Or more specifically hepatocellular carcinoma, commonly known as primary liver cancer or hepatoma. Or to put it another way cancer that originates in the liver.

Now liver cancer is rarely good news, those of a sensitive nature or those who think if you ignore something it will go away should use the back button convientently located in the upper left corner of your web browser.

Liver cancer is the 5th most common cancer world-wide although the vast majority of cases are found in south asia and black africa. Its also pretty deadly on the whole. To put deadly in perspective almost all people diagnosed with liver cancer will be dead within a year. Of course one of the main reasons for this is that in the geographical areas it occurs most frequently the standard of medical care may fall short of the standard we are used to in the developed world. The real kicker though is that once you get to the stage where liver cancer makes you unwell and/or is causing abdominal pain then it really is pretty far advanced, death will occur sooner rather than later.

How much you should worry about liver cancer depends on who you are. A normal Joe shouldn’t even let the thought cross your mind, chances are as near nil as it can be, Scotland have more chance of winning the world cup if that helps put “remote chance” in to perspective. If you have Hepatitis C or B then to a small extent the chances increase but to be honest not by much at all, its nothing to be worried about. However if your Hep C [or B for that matter] has damaged your liver to such an extent that you have Cirrhosis then it starts to become a real risk. Numbers are still low but are in the region of a 1-2.5% per year, another figure you will hear is that people with Cirrhosis have about a 15% chance of getting liver cancer over a 10 year period.

Lets look at some good news. There is a chance that if you can catch the cancer early enough you have a fighting chance. Early enough in real world terms means a small well defined tumor, 3cm or less and ideally only one. For somebody without Cirrhosis then you have a chance that the cancer ridden part of your liver can simply be cut out, the liver can regenerate and you can cross your fingers that the cancer won’t return. The odds aren’t great but well worth fighting for, you have a real chance of beating this thing.

For somebody with Cirrhosis things aren’t quite as straightforward, as you liver is already badly damaged you may be unable to do without the portion of it that will need cutting away, your liver won’t regenerate. It can work don’t get me wrong but the odds ain’t good. The best “cure” in these cases would be a liver transplant, but good livers are hard to come by and although survival rates are great when compare with the alternatives 25% of liver transplant patients will be dead in 3 years.

That all seems pretty bad news, lets flip and look at the good side. If you have hep c and Cirrhosis then your Doctor will be aware of your increased chance of liver cancer, they will monitor you in the hope of catching it early and being in a position where they can influence the outcome. With me, as someone with hep c, had hep b, have Cirrhosis, are a male and in my 40’s chances are pretty high so I have a schedule of regular monitoring.

I had a 6 month check up yesterday in fact, in my case this involves an ultrasound inspection of the liver to see if they can spot any cancer. As well as that I have regular blood checks looking for high levels of alpha-fetoprotein (AFP) which is a good indicator of cancer in about 60% of cases. All clear so far but who knows about the future.

There we have it but I know what you are all thinking, how can I avoid liver cancer?

Its real easy.

(1)Don’t engage in any high risk behavior that would put you at risk of contacting Hep C. The main one to avoid at all costs is injecting street drugs, over 80% [according to the HPA's figures] of hepatitis c is contracted in this way. There are other small areas of risk that you can avoid such as making sure that if you have a tattoo they use new sterlised needles every time and don’t share ink.

The other area to be aware of is sexual transmission. This is a controversial subject even amongst the experts who know what they are talking about but general consensus is that Hep C can be transmitted by sex albeit very rarely. In a stable monogomous rrelationship the chances of transmission are very small, ranging from zero to 1-3% chance in 10 years dependent on which study you read. A more promiscuous approach to your sex life increases the risk as does sexual practices that are high risk, anal sex being one example, fisting is pretty much a no no too. Whatever your view on sexual tranmisson you need to be aware of the fact that a significant number of people with hep c have no known risk factors and claim to have not engaged in any high risk behavouir. Either they are all lying [which is not that uncommon a view within the medical profession] or they caught it during a low risk episode such as having sex with somebody whose sexual history they were unaware of. My advice would be to always wear a condom during casual sexual encounters. If you are a woman whose partner for the night refuses kick him out the door. If you are a man whose partner for the night doesn’t insist then slip two on just to be on the safe side, I wouldn’t kiss the bitch either ;).

(2) If you think you may have hepatitis C then get tested, don’t let it go undiagnosed and progress to the point where it serverly damages your liver. It is treatable and you will find that some small lifestyle changes [such as cutting alcohol] can great reduce the chances of liver damage. Even if the treatment is unsuccessful then your chances of getting liver cancer are roughly halved anyway. Get tested and get treatment.

(3) If you have had hep c and already progressed to Cirrhosis then…good luck, you are going to need it. In my opinion you need to get treated ASAP, follow a liver friendly diet forthwith and make sure you get regular checkups. Ultimately it may come down to a major operation, either one which involves cutting away a part of your liver or a transplant. In each case the stronger you can be the better your chances of survival. Get as fit as you can, be optimistic, be mentally strong and above all learn to like to fight with all your soul. Learn to live with pain, welcome it, make it your bodies natural instinct to push back against it.

When you are under the general having your liver removed the strength to live to fight another day will come from your soul.

This entry was posted on Wednesday, December 14th, 2005 at 11:23 am and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.