LIVER CANCER

What causes liver cancer?

Ababolic steroids - used by athletes and weight lifters. These

male hormones, if used regularly and for long enough can raise the
risk of developing liver cancer, as well as some other cancers.

Aflatoxins - this is a substance that is made by a fungus and may

be found in mouldy wheat, groundnuts, corn, nuts, soybeans and
peanuts. For liver cancer risk to increase there needs to be long-
term exposure. This is more of a problem in some poor countries
than in industrialized nations.

Cirrhosis - when liver cells are damaged and replaced with scar
tissue. People with cirrhosis of the liver have a higher risk of
developing liver cancer.

Diabetes - patients with diabetes, especially if they also have

hepatitis, or regularly consume a lot of alcohol, are more likely to
develop liver cancer.

Family history - people whose mother, father, brother, or sister

with liver cancer have a higher risk of developing it themselves,
compared to others.

L-carnitine deficiency - studies suggest that an l-carnitine

deficiency increases the risk of developing liver cancer.

Liver disease and inherited liver disease - people with hepatitis

B or C have a significantly higher risk of developing liver cancer,
compared to other healthy individuals. According to the American
Cancer Society, hepatitis C is the most common cause of liver
cancer in the USA. The Society mentions that some inherited liver
diseases also increase the risk of liver cancer.

Low immunity - people with weakened immune systems, such as

those with HIV/AIDS have a risk of liver cancer that is five times
greater than other healthy individuals.

Obesity - obesity raises the risk of developing many cancers,

including liver cancer.

Gender - a higher percentage of males get liver cancer compared

to females. Some experts believe this is not due to gender, but to
lifestyle characteristics - on average, males tend to smoke and
abuse alcohol more than females.
Smoking - individuals with hepatitis B or C have a higher risk of
liver cancer if they smoke.

Water wells with arsenic - people who rely on water wells that
have arsenic may eventually have a significantly higher risk of
developing several conditions or diseases, including liver cancer.

Etiology

Hepatocellular carcinoma is usually a complication of cirrhosis.

The presence of HBV increases risk of hepatocellular carcinoma by
> 100-fold among HBV carriers. Incorporation of HBV DNA into the
host's genome may initiate malignant transformation, even in the
absence of chronic hepatitis or cirrhosis.
Other disorders that cause hepatocellular carcinoma include
cirrhosis due to chronic hepatitis C virus (HCV) infection,
hemochromatosis, and alcoholic cirrhosis. Patients with cirrhosis
due to other conditions are also at increased risk.
Environmental carcinogens may play a role; eg, ingestion of food
contaminated with fungal aflatoxins is believed to contribute to the
high incidence of hepatocellular carcinoma in subtropical regions.

CLINICAL MANIFESTATION

The early manifestations of malignancy of the liver included pain a

continuous dull ache in the right upper quadrant, epigastrium or
back. Weight loss, loss of strength, anorexia, and anemia my also
occur. The liver may be enlarged and irrigular on palpation.
Jaundice is present only if the larger bile ducts are occluded by the
pressure of malignant nodules in the helium of the liver. Ascites
develops if such nodules obstruct the portal veins or if tumor tissue
is seeded in the peritoneal cavity.

BENJAMIN VILLAFUERTE

BSN 3F