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Liver Cancer

Primary liver or hepatic cancer is a disease that develops when normal cells in the liver become abnormal in behavior and appearance. The abnormality is due to the cells’ DNA changes (mutations).  Since the DNA provides the instructions for the various chemical processes in the body, their changes or mutations also alter those instructions.

The changes may cause the cells to behave differently, attack normal tissues, multiply rapidly and spread throughout the liver as well as to the other organs.

Types of Liver Cancer

These are the types of primary liver cancer, or cancer that developed from the liver. Cancers that developed from another part of the body and spread to the liver are called metastatic cancers. So colon cancer that has spread to the liver is called metastatic colon cancer. There are more cases of secondary or metastatic cancer in the liver than cancer that begun in the liver or metastatic liver cancer.

  • Hepatocellular carcinoma or hepatoma is the most common type of liver cancer. It arises from hepatocytes the main type of liver cell. Hepatomas are round tumors that spread and destroy normal cells. Primary liver cancers spread to the lymph nodes and other parts of the body.
  • Cholangiocarcinomas are liver cancers that developed from the bile duct and are classified into intrahepatic and ductal cholangiocarcinoma. This is a rare type of cancer.
  • Hepatoblastoma is another rare liver cancer found in children that are usually below 4 years old.

Risk factors

Factors that increase the chances of developing primary liver:

  • Chronic infection with hepatitis B virus (HBV) or hepatitis C virus (HCV)
  • Cirrhosis or irreversible scarring of the liver. There are many causes of cirrhosis and the most common are: habitual excessive alcohol consumption and fatty liver or non-alcoholic liver disease.
  • Diabetes
  • Hemochromatosis, Wilson’s disease and other hereditary liver diseases
  • Exposure to aflatoxins, the poison from molds growing on improperly stored crops (e.g. peanuts, corn). Aflatoxins can cause mutation of liver cells’ DNA that result to the development of abnormal cells.

Symptoms of Liver Cancer

Early liver cancer often doesn’t cause symptoms. When the cancer grows larger, people may notice one or more of these common symptoms

  • Unexplained weight loss
  • Loss of appetite
  • Lump and pain in the upper right side of the abdomen
  • Nausea and vomiting
  • General weakness and fatigue
  • Abdominal swelling/ liver enlargement
  • Yellow discoloration of your skin and the whites of your eyes (jaundice)
  • Swollen legs
  • Frequent sleepiness (encephalopathy)

These symptoms may also be due to other health problems instead of liver cancer. See your doctor for guidance regarding the proper diagnostics you should undergo to determine the disease.

Diagnosing Liver Cancer

Following are the tests and diagnostic procedures that doctors use to determine if a patient has liver cancer or not:

  • Blood test is done to check the level of alpha-fetoprotein (AFP), des-gamma-carboxy prothrombin and other liver cancer markers in the blood. AFP is elevated in around 70% of liver cancer patients.
  • Imaging tests such as MRI (magnetic resonance imaging), CT (computerized tomography) scans, PET – CT scan and ultrasound may determine the size of the tumor and the extent of the spread of cancer.
  • Biopsy is done to confirm the diagnosis of liver cancer through laboratory analysis of liver tissue. Other tests may show abnormalities in the liver but are not conclusive that it’s cancer.

Stages of Liver Cancer

Cancer stage is the extent (stage) to which the cancerous tumor has grown or has spread. The medical team attending to a liver cancer patient needs to know the stage to be able to determine the most appropriate treatment plan.

There is more than one staging method for liver cancer. In one method, the stages are specified using numbers 1 (I) to 4(IV) and letters A to D. The higher the number, the more advanced is the cancer. A cancer stage can be: Stage 3. Stage 1A or Stage IIIB, 4C.

Another method used by the American Joint Committee on Cancer (AJCC) is the TNM (Tumor, Node, Metastasis) system which includes these 3 sets of information: “T” for the size or extent of the tumor, “N” describes if cancer has spread to the surrounding lymph nodes and “M” describes the extent at which liver cancer has spread to other areas outside the liver.  The stage is specified as T1, T2, M0 or N2.”

Liver Cancer Treatment

Treatments for primary liver cancer depend on the extent (stage) of the disease as well as the patient’s age, overall health and other individual factors.  The treatment plan is generally determined by a medical team that includes oncologists, surgeons, radiologists, pathologists and gastroenterologists.

Liver cancer treatment may include the following methods:

  • Surgery to remove the tumor if it’s still small and for liver transplant
  • Ablation therapy to kill cancer cells without surgery.
    Localized treatments applied directly to the cancer cells or the surrounding area that include:
    • radiofrequency ablation or the use of electric current to heat and destroy cancer cells
    • cryoablation or the use of very low temperature to destroy cancer cells.
    • transarterial chemoembolisation (TACE) administers chemotherapy drug through thin tube called a catheter into a large artery in the leg or arm.
  • Alcohol injection – pure alcohol is directly injected into the tumor
  • Embolization is the procedure to starve the cancer and prevent its growth by blocking the blood vessels to the affected area.
  • Chemotherapy is the use of medicine to kill cancer cells. The medicine is administered orally or by injection into a vein or artery.
  • Targeted therapy is the use of cancer growth blockers, monoclonal antibodies and other drugs that will help the body control cancer growth.
  • Radiation therapy uses high-dose energy to the liver area to kill cancer cells.

Treatment success rates are improved with the use of modern medical equipment and procedures that are minimally invasive allowing patients to recover in a shorter period of time.

Why people would like to have liver cancer treatment in Turkey?

At Turkey, one can surely find the best internationally known hospitals and special cancer treatment centers which are quality oriented and are renowned for their cleanliness standers.

There are three major reasons why even people from other countries prefer to have their liver cancer treatment in Turkey:

  • Availability of well-equipped hospitals and well-trained doctors that are certified by reputable international organizations.
  • More affordable costs of the various liver cancer treatment procedures that can be verified online or through telephone calls.
  • Hospitality of medical facilities in terms of providing multilingual staff and medical specialists as well as comfortable waiting areas for patients’ companions.

  1. Turkey has good oncologists / and hospitals

The high standards of both private and government healthcare facilities in Turkey is set and regularly monitored by the Ministry of Health of Health and the Turkish Medical Association. Many hospitals have also been inspected and accredited by the Joint Commissions International (JCI), the Joint Commission on Accreditation of Healthcare Organizations (JACHO) and International Organization for Standardization (ISO) and by other local and international accreditation bodies.

In fact, the country’s Ministry of Health owns and operates more than half of over a thousand hospitals in Turkey. The government also gives tax incentives to investments in hospitals and healthcare facilities. That’s why hospitals in Turkey are able to provide their patients with the latest in medical facilities, expertise and care.

  1. It is more affordable in Turkey compared to most countries, especially Europe and US.

Hospitals in Turkey perform liver cancer diagnostics and treatment according to international standards. However, patients will be pleasantly surprised to know that costs are lower compared to those charged by European and American hospitals as shown in the following examples:

  • Biopsy costs $ 1,500 to 2,000 in Turkey, 1,500 to 2,000 Euros in Germany and $2,000 to 7,000 in the USA.

Liver Transplant costs  $70,000 to 80,000 in Turkey, 200,000 to 300,000 Euros in Germany and $330,000 to 575,000 in the USA.