Liver Cancer is a type of cancer that starts in the liver — a large organ in the upper right part of the
abdomen that helps process nutrients, detoxifies harmful substances, and produces bile.
Types of Liver Cancer
    1. Primary Liver Cancer (originates in the liver)
               o   Hepatocellular carcinoma (HCC) – Most common type
               o   Intrahepatic cholangiocarcinoma – Cancer of the bile ducts inside the liver
               o   Hepatoblastoma – Rare and usually occurs in children
    2. Secondary (Metastatic) Liver Cancer
               o   Cancer that spreads to the liver from other organs (e.g., colon, breast, lung)
Risk Factors
       Chronic hepatitis B or C infection
       Cirrhosis (due to alcohol, non-alcoholic fatty liver disease, or hepatitis)
       Excessive alcohol use
       Non-alcoholic fatty liver disease (NAFLD)
       Aflatoxins (toxins from moldy food)
       Hemochromatosis (iron overload)
       Obesity and diabetes
       Smoking
Symptoms
Often silent in early stages. As the disease progresses:
       Unexplained weight loss
       Loss of appetite
       Upper abdominal pain
       Nausea or vomiting
       Fatigue
       Liver enlargement (mass in upper abdomen)
         Yellowing of skin and eyes (jaundice)
         Swelling in the abdomen (ascites)
Diagnosis
         Blood tests – Liver function tests, AFP (alpha-fetoprotein) marker
         Imaging – Ultrasound, CT scan, MRI
         Liver biopsy – Confirms diagnosis
         Staging tests – To determine spread
Staging
         Stage I–IV – Based on size, number of tumors, blood vessel invasion, and spread
         BCLC (Barcelona Clinic Liver Cancer) staging is also commonly used
Treatment Options
Depends on the stage, liver function, and overall health:
    1. Surgical options
              o   Liver resection (removal of part of the liver)
              o   Liver transplant
    2. Non-surgical options
              o   Ablation therapies – Radiofrequency ablation (RFA), microwave ablation
              o   Embolization – TACE (Transarterial chemoembolization), TARE (radioembolization)
              o   Targeted therapy – e.g., Sorafenib, Lenvatinib
              o   Immunotherapy – Checkpoint inhibitors (e.g., atezolizumab + bevacizumab)
              o   Radiation therapy – Sometimes used, especially if surgery is not possible
Prognosis
         Early-stage liver cancer may be curable with surgery or transplant
         Advanced stages have a lower survival rate but may be managed with therapy
         Prognosis also depends on underlying liver health (e.g., cirrhosis)
Prevention
      Vaccination for Hepatitis B
      Screening and treatment of Hepatitis C
      Avoid alcohol abuse
      Maintain healthy weight and diet
      Avoid aflatoxin-contaminated food
      Regular liver screening if high risk