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All About Liver Cancer

The liver is an organ with important functions for the body's operation, but when it has a cancerous tumor, it is often detected in an advanced stage. Prof. Ziv Ben-Ari, who is a doctor who works at a center for Liver Medicine, explains why it's important to be aware of the disease, who is at risk, and what are the treatment options. "Even at an advanced stage, there are new treatments in immunotherapy that slow the progression of the disease and extend the patient's life."

The liver has significant roles in the body. It is responsible, among other things, for storing sugars and fats as a future energy source. It also produces bile necessary for fat absorption and creates clotting factors to stop bleeding. Its most well-known role is filtering and removing toxins that come from the digestive system and excreting them from the body.

One of the known facts about the liver is that it is the only solid organ in the body capable of regeneration. Within about two weeks, it can restore 30-50% of its volume. This large reserve and regenerative ability allow the liver to function for a long time without the patient developing symptoms, which is why, unfortunately, in 70% of cases, the disease is discovered late.

Primary vs. Metastatic Liver Cancer
Prof. Ziv Ben-Ari emphasizes the difference between primary liver cancer, which develops from liver cells themselves, and liver cancer that is actually metastasis from cancer in other parts of the body, such as colon cancer that spreads to the liver. The treatment for the two diseases is entirely different.

Who is Usually Affected by the Disease?
"The disease is more common among men in their 60s and 70s and typically develops in patients with chronic liver disease that has progressed over the years to cirrhosis," explains Prof. Ben-Ari.

Main Risk Factors
"The primary factor is cirrhosis of the liver. In this condition, healthy liver tissue is replaced by scar tissue for various reasons, impairing its function. The main causes of chronic liver disease progressing to cirrhosis include chronic viral infections of the liver (known as Hepatitis B, C, and D), fatty liver disease, usually in people with excess weight, and chronic excessive alcohol consumption."

Symptoms
"The symptoms of liver cancer are not specific and can characterize several diseases. They include loss of appetite, rapid weight loss, nausea, vomiting, weakness, and high fever. Some patients report discomfort in the upper right part of the abdomen, where the liver is located. In some cases, ascites (abdominal swelling due to fluid buildup) develops. In most cases, by the time these symptoms appear, the disease is already in advanced stages."

Survival Rates
"Not very high," details Prof. Ben-Ari. "Liver cancer is considered aggressive and fatal with high mortality rates. Around 850,000 people die from it globally each year, primarily because it is detected late."

Early-Stage Treatment
The treatment depends on the stage at which the disease is diagnosed. "When the disease is discovered early, with a local and operable tumor, the treatment is surgical, involving selective removal of the tumor or, in rare cases, liver transplantation. Additionally, in some cases, focused thermal ablation of the tumor using microwave waves can be performed without damaging healthy liver tissue. At these stages, the cure rate is higher and can reach 50-70%."

What Innovations Exist for Advanced Stages?
Despite the grim statistics, there are encouraging developments for liver cancer patients diagnosed at advanced stages. "Today, with the introduction of new drugs from the immunotherapy group, lives can be extended even at an advanced stage," explains Prof. Ben-Ari. Immunotherapy helps the body's immune system recognize and attack cancer cells. The goal is to use the patient's immune system to attack the tumor cells more efficiently.

How Can One Reduce the Risk of Illness?
"Those at risk (patients with advanced liver disease and cirrhosis) must be regularly monitored in a liver clinic, undergo an ultrasound every six months, and have a blood test for a specific marker of the disease (alpha-fetoprotein). Regular monitoring can lead to early detection and significantly improve survival chances."

The professor further emphasizes the importance of ongoing monitoring for individuals at risk: "Close monitoring can lead to early detection and significantly improve survival chances." Additionally, antiviral treatment should be provided to patients with viral liver disease. For those with fatty liver disease, lifestyle changes are crucial, including weight loss and regular physical activity, along with controlling risk factors like diabetes and high blood lipids. Of course, it’s essential to stop alcohol consumption.

In summary, liver cancer is a serious and often late-detected disease with high mortality rates. However, with modern medical advances, particularly in immunotherapy, there is hope for extending life even in advanced stages. Early detection through regular checkups and managing chronic liver conditions are key to reducing the risk of developing this aggressive cancer.

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