The liver is the largest organ in the human body. Located in the upper right abdominal cavity below the ribs, the liver produces bile, a dark yellowish-brown fluid that helps digest vitamins, fats, and other nutrients.

The liver helps to remove toxins and other chemical waste products from the blood and gets the waste ready to be secreted out. The liver also stores nutrients such as glucose to keep the body nourished and functioning.

Liver cancer develops from the abnormal proliferation of the liver cells. Liver cancer also destroys healthy liver cells and can impede normal liver function.

Liver cancer can generally be grouped into:

• Primary liver cancer: Cancer that starts from the cells of the liver (hepatocellular carcinoma/HCC)
• Secondary cancer: Cancer that starts from a different part of the body, which has spread (metastasised) to the liver

Liver cancer is the eighth most prevalent cancer in Malaysia and is one of the causes of premature deaths in the country.

In 2020, 2149 new cases of liver cancer were reported in Malaysia, comprising 4.4% of all cancers reported in the country that year.

What causes liver cancer?

Below conditions have been known to cause of liver cancer:

• Chronic hepatitis B infection
• Chronic hepatitis C infection
• Liver cirrhosis (liver scarring)

However, liver cancer may also develop without a clear cause.

What are the risk factors of developing liver cancer?

Some of the risk factors that may increase the risk of liver cancer are:

• Alcohol abuse
• Smoking
• Chronic infection with hepatitis B or C virus
• Cirrhosis (liver scarring)
• Hepatitis
• Overweight/Obesity: Obesity may increase the risk of liver cancer and many other diseases as well
• History of diabetes: Some studies have indicated a link between diabetes and liver cancer, mainly attributed to fatty liver disease
• Non-alcoholic fatty liver disease
• Older age: Liver cancer is frequently seen in the older population (above 60 years old)
• Certain inherited liver disease such as Wilson’s disease and hemochromatosis

What are the signs and symptoms of liver cancer?

Symptoms may not be immediately apparent at the initial stages of liver cancer. Signs and symptoms will become more evident as the disease progresses. Some of the symptoms include:

• Unusual weight loss without even trying
• Discomfort in the right upper side of the abdomen
• A hard lump in the right abdomen just below the rib cage
• Nausea and vomiting
• Loss of appetite
• Jaundice (yellowing of the skin and white part of the eyes)
• A swollen abdomen
• Fatigue
• Dark-coloured urine

How do doctors diagnose liver cancer?

Anyone who experiences the symptoms of liver cancer should immediately consult an oncologist. A few tests would be performed to rule out cancer, including:

• Physical examination: Your doctor will check for liver cancer signs and symptoms.
• Blood tests: Increased alpha-fetoprotein (AFP) levels in the blood may suggest diseases such as liver cancer, liver cirrhosis, and hepatitis. High levels of AFP are considered a tumour marker.
• Ultrasound scan: Sound waves are used to view the tumours.
• Biopsy: Some suspected tissue is removed and viewed under a microscope to observe for abnormal cells. This may be one of the most reliable methods used to diagnose liver cancer.
• Computed tomography (CT) scan: Captures detailed images of the liver and conveys information on the size and location of tumours.
• Magnetic resonance Imaging (MRI): Uses magnetic fields to produce detailed images of the internal parts of the body.
• Laparoscopy: A thin, flexible tube is inserted into the abdomen through a small incision to check the liver and its surrounding tissues.

Learn more about the different types of screening and diagnostic procedures performed to diagnose liver cancer.

How is liver cancer treated?

Liver cancer can be treated in different ways:

• Cryotherapy: Freezing the tumour
• Radiofrequency Ablation (RFA): Uses radio waves to destroy the tumour
• Radiation therapy: High-energy radiation is used to shrink the size of the tumour
• Immunotherapy: Treatment to stimulate the body’s immune system to destroy cancer cells
• Targeted drug therapy: Treatment involves drugs that target particular abnormalities present in the cancer cells to destroy them
• Partial hepatectomy: Surgery to remove a part of the liver that contains the tumour
• Liver transplant surgery: Replacing the liver with a healthy donor's liver

Learn more about the different types of treatment technologies to treat liver cancer.

What can I do to reduce the risk of developing liver cancer?

The below measures can be taken to help keep the liver healthy:

• Maintain a healthy weight because being overweight or obese always leads to many health complications
• Get a hepatitis B vaccine
• Stop smoking
• Avoid excess consumption of alcohol
• Prevent hepatitis C infection by not using intravenous drugs, not getting a tattoo or piercing with unclean needles, and practising safe sex
• If you are a person with high risk, talk to your doctor and get liver screenings periodically

How do I get screened for liver cancer?

Liver cancer screening is recommended for those with risk factors, such as hepatitis B/C infection or liver cirrhosis. The screening includes a blood test and an ultrasound examination twice a year.

Make an appointment at Pantai Hospitals

Early detection of liver cancer makes it easier to treat the disease with effective and appropriate treatment. A dedicated multidisciplinary team of specialists and oncologists at Pantai Hospitals is available for consultation to provide the best care and assistance to patients through screening, diagnosis, and treatment.

Get in touch with us to book an appointment today if you have any concerns or questions about liver cancer treatment options.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.