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liver cancer logoWhat is Liver Cancer?

The liver is a large organ occupying the upper right portion of the abdomen. It is an important organ with many functions:

  • Production of bile for the digestion of fat in the intestines
  • Protein synthesis
  • Storage of glucose and fat
  • Breakdown of toxic sub stances such as alcohol

Liver cancer arises from hepatocytes (liver cells). Liver cancer often develops in livers that are severely damaged by longstanding diseases or chemicals. The liver becomes hardened and shrunken — a condition called liver cirrhosis.

 When the liver cancer is small (less than 5cm in diameter), it often does not present symptoms. When tumours have become bigger and more advanced, liver cancer can infiltrate the liver capsule or obstruct the bile ducts. At this stage, symptoms may start appearing.

Liver cancer can form many nodules within the liver and spread into the blood vessels. These features make it difficult to surgically remove them. The liver is also the seat of secondary or metastatic cancers. In such cases, the main cancer forms elsewhere in the body and secondary deposits are formed in the liver. A common example is colorectal cancer spreading to the liver via the bloodstream.

Liver cancer is the fourth most common cancer in males in Singapore. *

 

* Singapore Cancer Registry Annual Registry report, Trends in Cancer Incidence in Singapore 2010-2014

Risk Factors

The following factors increase the risk of liver cancer:

  • Chronic infection with hepatitis B and C viruses
  • Alcohol abuse leading to scar tissue formation in the liver
  • Aflatoxin, which is a poisonous substance produced in a fungus that affects peanuts
  • Inherited disorders that cause damage to the liver
  • Certain chemicals like vinyl chloride, hydrocarbons, solvents, nitrites
  • Long-term use of anabolic steroids
  • Drinking water contaminated with arsenic

Most liver cancers can be prevented by public health measures that reduce exposure to known risk factors. For example, the most significant risk factor for liver cancer worldwide is chronic infection with the hepatitis B and C viruses. Family members of patients with hepatitis B are advised to check their hepatitis B status and seek immunisation if they are not infected. Children are advised to be immunised at birth for hepatitis B as part of the national immunisation programme. There is currently no immunisation method for hepatitis C.