Hepatocellular carcinoma (HCC) is the 6th most common malignancy in the world and the most common primary liver tumor. Approximately 866,000 patients are diagnosed with the disease each year worldwide¹.
 

In Pakistan, liver cancer is the eighth most common cancer and is responsible for approximately 5% of all cancer-related deaths².

• The development of liver cancer occurs most often in patients with chronic liver disease, especially cirrhosis of various origins: excessive alcohol consumption, chronic hepatitis B and hepatitis C,
• Occurs more often in men than in women,
• Most often at the age of 50 and above.

• Abdominal pain in the right lower quadrant
• Bruising and bleeding
• Enlarged abdomen
• Unexplained weight loss
• Jaundice
• Dark urine and light stools

• Liver cirrhosis is scarring of liver tissue that is often caused by alcoholism, viral hepatitis, or nonalcoholic fatty liver disease (NAFLD).
• Excessive alcohol consumption – Long-term excessive alcohol drinking damages the liver and can lead to cirrhosis.
• Chronic viral liver infections – Hepatitis B (HBV) and hepatitis C (HCV) significantly increase the risk of developing hepatocellular carcinoma (HCC).
• Nonalcoholic fatty liver disease (NAFLD) – Often associated with obesity, type 2 diabetes, and metabolic syndrome.
• Metabolic syndrome - a group of health problems that occur together and increase the risk of diabetes, heart disease, and liver cancer. It is often caused by an unhealthy lifestyle - poor diet, lack of exercise, and genetic factors.

• Liver cirrhosis is scarring of liver tissue that is often caused by alcoholism, viral hepatitis, or nonalcoholic fatty liver disease (NAFLD).
• Type 2 diabetes – Increases the risk of liver cancer, especially in people with NAFLD.
• Obesity – It is associated with chronic inflammation and fatty liver disease, which increases the risk of HCC.
• Genetic and hereditary disorders – For example, hemochromatosis (excessive iron storage in the body).
• Hepatic steatosis⁵ - hepatic steatosis or fatty liver is a metabolic disorder in which there is excessive fat deposition in liver cells. Their accumulation then causes a significant enlargement of the liver. This disease most often occurs for two reasons, namely excessive alcohol consumption and long-term elevated blood cholesterol levels. Treatment of hepatic steatosis consists primarily of abstinence and dietary modification.

Early detection or secondary prevention of hepatocellular carcinoma may consist of preventive abdominal ultrasound examination, which can detect not only incipient changes in the liver, but also other changes in the abdominal cavity. Currently, screening is intended for patients who are already under the care of a specialist for chronic liver disease. Patients with asymptomatic HCC diagnosed during screening survive a 5-year period in more than 50% of cases thanks to radical treatment.

Hepatocellular carcinoma can be detected using examination and imaging methods:

• Ultrasound sonographic examination of the liver
• Elastography
• CT scan of the abdomen
• Magnetic resonance imaging
• Laboratory examination
• Angiographic examination of the liver
• Liver biopsy
• Laparoscopy

• Hepatitis B vaccination – effective protection against HBV.
• Safe behavior – use of sterile needles (when tattooing, piercing), safe sex (condoms), blood testing.
• Limit alcohol – excessive alcohol consumption leads to cirrhosis, which increases the risk of cancer.
• Diabetes treatment – uncontrolled type 2 diabetes increases the risk of liver disease.
• Lowering cholesterol and triglycerides – high levels can contribute to liver damage.
• Regular medical check-ups - liver screening for people at risk - if you have hepatitis, cirrhosis or metabolic syndrome, your doctor may recommend regular non-invasive methods to monitor your liver condition (ultrasound and blood tests)
• Healthy diet – eating fruits, vegetables, whole grains, healthy fats, and limiting processed foods.
• Maintaining a healthy weight – obesity is linked to non-alcoholic fatty liver disease (NAFLD), which can lead to fibrosis and cirrhosis.
• Regular physical activity – helps reduce the risk of obesity, diabetes and fatty liver disease.

Treatment of liver cancer must be tailored to each patient individually. In general, the treatment chosen depends on the size and location of the tumor, the stage of the disease, the patient's general condition and associated diseases, the functional state of the liver (i.e. the degree of involvement of the liver tissue by the tumor, the extent and condition of the healthy part of the liver, and possibly the presence of liver cirrhosis), etc.
 

Liver cancer can be treated with surgical treatment (surgical removal of the tumor, liver resection or liver transplantation), so-called locoregional treatment (radiofrequency ablation, trans arterial chemoembolization) or systemic treatment (targeted therapy or immunotherapy).

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