Liver Cancer

Liver Cancer

Liver cancer is the fifth commonest cancer and third commonest cause of cancer death in Hong Kong. Primary liver cancer is usually developed in a background of chronic liver disease or liver cirrhosis. The commonest cause of liver cancer in Hong Kong is chronic hepatitis B, which accounts for about 80% of new cases of liver cancer every year. Other important causes of liver cancer include chronic hepatitis C, non-alcoholic fatty liver disease and alcohol-related liver disease. In general, men have a higher risk of liver cancer than women. Early liver cancer has no symptom. Abdominal pain is not a feature of early liver cancer. Liver enzymes can be normal. Regular surveillance with ultrasound and alfa-fetoprotein is required to pick up early cancer in high risk individuals. Confirmation of diagnosis requires CT scan, MRI, and sometimes liver biopsy.

There are many treatment options for liver cancer. The choice of treatment depends on the number and size of tumor, spread of tumor into blood vessels and other organs, severity of liver cirrhosis, and other medical illnesses of the patient. Different specialists may be required for different modalities of treatment. For some patients, combination of more than one treatment may be needed.

1. Liver resection (hepatobiliary surgeon)
2. Loco-ablative treatment, e.g. radiofrequency ablation, microwave, transarterial chemoembolization (interventional radiologist)
3. Radiotherapy (clinical oncologist)
4. Systemic therapy as targeted therapy or immune therapy (medical oncologist)

At the same time, the underlying liver disease and its related complications has to be managed (hepatologist). Hence, a multi-disciplinary team is needed to offer the best treatment plan.