Hepatocellular Carcinoma (HCC): Symptoms, Causes, Treatment

What are the symptoms of hepatocellular carcinoma?

Hepatocellular carcinoma (HCC) is a type of liver cancer that can cause a range of symptoms, which may vary depending on the stage and size of the tumor. Here are some common symptoms of HCC:

Abdominal pain: Pain in the upper right side of the abdomen is a common symptom of HCC, often described as a dull ache or sharp pain.
Weight loss: Unexplained weight loss is a common symptom of HCC, which can be due to a combination of factors, including malnutrition, anorexia, and ascites (fluid accumulation in the abdomen).
Fatigue: Fatigue is a common symptom of HCC, which can be caused by anemia, malnutrition, and other systemic effects of the disease.
Loss of appetite: Loss of appetite is a common symptom of HCC, which can be due to anorexia, nausea, and vomiting.
Jaundice: Jaundice is a yellowing of the skin and eyes caused by increased levels of bilirubin in the blood. It’s a common symptom of HCC, especially in advanced stages.
Dark urine: Dark urine is a common symptom of HCC, caused by increased levels of bilirubin in the blood.
Pale or clay-colored stools: Pale or clay-colored stools are a common symptom of HCC, caused by increased levels of bilirubin in the blood.
Ascites: Ascites is a condition characterized by fluid accumulation in the abdominal cavity, which can cause abdominal swelling and discomfort.
Enlarged liver: An enlarged liver is a common symptom of HCC, especially in advanced stages.
Mass in the abdomen: A palpable mass or lump in the abdomen is a common symptom of HCC, especially in advanced stages.
Vomiting: Vomiting is a common symptom of HCC, especially if the tumor has spread to the bile ducts.
Fever: Fever is a common symptom of HCC, especially if there’s an infection or inflammation present.

It’s essential to note that these symptoms can also be caused by other conditions, so it’s crucial to consult with a healthcare provider for proper diagnosis and treatment.

In addition to these symptoms, patients with HCC may also experience:

Loss of muscle mass
Edema (swelling)
Hematemesis (vomiting blood)
Melena (black tarry stools)
Abdominal distension
Nausea and vomiting

Early detection and treatment are crucial for improving outcomes in patients with HCC.

What are the causes of hepatocellular carcinoma?

Hepatocellular carcinoma (HCC) is a type of liver cancer that is caused by a combination of genetic and environmental factors. The exact causes of HCC are not fully understood, but several risk factors have been identified. Here are some of the most common causes of HCC:

Chronic liver disease: Chronic liver disease, such as cirrhosis, is a major risk factor for HCC. Cirrhosis is often caused by hepatitis B or C virus infection, alcohol abuse, or non-alcoholic steatohepatitis (NASH).
Hepatitis B virus (HBV) infection: HBV infection is a significant risk factor for HCC, especially in areas where the virus is prevalent.
Hepatitis C virus (HCV) infection: HCV infection is also a major risk factor for HCC, especially in people with chronic liver disease.
Alcohol abuse: Heavy alcohol consumption can cause liver damage and increase the risk of HCC.
Aflatoxin exposure: Aflatoxins are toxins produced by certain types of mold that can contaminate food and increase the risk of HCC.
Cigarette smoking: Smoking has been linked to an increased risk of HCC, although the exact mechanism is not fully understood.
Obesity: Obesity is a growing public health concern worldwide and has been linked to an increased risk of HCC.
Type 2 diabetes: Type 2 diabetes has been linked to an increased risk of HCC, possibly due to insulin resistance and chronic inflammation.
Non-alcoholic fatty liver disease (NAFLD): NAFLD is a condition characterized by fat accumulation in the liver that can increase the risk of HCC.
Family history: A family history of HCC or liver disease can increase an individual’s risk of developing the disease.
Genetic predisposition: Certain genetic mutations, such as those in the TP53 gene, may increase an individual’s risk of developing HCC.

It’s essential to note that many cases of HCC are likely caused by a combination of these factors, rather than a single underlying cause.

How is the diagnosis of hepatocellular carcinoma made?

