The Silent organ’s loud cancer - Dr Dinesh

Fear takes over when patients hear liver surgery. Often, patients imagine the procedure as extremely risky, but medicine has moved on.

Today, with meticulous planning and using simple scans like MRI and CT scans to map the liver in advance, and in some cases deliberately blocking a small portion of its blood supply ahead of time, so that the remaining liver strengthens before surgery. With the deployment of state-of-the-art tools in the operating room, there is less loss of blood and a clear view.

Why do people feel “fine”, and why can that be dangerous?

Surprisingly, those diagnosed with liver cancer always say, “they feel fine”. That’s because the liver is resilient; it can keep working yet compensate for damage, even when a large part is compromised. It’s difficult to accept when you feel healthy.

This underlines why liver cancer often remains silent for a long time, especially among those with liver conditions or fatty liver disease. That is why regular scans and blood tests in such vulnerable groups make a significant difference.

Is minimally invasive surgery is it possible for liver cancer?

Absolutely YES. In many cases, laparoscopic surgery is suitable. With a tiny camera and minor cuts, we achieve faster recovery, less pain and most of all shorter hospital stay. Often the camera gives a clear view of deep parts o the liver, but it’s not for everyone.

Factors like size, location and type of tumour define whether it’s appropriate. That said, priority must be safe and complete removal and not the size of the cut.

The surgeon’s balancing act

A surgery mainly demands patience, timing and the right judgement. It isn’t just about a cut. For a surgeon, the hardest part is balance. It is up to the surgeon to decide how much of the liver shall be removed and how much of it needs to be left behind, as if too little, then the cancer can recur, and if too much then the liver has possibilities of failing.

So not all cases we see are the same; each is unique. Each of it requires detailed planning, sometimes prepare for quick decision while at the surgery if the liver appears weaker than expected.

Not always surgery: other treatment paths

Liver cancer does not always require surgery. It’s not always the first best option, especially if the larger part of the liver is damaged or the cancer has spread. In such cases, treatments such as ablation, chemo-embolisation, targeted drugs, or immunotherapy may be used first to control the disease.

If the liver improves, then we may consider surgery later. The goal is to tailor the best chance for a longer, better life.

Prevention: simple steps that matter

In many cases, liver cancer is preventable. Liver cancer may arise due to long-term issues such as viral hepatitis, fatty liver or heavy alcohol use, but it can often be prevented. Vaccination against hepatitis B, ensuring timely treatment and diagnosis for infections, following a healthy diet, controlling weight and reducing excessive alcohol will help in protecting the liver.

People with diabetes and obesity must necessarily undertake periodic liver function tests. These preventive measures may not sound dramatic, but they do help in saving lives, quietly.

Lessons from survivors

Survivors teach me strength. I’ve seen patients arrive very ill, undergo surgery, change their lifestyles completely and go on to live many years. Some begin exercising, stop drinking, eat carefully and embrace life with more positivity. Their courage inspires us.

Medicine and surgery can treat the disease, but the patient’s mindset is what keeps them alive and well.

Disclaimer: The views expressed in this article are of the author and not of Health Dialogues. The Editorial/Content team of Health Dialogues has not contributed to the writing/editing/packaging of this article.