New Delhi: Popular television actress Dipika Kakar recently shared an update about her health on Instagram. She has been diagnosed with Stage 2 Liver Cancer, leaving her family, close friends and fans heartbroken. Dr Srujan Kumar Dasyam, consultant medical gastroenterologist, hepatologist and therapeutic, KIMS Hospital Hyderabad shared his insights on understanding the causes and symptoms of liver cancer is so vital. Catching it early dramatically improves treatment success, a truth underscored by recent cases, including public figures.
Liver cancer, especially hepatocellular carcinoma (HCC) — the most common type — typically emerges in livers already compromised. Experts at Johns Hopkins Medicine and Mayo Clinic
consistently point to chronic viral hepatitis (Hepatitis B and C) as a primary culprit. These viruses spark ongoing inflammation, scarring (cirrhosis), and eventually, a higher risk of cancerous
changes. But they’re not the only risk factors:
* Cirrhosis, no matter the cause: Whether it’s from heavy alcohol use, non-alcoholic fatty liver disease (NAFLD), or other conditions, cirrhosis creates a breeding ground for cancer. NAFLD, now
more common with rising rates of obesity, insulin resistance, and type 2 diabetes, is a growing concern.
* Heavy drinking: Too much alcohol directly harms liver cells, leading to inflammation and scarring that can progress to cirrhosis and cancer.
* Obesity and Type 2 Diabetes: These conditions are strongly linked to NAFLD, which can escalate to severe liver disease and, ultimately, cancer.
* Certain inherited liver conditions: Diseases like hemochromatosis can also elevate your risk.
* Exposure to specific toxins: For instance, aflatoxins, a mold byproduct found in improperly stored crops, are known carcinogens.
The tricky part about liver cancer is its sneaky nature; symptoms often don’t show up until the disease has advanced. This makes staying vigilant incredibly important. Here are some critical red
flags, highlighted by Mayo Clinic and Johns Hopkins Medicine, that you should never brush aside:
* Unexplained weight loss and poor appetite: Losing a significant amount of weight without trying, along with a lack of hunger, can be a major warning sign.
* Upper abdominal pain or discomfort: A dull ache or discomfort, often in the upper right side of your belly, needs attention.
* Persistent nausea and vomiting: If you’re constantly feeling sick to your stomach or throwing up, it’s a symptom to address.
* Constant weakness and fatigue: Feeling unusually drained and lacking energy could signal an underlying issue.
* Abdominal swelling (ascites): Fluid buildup in your belly causing noticeable distension is a serious indicator.
* Jaundice: A yellowish tint to your skin and the whites of your eyes points to problems with liver function.
* Changes in stool or urine color: If your stools become pale or chalky, or your urine turns unusually dark, it could indicate a bile duct issue.
* Unrelenting itching: This can occur when bile salts accumulate under the skin.
Liver Cancer in India: The Shifting Landscape
In India, liver cancer presents a significant public health challenge, with its incidence showing an upward trend over the last decade. From 2004 to 2014, the overall hepatocellular carcinoma
(HCC) incidence rate in India saw an 11% increase, rising from an age-standardized rate of 3.0 to 3.3 per 100,000 persons. While still lower than in some global regions, this rise is a cause for
concern.
Demographically, liver cancer disproportionately affects males, with a male-to-female ratio often cited around 4:1. The age of presentation typically varies, but a significant number of cases are
seen between 40 to 70 years, with some studies indicating peaks around 40-55 years and again above 60 years. This bimodal distribution is often linked to the timing of hepatitis B infection
acquisition.
While Hepatitis B remains a dominant cause, the increasing prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD), driven by rising rates of obesity and type 2 diabetes in the Indian
population, is swiftly becoming a major contributor to the climbing HCC incidence. This demographic shift highlights the urgent need for public health strategies focusing on lifestyle
interventions to prevent NAFLD.
What Patients Need to Know: Spotting Red Flags and Getting Screened
If you notice any of these persistent symptoms, particularly if you have known risk factors for liver disease, don’t wait — reach out to your doctor immediately. Getting evaluated quickly is essential.
Your doctor might order blood tests (including liver function tests and AFP, a tumor marker), imaging like ultrasounds, CT scans, or MRIs, and in some cases, a liver biopsy for a definitive
diagnosis. If you have chronic Hepatitis B or C, or cirrhosis, talk to your doctor about regular screening protocols.
The Horizon of Hope: Advances in Liver Cancer Research
While the path to managing liver cancer can be challenging, groundbreaking research is continually offering new hope. Scientists are making strides in several key areas:
* Immunotherapy and Combination Treatments: A major breakthrough has been the integration of immunotherapy drugs with targeted therapies or localized treatments like transarterial
chemoembolization (TACE). These combinations are showing significant promise in extending lives and improving outcomes, even in advanced stages of the disease, by harnessing the body’s
own immune system to fight cancer.
* Non-Invasive Therapies: Innovative procedures like Histotripsy are emerging, using focused ultrasound waves to destroy tumors without the need for incisions, leading to fewer complications
and faster recovery for eligible patients.
* Smarter Diagnostics: Beyond traditional imaging, new blood tests (some combining multiple markers with demographic data) are being developed to detect liver cancer earlier, even before
symptoms appear. The use of liquid biopsies, which analyze cancer cells or DNA fragments in blood, offers a less invasive way to diagnose and monitor the disease. Furthermore, Artificial
Intelligence (AI) is being integrated into imaging to enhance the accuracy and speed of detection.
These advancements represent a dynamic shift in how liver cancer is treated and diagnosed, offering more personalized and effective options for patients.
Boosting Your Liver Health: Practical Advice for Everyone
Beyond early detection, actively protecting your liver is a powerful preventive step. Here’s what you can do:
* Go easy on alcohol, or cut it out entirely: This is fundamental to preventing liver damage.
* Maintain a healthy weight: Combat obesity with a balanced diet and regular exercise to prevent and manage NAFLD.
* Eat smart: Load up on fruits, vegetables, whole grains, and lean proteins. Limit processed foods, sugary drinks, and unhealthy fats.
* Get vaccinated: Make sure you’re protected against Hepatitis A and B if you’re at risk.
* Practice safe habits: Use safe sex practices and avoid shared needles to significantly lower your risk of Hepatitis B and C.
* Be careful with meds and supplements: Always follow dosage instructions and tell your doctor about everything you’re taking, including over-the-counter drugs and herbal supplements, as
some can harm your liver.
* Stay hydrated: Drinking enough water helps your liver with its crucial detoxification work.
By understanding what causes liver cancer, recognizing its warning signs, and taking proactive steps for liver health, we can all contribute to reducing its impact and embracing a future with
more effective treatments.
