1 A 55- year-old woman developed a loss of appetite and started feeling nauseous. Her condition persisted in spite of the medication she received for over 4 to 6 weeks. When she went to hospital for consultation, she underwent a clinical examination, and to her shock, she had liver cancer. Liver cancer usually occurs more in men than women. It is the malignancy that originates in the liver however the exact cause of the ailment is not known but there are several conditions that predispose one to develop it. Viral infections of the liver like hepatitis B and C tend to cause chronic inflammation of the liver and cancer occurs as a sequel. Liver damage due to chronic use of alcohol also predisposes one to liver cancer. Individuals who smoke have a much higher risk of developing liver cancer as compared to non-smokers. People with long standing diabetes and those with an immune depressed state such as people with HIV, are also prone to this cancer. Women using oral contraceptive pills for a long time are susceptible for developing liver cancer. Individuals on anabolic steroids (steroids used for body building) such as athletes expose themselves to risk of getting liver cancer. People consuming ground nuts or beans contaminated with aflatoxin, a mouldy substance, have been found to be at higher risk of liver cancer. Exposure to heavy metals like arsenic, cadmium in industries has been linked to this cancer as well. When someone has liver cancer, there may be a visible and palpable painful swelling in the right upper side or middle of abdomen. Initially the pain can be intermittent but as the disease progresses, the pain can last for longer intervals and can also be severe in intensity. One can also develop loss of appetite, nausea and vomiting. This results in physical weakness in the affected person. This tumour can also spread to other parts of the body. Due to liver dysfunction, there is yellow discoloration of eyes and widespread itching. There is also increased susceptibility to easy bleeding, over time; the affected person develops liver failure, unconsciousness and death. Liver cancer is easily detected by physical examination. Imaging techniques like ultrasound and CT scan show it in greater detail. A biopsy confirms the diagnosis. If detected early, the cancerous mass can be treated surgically. However patients tend to seek medical advice when they are very sick and the liver has already been damaged. When this happens, the only option left is chemotherapy or radiation to kill the tumour cells. However these are associated with many harmful effects. Ultimately one dies a slow painful death. People need to be aware of liver cancer and the risk factors causing it such that they can be careful enough to prevent it. Avoiding alcohol can prevent damage to the liver; similarly avoiding promiscuous sexual indulgencies helps in preventing viral hepatitis B and C. As such, use of anabolic steroids is not legal in arena of sports and one should avoid it. Women on contraceptive pills also have to be careful in this regard. Diabetic individuals should keep the disease well under control. Those involved in lifting heavy metals should also mind considering safety precautions. People need to be cautioned to avoid contaminated food with mould to avoid complications including liver cancer. Those with high risk of getting liver cancer should be screened regularly via ultrasound and liver function tests. This way, the cancer can be detected in the nascent stages where it can be treated. A healthy life style along with regular use of freshly cooked healthy food helps in the body’s ability to prevent and fight any type of cancer. Hence one should follow it. Dr Rachna Pande, Specialist, internal medicine rachna212002@yahoo.co.uk