The diagnosis of hepatocellular carcinoma (HCC) typically involves a combination of medical history, physical examination, imaging studies, and laboratory tests. Here are the steps involved in making a diagnosis of HCC:

Medical History: A thorough medical history is taken to identify any risk factors, symptoms, and medical conditions that may be related to HCC.
Physical Examination: A physical examination is performed to check for signs of liver disease, such as abdominal tenderness, ascites (fluid accumulation in the abdomen), or jaundice (yellowing of the skin and eyes).
Imaging Studies: Imaging studies are used to evaluate the liver and detect any abnormalities:
- Ultrasound (US): An ultrasound is used to evaluate the liver and detect any abnormalities, such as a tumor.
- Computed Tomography (CT) scan: A CT scan is used to evaluate the liver and detect any abnormalities, such as a tumor.
- Magnetic Resonance Imaging (MRI): An MRI is used to evaluate the liver and detect any abnormalities, such as a tumor.
- Positron Emission Tomography (PET) scan: A PET scan is used to evaluate the liver and detect any abnormalities, such as a tumor.
Laboratory Tests: Laboratory tests are used to evaluate liver function and detect any abnormalities:
- Liver function tests (LFTs): LFTs are used to evaluate liver function and detect any abnormalities, such as elevated levels of bilirubin or enzymes.
- Alpha-fetoprotein (AFP) test: An AFP test is used to detect elevated levels of AFP, which is a protein produced by HCC cells.
- Des-γ-carboxyprothrombin (DCP) test: A DCP test is used to detect elevated levels of DCP, which is a protein produced by HCC cells.
Biopsy: A biopsy may be performed to confirm the diagnosis:
- Transjugular liver biopsy: A transjugular liver biopsy involves inserting a needle through the jugular vein to collect a sample of liver tissue.
- Percutaneous liver biopsy: A percutaneous liver biopsy involves inserting a needle through the skin to collect a sample of liver tissue.

The combination of these tests helps healthcare providers diagnose HCC and determine the best course of treatment.

What is the treatment for hepatocellular carcinoma?

The treatment for hepatocellular carcinoma (HCC) depends on the stage and severity of the disease, as well as the patient’s overall health and medical history. Here are some common treatments for HCC:

Surgery:

Liver resection: Surgical removal of the tumor and surrounding liver tissue is the most effective treatment for HCC.
Liver transplantation: In some cases, liver transplantation may be necessary to remove the entire liver and replace it with a healthy one.

Chemotherapy:

Systemic chemotherapy: Chemotherapy is used to kill cancer cells throughout the body.
Regional chemotherapy: Chemotherapy is delivered directly to the liver through a catheter.

Radiation Therapy:

External beam radiation therapy: Radiation therapy is used to kill cancer cells in the liver.
Internal radiation therapy: Small amounts of radioactive material are placed inside the tumor to kill cancer cells.

Other Treatments:

Transarterial chemoembolization (TACE): TACE is a minimally invasive procedure that delivers chemotherapy directly to the tumor through an artery.
Radiofrequency ablation (RFA): RFA uses heat or cold to kill cancer cells in the liver.
Yttrium-90 radioembolization (Y90): Y90 is a radioactive material that is delivered directly to the tumor through an artery.
Systemic therapy: Targeted therapies, such as sorafenib, are used to treat advanced HCC.

Palliative Care:

Pain management: Palliative care focuses on managing symptoms and improving quality of life.
Symptom control: Medications are used to manage symptoms such as pain, nausea, and fatigue.

Monitoring and Follow-up:

Regular imaging studies: Regular imaging studies are performed to monitor the progression of the disease and response to treatment.
Blood tests: Blood tests are performed regularly to monitor liver function and detect any changes in the disease.

It’s essential for patients with HCC to work closely with their healthcare team to develop a personalized treatment plan that meets their individual needs and improves their quality of life.

What is the life expectancy of a person with hepatocellular carcinoma?

The life expectancy of a person with hepatocellular carcinoma (HCC) depends on several factors, including the stage and grade of the cancer, the patient’s overall health, and the effectiveness of treatment.

Overall Survival Rate:

The overall 5-year survival rate for patients with HCC is around 15-20%.
The 1-year survival rate is around 70-80%, and the 2-year survival rate is around 40-50%.

Survival Rates by Stage:

Stage I: The 5-year survival rate for stage I HCC is around 70-80%.
Stage II: The 5-year survival rate for stage II HCC is around 50-60%.
Stage III: The 5-year survival rate for stage III HCC is around 30-40%.
Stage IV: The 5-year survival rate for stage IV HCC is around 10-20%.

Factors Affecting Survival:

Age: Older patients tend to have a poorer prognosis than younger patients.
Tumor size: Larger tumors tend to have a poorer prognosis than smaller tumors.
Tumor grade: More aggressive tumors tend to have a poorer prognosis than less aggressive tumors.
Liver function: Patients with impaired liver function tend to have a poorer prognosis than those with normal liver function.
Treatment response: Patients who respond well to treatment tend to have a better prognosis than those who do not respond as well.

It’s essential to note that these are general statistics, and individual outcomes can vary significantly. Treatment options and outcomes may vary depending on the specific circumstances of each patient.