There are different types of liver cancer based on the cells where the cancer starts. Here are the main types explained simply:

Hepatocellular Carcinoma (HCC)

• This is the most common type of liver cancer.
• It starts in the main liver cells called hepatocytes.
• Usually seen in people with liver diseases like cirrhosis (scarring of the liver) or hepatitis B or C.
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Cholangiocarcinoma (Bile Duct Cancer)

• This cancer starts in the bile ducts, which are small tubes that carry bile from the liver to the intestines to help digest food.
• Can occur inside the liver (intrahepatic) or outside the liver (extrahepatic).
• It is less common but serious.
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Angiosarcoma

• A rare type of liver cancer that begins in the blood vessels of the liver.
• It grows very quickly and is difficult to treat.
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Hepatoblastoma

• A rare liver cancer that mostly affects young children, usually under the age of 5.
• It can often be treated successfully if found early.
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Secondary Liver Cancer (Metastatic Cancer)

• This isn’t a type of liver cancer but happens when cancer starts in another part of the body (like the colon or lungs) and spreads to the liver.
• It is more common than cancer that starts in the liver.
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Key Point

The most common type is hepatocellular carcinoma (HCC), but other types like bile duct cancer and rare forms like angiosarcoma also exist. Early diagnosis and treatment improve the chances of managing these cancers effectively.

CAUSES AND RISK FACTORS OF LIVER CANCER

Liver cancer happens when healthy cells in the liver change and start to grow uncontrollably. This can be caused by certain diseases, lifestyle habits, or inherited conditions. Here are the main causes and risk factors explained simply:

Causes

Chronic Liver Damage (Cirrhosis):

• • Scarring of the liver from long-term damage can lead to cancer.

Infections:

• • Hepatitis B (HBV) or Hepatitis C (HCV) infections are major causes of liver cancer because they damage the liver over time.
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Fatty Liver Disease:

• • Non-alcoholic fatty liver disease (NAFLD) caused by too much fat in the liver can increase the risk.

Toxins:

Aflatoxins, poisons from moldy food (like peanuts or grains), can damage liver cells.

Inherited Conditions:

• • Genetic diseases like hemochromatosis (too much iron in the body) or Wilson’s disease (too much copper) can raise the risk.

Risk Factors

Health-Related Risks:

Chronic Hepatitis Infections:

• • Long-term hepatitis B or C infections are the most common risk factors.

Cirrhosis:

• • Scarring of the liver from conditions like alcohol abuse or hepatitis increases the risk.

Diabetes:

• • Having diabetes, especially with obesity, can lead to fatty liver and increase cancer risk.

Obesity:

• • Being overweight can cause fatty liver disease, which raises cancer risk.
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Lifestyle-Related Risks:

1. Alcohol Use:
   • Drinking too much alcohol over a long time can damage the liver and lead to cancer.
2. Smoking:
   • Smoking increases the risk of liver cancer, especially in people with other liver diseases.
3. Exposure to Chemicals:
   • Long-term exposure to harmful chemicals like vinyl chloride or arsenic can raise the risk.

Other Risks:

1. Gender:
   • Men are more likely than women to develop liver cancer.
2. Age:
   • Liver cancer is more common in people over 50.
3. Family History:
   • A family history of liver cancer increases your risk.

Key Point

The main causes of liver cancer are long-term liver damage from infections (like hepatitis B or C), alcohol abuse, or fatty liver disease. You can lower your risk by avoiding alcohol, quitting smoking, maintaining a healthy weight, and getting vaccinated for hepatitis B. Regular check-ups are important if you have any risk factors.

TREATMENT OF LUNG CANCER

Treatment for liver cancer depends on the stage of the cancer, the patient’s overall health, and liver function. The main goal is to remove or destroy the cancer while preserving as much healthy liver as possible. Here are the main treatment options:

Surgery

• Partial Hepatectomy: Removes the part of the liver affected by cancer. Suitable for patients with good liver function and no significant underlying liver disease.
• Liver Transplant: Replaces the diseased liver with a healthy one from a donor. Often used for patients with small tumors and severe liver damage (like cirrhosis).
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Localized (Liver-Directed) Treatments

These focus directly on the cancer without affecting the whole body:

• Ablation Therapy:
  • Uses heat (radiofrequency ablation), cold (cryotherapy), or alcohol injections to destroy cancer cells.
  • Best for patients who cannot undergo surgery.
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• Embolization Therapy:
  • Transarterial Chemoembolization (TACE): Delivers chemotherapy directly to the liver and blocks blood flow to the tumor.
  • Radioembolization: Delivers radioactive particles to the tumor.
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Targeted Therapy

• Uses drugs that target specific molecules involved in cancer growth.
• Common drugs:
  • Sorafenib and lenvatinib: For advanced liver cancer.
  • These drugs slow tumor growth and may improve survival.
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Immunotherapy

