The liver, a vital organ responsible for numerous metabolic processes, faces a growing threat in today's modern society with an increasing number of people being diagnosed with fatty liver disease. It’s important to understand the intricate relationship between fatty liver and cancer risk, besides its implications on our health.
Traditionally, liver cancer, particularly hepatocellular carcinoma (HCC), was primarily linked to chronic viral infections like hepatitis B and C or prolonged alcohol consumption. However, with the rise in fatty liver disease and its more severe form, non-alcoholic steatohepatitis (NASH), the landscape of liver cancer aetiology is shifting.
Know the link between Fatty Liver and cancer
According to Dr Vineet Talwar, Director, of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre (RGCIRC), NASH is characterised by the accumulation of fat in the liver, leading to inflammation and liver cell damage. Over time, this chronic insult to the liver can progress to fibrosis, cirrhosis, and ultimately, hepatocellular carcinoma.
As fatty liver disease becomes increasingly prevalent, fuelled by sedentary lifestyles, high-fat diets, and metabolic syndrome, so does the risk of liver cancer. Studies have shown that individuals with NASH have a significantly higher risk of developing HCC compared to those without liver steatosis. This trend underscores the need for awareness, early detection, and intervention strategies. One of the challenges in combating fatty liver-related cancer lies in its asymptomatic nature during the early stages.
Prevention
Lifestyle modifications emerge as key pillars in managing fatty liver disease and reducing cancer risk. Adopting a balanced diet low in saturated fats, sugars, and processed foods, coupled with regular physical activity, can help mitigate liver fat accumulation and promote overall metabolic health. Moreover, avoiding excessive alcohol consumption and addressing underlying conditions like obesity and diabetes are essential steps in safeguarding liver health.
Symptoms
The symptoms of chronic liver disease can vary widely among patients. Signs of liver cell failure may be present, and these can manifest in a variety of ways. Patients may experience abdominal distention or swelling, indicating fluid buildup in the abdomen. Jaundice, characterized by yellowing of the skin and eyes, may also be present. Additionally, patients may suffer from sarcopenia, which involves the loss of muscle mass. Unexplained weight loss accompanied by severe weakness and loss of appetite are also common symptoms. It's important to note that these symptoms can occur individually or in combination, and their severity can vary from patient to patient.
Treatment
Treatment modalities for HCC vary depending on disease stage and patient characteristics, ranging from surgical resection and liver transplantation to locoregional therapies and systemic agents.
If the cancer is confined to the liver, there are several targeted treatments available. These may include surgical procedures or radiation therapy, treatments such as Transarterial Chemoembolization (TACE) or Transarterial Radioembolization (TARE).
In TACE, chemotherapy is delivered directly to the tumour by isolating the blood vessel that supplies it. TARE involves injecting tiny microspheres containing radioactive substances into the affected area, releasing radiation therapy specifically to the tumour. Cryotherapy is another option, where a cold probe is inserted into the tumour to freeze and destroy it. Radiofrequency ablation (RFA) uses high-frequency energy to burn away the tumour.
Alternatively, if the tumour can be completely removed, surgery may be performed. In some cases, if the patient is deemed suitable and a donor is available, a liver transplant may be considered. In stage 4, the final stage of cancer, treatment options such as chemotherapy, targeted therapy, and immunotherapy are utilised.
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