Do you sometimes feel constantly tired, no matter how much rest you get? Or experience a lingering, mild pain on the upper right side of your abdomen? You may even notice a faint yellow tinge in your skin or eyes – signs we often brush off as stress or just a hectic lifestyle.The liver’s role is vital, quietly performing its essential metabolic and detoxification functions and supporting overall health. Yet liver cancer remains a serious concern, often slipping under the radar until its late stages. In 2022, over 759,000 lives were lost to liver cancer worldwide. It is now ranked as the third leading cause of cancer related deaths globally, and as overall cancer fatalities are projected to cross 10 million by 2025 making early awareness and intervention crucial.Not Just a Drinker’s DiseaseFor decades, liver cancer was closely linked to heavy alcohol consumption and hepatitis infections. However, recent trends show a worrying rise in cases among non-drinkers. The culprit is often MASLD (Metabolic Dysfunction Associated Steatotic Liver Disease) and its severe form, MASH (Metabolic Dysfunction Associated Steatohepatitis). In these conditions, excess fat accumulates in the liver, causing long-term inflammation and scarring that can eventually lead to cancer even without the traditional causes like alcohol or viral hepatitis.Lifestyle factors such as obesity, type 2 diabetes, high cholesterol, sedentary habits and poor dietary choices play a significant role, making even young adults susceptible. The challenge is that early symptoms are vague or non-existent, so many people remain unaware of their risk until the disease is advanced.The Importance of Early DetectionEarly detection saves lives. I recommend routine liver screenings, especially for individuals with diabetes or a family history of liver disease. Liver function tests and abdominal ultrasounds can detect early changes in the liver before cancer develops or worsens. Unfortunately, many avoid check-ups until symptoms become severe, missing a critical therapeutic window.Exploring Modern Treatment OptionsLiver cancer treatment varies widely based on the stage of the disease and patient’s overall health. Surgery, including liver resection or transplantation, offers the best chance for a cure but isn’t always feasible, especially in late-stage cancer. Other options include ablation therapies, systemic treatments like chemotherapy or targeted drugs, and radiation.One increasingly important treatment is Transarterial Chemoembolization, or TACE. This minimally invasive technique delivers chemotherapy directly to the tumor while cutting off its blood supply, limiting tumor growth. It’s generally palliative but can significantly improve symptoms and quality of life when surgery is not an option. Globally, TACE has become a standard of care for many patients, slowing disease progression and reducing complications.Not long ago, a 21-year-old gym enthusiast came to us with severe abdominal pain and exhaustion. Despite regular exercise and a clean diet, he was diagnosed with primary liver cancer. The tumor was too large and located unfavourable for surgery, so TACE was chosen. This helped control the tumor and alleviate symptoms, enabling him to maintain a good quality of life while continuing treatment. This case reflects growing global trends – liver cancer no longer follows old patterns, necessitating vigilance across all age groups.Lifestyle and PreventionWhile liver cancer presents a serious challenge, many risks can be minimized through lifestyle modifications. A balanced diet rich in fruits, vegetables, and whole grains supports liver health, as does staying well-hydrated and engaging in regular physical activity – aiming for at least 150 minutes per week through walking, cycling, swimming, or any similar activities. Avoiding alcohol consumption, smoking, and environmental toxins also lowers risk.Vaccination against hepatitis B is critical in many regions, and maintaining safe practices to prevent hepatitis C infection rounds out preventive care. Regular health check-ups enable early problem detection and timely intervention, which can be lifesaving.This Liver Cancer Awareness Month, the message is clear: liver cancer is a silent threat that can affect anyone. Increased awareness, proactive lifestyle choices, and timely medical screening can help detect problems early and improve outcomes, offering hope against a rising global health challenge.(Dr Rajesh V. Helavar, Consultant – Interventional and Diagnostic Radiology, Manipal Hospitals, Yeshwanthpur)
