Q1. What is primary liver cancer?
Primary liver cancer occurs when a tumour develops out of liver cells. According to the statistics of the Department of Health, each year there are over 1700 new cases of primary liver cancer in Hong Kong.
The number is relatively high because in Hong Kong and the South China region, hepatitis B carriers account for about 8% of the population. And hepatitis B is the major cause of primary liver cancer.
Q2. What are the causes of primary liver cancer?
The causes of primary liver cancer are multiple, the most important of which is hepatitis, including hepatitis B and C. In our region, hepatitis B is more common. Hepatitis viruses directly attack the nucleus of liver cells, causing genetic mutation and thus liver cancer.
Alcohol abuse is also a risk factor, as alcohol can lead to hepatitis. Other causes are fatty liver or ingestion of moldy dried foods, such as peanuts, where a substance called “aflatoxin” is present which can lead to primary liver cancer.
Q3. How to treat primary liver cancer?
Primary liver cancer is best treated with surgical removal, or hepatectomy. While early and mid-stage primary liver cancer can be cured in 80% of cases with hepatectomy, it is not suitable for all patients. One’s health, such as the cardiopulmonary and liver functions must be first assessed before considering surgery
Tumour location and distribution are also important. Are there tumours on both sides of the liver? Or one side only? If they are found in the right lobe, only the right lobe needs to be treated. When surgery is not feasible due to tumour distribution, other treatments may be considered.
Q4. What should be noted after hepatectomy?
Patients should have examination every 3 months in the first two years after hepatectomy,
including CT scan and ultrasound examination. Close monitoring will help detect new primary tumours or recurrence. Blood tests should also be arranged to test liver functions and AFP tumour markers.
If early recurrence or any primary tumour is found, the earlier the detection, the better outcome with appropriate treatments.
Q5. What is the treatment of late-stage primary liver cancer?
For patients with late-stage primary liver cancer, surgery may not be suitable. There are still treatment options such as interventional therapy by delivering chemotherapeutic drugs directly to the liver tumour via the hepatic artery, or internal radiotherapy using Yttrium-90 particles, to achieve effective control. Other treatments may also be adopted such as immunotherapy, targeted therapy, and radiotherapy, including proton therapy for curing cancer.
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