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Liver cancer, a formidable adversary, often requires a combination of expertise, innovation, and unwavering determination to overcome. Often diagnosed at an advanced/last stage, liver cancer presents a challenge for patients and healthcare providers. Liver malignancies, including Cholangiocarcinoma and Hepatocellular Carcinoma (HCC), are among the top five most common cancers worldwide and frequently cause cancer-related mortality. 

The cost of liver cancer treatment in India ranges from Rs. 1,50,000 to Rs. 4,00,000.

What is Liver Cancer?

Liver cancer occurs when the liver cells start to grow uncontrollably, leading to the development of abnormal cells. The functions of the liver include:

  • Converting and storing nutrients
  • Breaking down drugs and alcohol
  • Delivering bile into the intestine to help digestion of fat
  • Producing clotting factors

Different cell types in the liver can develop different types of cancer, such as malignant or benign (non-cancerous). The most common liver cancer type is HCC, which arises in hepatocytes, the main type of liver cell.

Liver cancer can be primary, which begins in the liver itself, or secondary, which spreads from other parts of the body. In primary liver cancer, malignant (cancer) cells form in the tissues of the liver. Primary liver cancer can occur in both children and adults. 

What are the Different Types of Liver Cancer?

The various kinds of liver cancer are mentioned below:

  1. Hepatic adenoma: This is a benign liver cancer that can cause stomach This benign liver cancer can cause stomach discomfort and bleeding. Surgical removal is generally the best option.
  2. Focal nodular hyperplasia (FNH): FNH is a cancer made up of a variety of cell types.
  3. Hepatic angiosarcoma and hemangiosarcoma: These uncommon cancers affect the liver.
  4. HCC: HCC is the most frequent type of liver cancer and usually develops in individuals with long-term liver disease due to hepatitis virus infection or cirrhosis. Men are at a higher risk of developing HCC than women. 
  5. Intrahepatic cholangiocarcinoma (bile duct cancer): It accounts for 10-15% of all liver cancers. Lymph nodes, the lungs, and the bone marrow are all typical places for it to spread. It typically affects individuals over 50 but can occur at any age. It is often diagnosed when it’s advanced, making successful treatment difficult.
  6. Hepatoblastoma: This is a rare malignancy that affects children under the age of four.
  7. Secondary liver cancer: It begins in another part of the body, such as the colon, pancreas, stomach, breast, or lung, and spreads to the liver (metastasis).

What are the Symptoms of Liver Cancer?

The symptoms of liver cancer include the following:

  • A hard mass located on the right side, just below the rib cage
  • A swollen abdomen
  • Discomfort on the upper right side of the abdomen
  • Pain around the right shoulder blade or in the back
  • Unusual tiredness or weakness
  • Vomiting and nausea 
  • Loss of appetite
  • Jaundice
  • Easy bruising or bleeding
  • Weight loss for no known reason
  • Pale, chalky bowel movements and dark urine
  • Fever

What are the Risk Factors of Liver Cancer?

The risk factors associated with liver cancer include the following:

  • Hepatitis B virus (HBV) infection
  • Hepatitis C virus (HCV) infection
  • Cirrhosis
  • Heavy alcohol use
  • Foods containing Aflatoxin B1 (a poisonous fungus that can grow on food items like corn and nuts when they are stored in hot and humid conditions)
  • Nonalcoholic steatohepatitis (NASH)
  • Cigarette smoking
  • Other conditions include Untreated hereditary hemochromatosis, Alpha-1 antitrypsin deficiency, Glycogen storage disease, Wilson disease, etc.

What Treatment Options Available for Liver Cancer?

Tumor ablation and chemotherapy, delivered directly into the cancer, are used for primary liver cancer, while chemotherapy surgery with chemotherapy is used for secondary cancer.

Surgery: It may involve removing a part of the liver or a liver transplant. Partial hepatectomy may also be performed to remove a part of the liver. If it is not possible to remove part of the liver, the patient may be suggested a liver transplant.

Tumor ablation: Tumor ablation treatments mostly use microwaves and radio waves to destroy the cancerous cells. Some less common types of ablation treatment include cryotherapy and alcohol injection.

Chemotherapy: Depending on the type of cancer, you may receive chemotherapeutic drugs. This may be given following other treatments, such as surgery or cryotherapy. Systemic chemotherapy can also be used as a palliative treatment to slow down cancerous growth and reduce pain. 

Chemotherapy can also be given directly to the tumor, which is called chemoembolization (or TACE), more commonly used for primary liver cancer. 

Biological therapy: It is used for both primary and secondary liver cancers. It can be used in combination with or after other treatments for cancer. Biological therapy works against the cancer cells by:

  • Either stopping their growth or function
  • Helping the body’s immune system destroy them

Selective internal radiation therapy (SIRT): This is also known as radioembolization. The treatment targets liver tumors directly with high doses of internal radiation in tiny beads. 

Endoscopic stent placement: If cancer in the liver has blocked the bile duct, leading to the accumulation of bile in the liver, a stent may be suggested to be placed in the liver to drain the bile and alleviate symptoms.

Palliative care: It is specialized medical care focussed on improving the quality of life of patients living with a serious illness like cancer. It aims to relieve the symptoms of cancer and provide comfort to the patients. In addition to slowing down the spread of liver cancer, palliative treatment can help manage pain and other symptoms. The treatment options include chemotherapy, radiation therapy, or other drug therapies. 

What Does the Cost of Liver Cancer Treatment Include?

The cost of liver cancer treatment in India includes the following:

  • Liver resection: INR 2,50,000 to INR 6,00,000 (USD 3,400 to USD 8,200) 
  • Liver transplantation:  INR 20,00,000 to INR 40,00,000 (USD 27,300 to USD 54,600)
  • Radiofrequency ablation (RFA): INR 1,50,000 to INR 3,50,000 (USD 2,050 to USD 4,800)
  • Transarterial chemoembolization (TACE):  INR 1,00,000 to INR 3,00,000 (USD 1,370 to USD 4,100) 
  • Systemic therapy: INR 50,000 to INR 1,50,000 (USD 680 to USD 2,050) per cycle

India’s dedication to delivering world-class oncological care is not just a promise of recovery but a ray of hope for countless individuals and their families. The affordable cost of liver cancer treatment in India is an advantage for patients getting the treatment. 

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