With the recent news that 30 year old British Tennis player, Elena Baltacha is being treated for Liver cancer, Independent Oncology’s Dr Debs Sarker provides some useful information on Liver cancer, the symptoms to watch out for and how it’s treated.

There are two main types of liver cancer. Hepatocellular cancer (HCC) is the most common type of liver cancer, accounting for approximately two thirds of cases, and originates from the main cells within the liver (hepatocytes) that are responsible for production of key proteins, making bile and cholesterol and breaking down toxins. HCC usually occurs in patients with underlying long term liver damage leading to liver cirrhosis.

Cholangiocarcinoma is the other main type of liver cancer and arises from the bile ducts within the liver that drain bile from the liver to the small bowel.

So what are the main symptoms of the disease? The symptoms can be quite variable and sometimes non-specific but may include jaundice, abdominal pain, nausea, weight loss, itching and fever. Some patients have very few symptoms and are diagnosed incidentally when they are being investigated for other abdominal complaints such as urine infection or gallstones.

On the whole, liver cancer is more common in men than women except in younger age groups. In the UK the incidence of liver cancer is strongly related to age and an average of 70% of cases are diagnosed in men and women aged 65 years and over.

Once a diagnosis of Liver cancer has been made, treatment will depend on the type of liver cancer, the extent of any underlying liver damage and how far the cancer has spread. For Hepatocellular cancer, treatment options include liver transplantation or surgery for patients with early cancer. Other localised therapies for HCC include heating the tumour using radio waves (radio frequency ablation) or injecting chemotherapy directly into the liver and blocking off the blood supply to the tumour (chemo-embolisation). For patients with more advanced cancer drug therapy with sorafenib is often used, but HCC is often resistant to other commonly used chemotherapy drugs.

For cholangiocarcinoma, surgery is the main treatment in patients with localised disease. In more advanced cases or where the cancer has spread, chemotherapy is often used.

Elena Baltacha may have been at risk of the disease as she had Primary sclerosing cholangitis (PSC), a condition she had suffered from since childhood. PSC is a very rare condition where the bile ducts inside and outside the liver become inflammed, leading to scarring, narrowing and blocked ducts, potentially causing a build-up of bile in the liver, and in some cases cirrhosis. Patients with PSC are at a high risk of developing liver cancer, especially cholangiocarcinoma.

More commonly HCC is associated with liver cirrhosis caused by hepatitis B and C viruses, chronic heavy alcohol consumption and a condition associated with diabetes and obesity called NAFLD (non-alcoholic fatty liver disease) where fat builds up in the liver and causes inflammation. Smokers also have a higher risk of developing HCC.

Further information about Liver cancer can be found at Macmillan Cancer.

For more information about Dr Debashis Sarker, visit www.independentoncology.org.uk
If you have any concerns about your health, discuss these with your GP.