Liver Cancer
Liver cancer is the fifth most common cancer in the world (Krishnamurthy, Brown, Agrawal & Short, 2017). Males are usually more affected, and is most common between the ages of 30 to 50, as a result of chronic liver inflammation from one or more causative factors (Giusy & Poupak, 2017).
There are several types of liver cancer, including the following:
Symptoms of liver cancer can include the following (Giusy & Poupak, 2017):
The risk factors of liver cancer include the following:
There are several types of liver cancer, including the following:
- Hepatocellular carcinoma - this is the most common type which develops from the main liver cells (called hepatocytes). This type is more common in men, and those who have a liver damaged by cirrhosis.
- Fibrolamellar carcinoma - this is a rare type, and tends to develop in younger people.
- Cholangiocarcinoma - this is a bile duct cancer. The liver makes bile to help digest fats in foods, and bile is secreted through the bile ducts from the liver to the gall bladder which stores it.
- Angiosarcoma - also known as haemangiosarcoma, as this rare type of liver cancer starts in the blood vessels of the liver. This form is mostly diagnosed in people in the 70s-80s age group.
Symptoms of liver cancer can include the following (Giusy & Poupak, 2017):
- Yellow skin (jaundice)
- Loss of appetite
- Weight loss
- Abdominal pain (in the upper right quadrant)
- Nausea and vomiting.
The risk factors of liver cancer include the following:
- Inflammation - 90% of liver cancers result from chronic inflammation of the liver, which can be caused by some of the causative factors listed here (Osiecki, 2012, p434).
- Diet – a poor diet of high refined or processed carbohydrate-rich foods can cause insulin resistance and increased production of fat stored in the liver. These factors can increase the risk of liver cancer (Banini & Sanyal, 2017). Insulin resistance, diabetes and high body mass index are additional risk factors. A dietary deficiency in choline, methionine, folate and vitamin B12 can cause liver tumours (Osiecki, 2012, p435).
- Fatty liver disease - Non-alcoholic fatty liver disease (NAFLD) can progress to a more aggressive form called Non-alcoholic Steatohepatitis (NASH), which in turn can progress to cirrhosis (scar tissue formation) of the liver and then to hepatocellular (ie, liver) cancer in 5-15% of patients. NAFLD can result from increased gut permeability (ie, "leaky gut") which allows various metabolites and bacteria into the blood circulation to the liver. Fatty liver disease is also linked to increased oxidative stress and inflammation (Banini & Sanyal, 2017).
- Infections - viral infections such as hepatitis B or C account for about 25% of liver cancer diagnoses. Aflatoxin, a toxin from an Aspergillis species of fungus found in soil, decaying plant matter and in legumes, peanuts, grains or grain products, is a carcinogen and increasing levels of aflatoxin in the liver can lead to liver cancer (Giusy & Poupak, 2017). Infestation with liver flukes can lead to liver cancer (Osiecki, 2012, p435).
- Smoking and alcohol - alcohol is a metabolic toxin which the liver needs to metabolise and detoxify. In high intakes, alcohol can cause Alcoholic Fatty Liver Disease (AFLD) which can lead to cirrhosis of the liver and liver cancer (Giusy & Poupak, 2017). Alcohol can also exacerbate hepatitis C infection to cause further liver damage (Osiecki, 2012, p435).
- Environmental chemicals – many industrial chemicals and chemicals can damage human health and are carcinogenic. Because the liver has to detoxify these chemicals, it is more exposed to them than other organs and can cause toxicity to the liver (Giusy & Poupak, 2017). Exposure to arsenic in some waterways and foods can increase the risk (Osiecki, 2012, p435).
- Genetics – the genetic and inherited conditions of haemochromatosis, alpha 1-antitrypsin deficiency, and other conditions increase liver cancer risk. Haemochromatosis can cause high iron levels, oxidative stress, and liver damage (Osiecki, 2012, p435).