biopsy: Confirm diagnosis & type of cancer.

● Viral markers: Hepatitis B & C tests.

Treatment

Medical / Surgical Management:

● Surgical resection: For small localized tumors.

● Liver transplantation: For advanced but non-metastatic cases.

● Ablation therapy: Destroy tumor using radiofrequency or alcohol injection.

● Transarterial Chemoembolization (TACE): Deliver chemo directly to tumor.

● Targeted therapy: Sorafenib, Lenvatinib.

● Immunotherapy: Nivolumab, Pembrolizumab.

● Radiation therapy: For pain relief or metastasis.

Nursing Management

● Monitor vital signs, weight, abdominal girth (ascites).

● Assess for signs of bleeding & jaundice.

● Maintain adequate nutrition (high-protein, low-sodium diet).

● Provide emotional & psychological support.

● Administer prescribed medications & monitor side effects.

● Maintain fluid balance and monitor intake-output.

● Educate about avoiding alcohol & hepatotoxic drugs.

● Encourage regular follow-up & screening for hepatitis patients.

Prevention

● Hepatitis B vaccination.

● Avoid sharing needles or unsafe sexual practices.

● Limit alcohol intake.

● Maintain healthy weight & balanced diet.

● Avoid aflatoxin-contaminated food.

● Regular screening in high-risk individuals (ultrasound, AFP).

Prognosis

● Early detection → better survival after surgery or transplant.

● Advanced liver cancer → poor prognosis (limited curative options).

● Supportive & palliative care improve quality of life.

Recommendation

Diabetes Mellitus Type 1

Hypertension (High Blood Pressure)

Gout-Inflammatory-Arthritis

Mycobacterium Tuberculosis

Sickle Cell Anemia 

Immune Thrombocytopenia