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Liver Cancer

Liver cancer is cancer that occurs in the liver. When the liver cells grow out of control, liver cancer can be developed. The most common type of liver cancer in Hong Kong is hepatocellular carcinoma (HCC).

Liver cancer is among the top five commonest cancer and the third leading cause of cancer deaths in Hong Kong. Annually, there are about 1800 new cases and 1500 deaths. Men are much more likely to have liver cancer than women. The majority of liver cancer cases in Hong Kong is related to hepatitis B virus infection.

Symptoms of Liver Cancer

Liver cancer can be asymptomatic at its early stage.

The common signs and symptoms include:
  • Weight loss without known reason
  • Jaundice (yellowing of skin and whites of eyes)
  • Tea-coloured urine
  • Pale stool
  • Abdominal pain or discomfort in upper right abdomen
  • Swollen abdomen

Other symptoms include loss of appetite, nausea and vomiting, and tiredness. People with these signs and symptoms should seek medical consultation as soon as possible.

Risk Factors of Liver Cancer

The major risk factors for liver cancer include:
  • Chronic hepatitis B virus (HBV) infection or hepatitis C virus (HCV) infection
  • Cirrhosis (Scarring of liver)
  • Excessive consumption of alcohol
  • Eating foods contaminated with aflatoxin (a fungus which can be found in mouldy grains and peanuts)
  • Diabetes
  • Obesity
  • Smoking
  • Hemochromatosis (a hereditary condition that the body absorbs excessive iron)

Reduce the Risk for Liver Cancer

The risk of getting liver cancer can be reduced by the following measures:
  • Receive vaccination of hepatitis B for people without immunity to HBV
  • Avoid consumption of alcohol
  • Avoid ingesting foods contaminated with aflatoxin
  • Do not smoke
  • Practise safe sex
  • Do not share needles and syringes; receive serologic testing for hepatitis C if necessary
  • Maintain healthy lifestyle with healthy diet and regular exercise
  • Regular check-ups for people known to have chronic liver diseases

Screening of Liver Cancer

The purpose of liver cancer screening is to detect liver cancer early well before development of symptoms so as to maximise benefit of early treatment. However, routine liver cancer screening is not recommended for persons at average risk.
People with chronic HBV infection, chronic HCV infection or liver cirrhosis are at increased risk of liver cancer. Depending on certain criteria such as age, family history, presence of cirrhosis and other clinical parameters, some subgroups are at higher risk and should consider receiving periodic cancer surveillance (e.g. every 6 -12 months) with Alpha-fetoprotein (AFP) test and Ultrasonography (USG). People with chronic HBV and HCV infection, or liver cirrhosis should thus seek advice from doctors to determine their need for and approach of cancer surveillance.

Two common tests used for this purpose are:
  • Blood tests; such as Alpha-fetoprotein (AFP) test
    • AFP is elevated in approximately 70% of HCC caused by HBV
  • Ultrasonography (USG)
    • USG can detect abnormalities as small as 1cm in diameter

Treatment

The treatment for liver cancer depends on the stage of the condition. Treatment can include surgery and medicine. For small HCC developed at early stage, it can be cured by radiofrequency ablation, surgical resection or liver transplantation.