• Helps the immune system recognize and attack cancer cells.
• Checkpoint Inhibitors:
  • Drugs like atezolizumab and nivolumab are used to treat advanced liver cancer.
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Radiation Therapy

• Uses high-energy rays to kill cancer cells or shrink tumors.
• A newer form, stereotactic body radiation therapy (SBRT), focuses radiation precisely on the tumor while sparing healthy liver tissue.
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Chemotherapy

• Rarely used for liver cancer because it is less effective compared to other treatments.
• Sometimes used if other treatments are not suitable.
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Palliative Care

• For advanced cases, treatments focus on relieving symptoms and improving quality of life.
• Includes pain management, treating fluid buildup, and addressing nutritional needs.
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Key Points

• Early-stage liver cancer is often treated with surgery or localized therapies.
• Advanced liver cancer may require systemic treatments like targeted therapy or immunotherapy.
• A multidisciplinary team helps decide the best treatment plan based on the patient’s specific condition and needs. Regular follow-ups are essential to monitor progress.

PREVENTION OF LIVER CANCER

Preventing liver cancer involves protecting your liver and reducing the risk of things that can cause liver damage. Here are some simple ways to prevent liver cancer:

Get Vaccinated Against Hepatitis B

• Why: Hepatitis B is a major cause of liver cancer.
• How: A safe and effective vaccine is available. Make sure you and your children are vaccinated.

Prevent Hepatitis C

• Why: Hepatitis C can cause long-term liver damage and lead to cancer.
• How:
  • Avoid sharing needles, razors, or other personal items.
  • Use clean needles if you need tattoos or piercings.
  • Practice safe sex to lower the risk of infection.

Limit Alcohol

• Why: Drinking too much alcohol can cause liver damage (cirrhosis), which increases cancer risk.
• How: Drink in moderation or avoid alcohol altogether.

Avoid Smoking

• Why: Smoking increases the risk of liver cancer.
• How: Quit smoking and avoid exposure to secondhand smoke.
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Maintain a Healthy Weight

• Why: Being overweight can lead to fatty liver disease, which increases cancer risk.
• How: Eat a balanced diet with plenty of fruits, vegetables, and whole grains, and stay active.
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Avoid Exposure to Toxins

• Why: Chemicals like aflatoxins (found in moldy food) and industrial toxins can damage your liver.
• How:
  • Store food properly to prevent mold.
  • Wash fruits and vegetables thoroughly.
  • Follow safety guidelines at work if exposed to chemicals.
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Manage Medical Conditions

• Why: Diseases like diabetes, fatty liver disease, and hemochromatosis (too much iron) increase liver cancer risk.
• How: Work with your doctor to manage these conditions and follow treatment plans.
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Regular Check-ups

• Why: If you have liver disease or are at high risk, regular screening can detect problems early.
• How: Talk to your doctor about regular liver health tests.
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Key Point

You can reduce your risk of liver cancer by protecting your liver through healthy habits, vaccinations, and regular medical care. Taking care of your liver helps keep you healthy and lowers your chances of developing liver cancer.

NEWER ADVANCEMENTS AND RESEARCHES

Recent advancements in liver cancer research have led to significant improvements in diagnosis, treatment, and patient outcomes. Key developments include:

Targeted Therapies

Glypican-3 (GPC3) Targeting: Researchers have developed antibodies that specifically target GPC3, a protein commonly found on liver cancer cells. These antibodies, such as HN3 and HS20, inhibit cancer cell growth by blocking essential signaling pathways. 

Immunotherapy

Checkpoint Inhibitors: Drugs like pembrolizumab (Keytruda) have shown promise in treating advanced liver cancer by enhancing the immune system’s ability to recognize and attack cancer cells. Clinical trials have demonstrated improved survival rates in patients receiving these therapies. 

Personalized Cancer Vaccines

Geneos Therapeutics’ Vaccine: A personalized cancer vaccine developed by Geneos Therapeutics has shown encouraging results in early trials, shrinking tumors in nearly a third of patients with advanced liver cancer. This approach customizes treatment based on individual tumor profiles, enhancing the immune response against cancer cells. 

Non-Invasive Treatments

Histotripsy: HistoSonics has developed a non-invasive treatment called histotripsy, which uses high-intensity sound waves to destroy liver tumors. This technique mechanically breaks down cancer cells without the need for incisions, offering a less invasive alternative to traditional surgery. 

Artificial Intelligence in Radiation Therapy

AI-Enhanced Imaging: Researchers are integrating artificial intelligence into MRI-guided radiation therapy to improve the precision of liver cancer treatments. AI algorithms provide real-time imaging, allowing for dynamic adjustments during radiation delivery, thereby minimizing damage to healthy tissues. 

These advancements reflect a multidisciplinary approach to combating liver cancer, integrating targeted therapies, immunotherapy, personalized medicine, non-invasive treatments, and technological innovations to improve patient outcomes.