Liver Cancer Care: Diagnosis, Treatment Options, and Recovery Tips - Dr Kirankumar Sajjanshetty

A diagnosis of liver cancer is a life-altering event that demands a comprehensive approach to treatment and post-treatment care.

Liver cancer, most commonly known as hepatocellular carcinoma (HCC). This disease often arises in the context of chronic liver conditions like hepatitis or cirrhosis. Effective management and recovery from liver cancer involve understanding the disease, undergoing appropriate treatments based on the cancer stage, and adopting crucial lifestyle changes to support overall health and prevent recurrence.

This article delves into an overview of liver cancer, typical treatments based on the cancer stage, and essential lifestyle adjustments post-treatment.

What is Liver Cancer?

Liver cancer is a type of cancer that starts in the liver, an organ involved into various bodily functions including detoxification, nutrient storage, and digestion. The most common form, hepatocellular carcinoma (HCC), originates from hepatocytes, the primary liver cells. Other types, like intrahepatic cholangiocarcinoma and angiosarcoma, are less common.

Risk factors for liver cancer include chronic infection with hepatitis B or C, heavy alcohol consumption, non-alcoholic fatty liver disease, and exposure to aflatoxins.

Typical Treatments Depending on Stages of Liver Cancer Treatment options for liver cancer vary based on the stage of the disease, the patient’s overall all health, and liver function.

After a liver cancer diagnosis, typical treatments include:

• Surgery: Removing part of the liver (partial hepatectomy) or a liver transplant for eligible patients.
• Ablation: Techniques such as radio frequency ablation (RFA) or microwave ablation to destroy cancer cells.
• Embolization: Blocking blood flow to the tumour, either through trans-arterial chemo embolization (TACE) or radio embolization.
• Radiation Therapy: Using high-energy rays to target and kill cancer cells.
• Targeted Therapy: Medications that specifically target cancer cell mechanisms, such as so rafenib.
• Immunotherapy: Boosting the body's immune system to fight cancer using specialized monoclonal antibodies.

Therapy for HCC may be broadly categorized into:

• Early-Stage Liver Cancer

Surgery: For small, localized tumours, surgical resection (partial hepatectomy) can be effective. In some cases, if the liver function is severely compromised or multiple tumours are present, a liver transplant might be considered.

Ablation: Techniques like radio frequency ablation (RFA) or microwave ablation use heat to destroy cancer cells and are often used when surgery is not an option

• Intermediate-Stage Liver Cancer

Trans-arterial Chemo embolization (TACE):

This procedure delivers chemotherapy directly to the liver tumour and blocks its blood supply, helping to shrink the tumour.

Radio embolization (TARE): Involves injecting radioactive beads into the blood vessels feeding the tumour, delivering targeted radiation to the cancer cells.

• Advanced-Stage Liver Cancer

Systemic Therapy: Includes targeted therapies like Sorafenib and Lenvatinib, which inhibit cancer cell growth. Immunotherapy drugs help the immune system recognize and attack cancer cells.

Radiation Therapy: Uses high-energy rays to kill cancer cells and is typically used when the tumour is too large for other localized treatments.

After liver cancer treatment, follow these important guidelines to support recovery and maintain health:

• Post-Surgery: Follow your surgeon's instructions for wound care and activity restrictions. Monitor for signs of infection or complications, and attend all follow-up appointments for liver function assessment.
• After Ablation: Rest and avoid strenuous activities as recommended by your healthcare provider. Report any unusual pain, fever, or symptoms to your doctor promptly.
• Post-Embolisation: Stay hydrated and rest as advised. Be vigilant for symptoms such as pain, fever, or jaundice, and inform your healthcare team if they occur.
• Following Radiation Therapy: Manage side effects like fatigue and skin irritation with appropriate care. Maintain regular check-ups to monitor liver function and assess for any delayed effects.
• After Targeted Therapy: Adhere to the prescribed medication regimen and report any side effects to your oncologist. Regular blood tests and scans will be needed to monitor the treatment's effectiveness.
• Post-Immunotherapy: Stay alert for immune-related side effects and communicate any new symptoms to your healthcare provider. Continue with regular follow-up visits to track progress and manage any adverse effects.

For all treatments, maintaining a healthy lifestyle, including a balanced diet, regular exercise, and avoiding alcohol, is crucial for supporting liver health and overall recovery.

Lifestyle changes after various types of therapy: After liver cancer treatment, lifestyle changes play a critical role in recovery and long-term health.

These changes include dietary modifications, regular exercise, and managing risk factors for liver disease.

Dietary Changes A healthy diet supports liver function and overall recovery. Here are some simple dietary changes to consider:

• Nutrient-Dense Foods: Incorporate a variety of fruits, vegetables, whole grains, lean proteins (like fish and poultry), and healthy fats (such as avocados and nuts). These foods provide essential nutrients and antioxidants.
• Limit Processed Foods: Avoid foods high in sugars, unhealthy fats, and preservatives, as they can put additional stress on your liver.
• Avoid Alcohol: Alcohol can exacerbate liver damage and should be completely avoided to prevent further complications.

Exercise Recommendations Regular physical activity benefits cancer survivors by enhancing physical and mental health.

Here are some exercise tips:

• Begin with low-impact activities like walking, swimming, or gentle yoga. Gradually increase intensity and duration as your strength improves.
• Engage in light weightlifting or resistance exercises to build muscle mass and improve strength, aiming for at least two sessions per week.
• 150 minutes of moderate-intensity aerobic exercise weekly, divided into manageable sessions spread across the week.
• Avoid overexertion and stop if you experience pain, dizziness, or shortness of breath. Consult your healthcare provider if these symptoms occur.

Managing Risk Factors for Liver Disease To prevent liver disease progression and support overall health, consider these strategies:

• Regular Medical Check-Ups: Attend follow-up appointments for liver function monitoring and early detection of potential complications. Regular blood tests and imaging studies are essential.
• Medication Management: Follow your doctor's advice regarding medications and avoid over-the-counter supplements without consultation, as some can harm the liver.
• Vaccinations: Stay updated on vaccinations, especially for hepatitis A and B, which can cause significant liver damage.
• Avoid Toxins: Minimize exposure to harmful chemicals and environmental toxins. Use protective gear when necessary and avoid smoking.
• Manage Chronic Conditions: Effectively manage conditions like diabetes, hypertension, and high cholesterol through lifestyle changes and medications, as these can impact liver health.