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Liver Cancer

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​What Is Liver Cancer?

Primary liver cancer refers to cancer occurring in the cells of the liver. It is classified based on the type of cells affected by cancer:

  • Hepatocellular carcinoma starts in the liver cells which are called hepatocytes
  • Cholangiocarcinoma or bile duct cancer begins in the bile ducts
  • There are many other rare forms of liver cancer

Metastatic liver cancer refers to cancer spread from other organs such as colon, lung, breast and stomach to liver. Metastatic liver cancer is more common than primary liver cancer.

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Risk Factors

The risk of liver cancer is increased in:

  • Chronic carriers of Hepatitis B virus and Hepatitis C virus
  • Those with liver cirrhosis (liver hardening)
  • Those with a bile duct disease called primary sclerosing cholangitis
  • Heavy alcohol drinkers and alcohol abusers (alcohol abuse can lead to liver cirrhosis)
  • Those with exposure to Aflatoxin which is produced by a mould found in peanuts and other nuts, corn and grains
  • Those with a family history of liver cancer


  • Early stage liver cancer may not produce any signs. As the cancer advances to a later stage, it may produce the following symptoms:
  • Loss of appetite and weight
  • Weakness and fatigue
  • Nausea and vomiting
  • Abdominal swelling/ bloatedness
  • Lump in the abdomen
  • Abdominal pain
  • Yellowish discoloration of the skin and whites of eyes (jaundice)


  • Ultrasound (Scan)
  • Computerised Tomography (CT) and Magnetic Resonance Imaging (MRI)
  • Blood Tests for the presence of a cancer marker called alphafetoprotein (AFP). It is important to note that AFP levels may be normal even in the presence of liver cancer and hence it is NOT used in making a diagnosis
  • Liver Biopsy is a procedure where a small sample of tissue is taken for examination under the microscope


Some of the treatment options available include:

  1. Surgical removal of the tumour
  2. Liver Transplantation
  3. Local Ablative Therapies:
    • Radiofrequency Ablation involves the use of electric current at the needle tip to destroy cancer cells by heat energy
    • Alcohol (Ethanol) Injection involves injecting ethanol directly to the tumours through the skin under scan
    • Microwave Ablation involves the use of microwave energy to destroy tumour cells
  4. Transarterial Embolisation: Sometimes also called TACE (TrAnsarterial Chemo Embolisation). Transarterial embolization involves using beads to block off the blood supply to the liver tumour via the arterial system. Radioactive substances can be used to attach to these beads for treatment, which is called selective internal radiation therapy.
  5. Chemotherapy or Immunotherapy: The use of anti-cancer drugs to destroy cancer cells or to stop them from multiplying.


  1. Getting vaccinated for Hepatitis B
  2. Avoiding body piercing and tattooing
  3. Limiting alcohol intake
  4. Not engaging in unprotected sex
  5. Not abusing drugs or sharing intravenous drug needles
  6. Chronic carriers of Hepatitis B virus and Hepatitis C carriers are advised to consider regular screening
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